If there was difficulty in bringing about the reposition of the
intestines, they were first to be pressed back with a sponge soaked in
warm wine. Other manipulations are suggested, and if necessary the wound
must be enlarged. If the omentum finds its way out of the wound, all of it
that is black or green must be cut off. In cases where the intestines are
wounded they are to be sewed with a small needle and a silk thread, and
care is to be exercised in bringing about complete closure of the wound.
This much will give a good idea of Bruno's thoroughness. Altogether,
Gurlt, in his "History of Surgery," gives about fifteen large octavo pages
of rather small type to a brief compendium of Bruno's teachings.
One or two other remarks of Bruno are rather interesting in the light of
modern development in medicine. For instance, he suggests the possibility
of being able to feel a stone in the bladder by means of bimanual
palpation. He teaches that mothers may often be able to cure hernias, both
umbilical and inguinal, in children by promptly taking up the treatment of
them as soon as noticed, bringing the edges of the hernial opening
together by bandages, and then preventing the reopening of the hernia, by
prohibiting wrestling and loud crying and violent motion. He has seen
overgrowth of the mamma in men, and declares that it is due to nothing
else but fat, as a rule. He suggests if it should hang down and be in the
way on account of its size, it should be extirpated. He seems to have
known considerable about the lipomas, and advises that they need only be
removed in case they become bothersomely large. The removal is easy, and
any bleeding that takes place may be stopped by means of the cautery. He
divides rectal fistulæ into penetrating and non-penetrating, and suggests
salves for the non-penetrating and the actual cautery for those that
penetrate. He warns against the possibility of producing incontinence by
the incision of deep fistulæ, for this would leave the patient in a worse
state than before.
Public-domain text, read in full here on John Shaqi.
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