The apparent confusion between these two passages is easily relieved
by the explanation that inguinal or other herniae not extending into
the scrotum are called by Gilbert ruptures of the siphac, but scrotal
hernia is classed with other troubles located in the scrotum as
hernia. Accordingly hernia, with Gilbert, includes not only scrotal
hernia, but also hydrocele, orchitis, tumors of the testicles, etc.
This is apparent, too, in his treatment of hernia, which consists
usually in the employment of various poultices and ointments, bleeding
from the saphena, cups over the kidneys, etc., though hydrocele is
tapped and a seton inserted. If the testicle itself is "putrid,"
it should be removed; otherwise it is left. It may be remarked _en
passant_ that the surgeons of medieval times, in their desire for
thoroughness, often displayed very little respect to what Baas calls
"the root of humanity."
We will terminate our hasty review of diseases discussed in the
Compendium by an abstract of Gilbert's views on vesical calculus and
its treatment, which cover more than fifteen pages of his work.
Stone and gravel arise from various viscous superfluities in the
kidneys and bladder, which occasion difficulty in micturition. Stone
is produced by the action of heat upon viscous moisture, sublimating
the volatile elements and condensing the denser portions.
Putrefication of stone in the bladder is the result of three causes,
viz., consuming heat, viscous matter and stricture of the meatus.
For consuming heat acting on viscous material retained by reason
of stricture of the meatus, by long action dries up, coagulates and
hardens the moisture. This is particularly manifest in boys who have a
constricted meatus.
Stones are thus generated not only in the kidneys and bladder,
but also even in the stomach and the intestines, whence they are
ejected by vomiting or in the stools. Indeed they may also be found
occasionally in the lungs, the joints and other places. They are
comparatively rare in women, in consequence of the shortness of the
urethra and the size of their meatus.
Public-domain text, read in full here on John Shaqi.
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