Old-Time Makers of Medicine: The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle AgesWalsh, James J. (James Joseph)
History
Old-Time Makers of Medicine: The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle Ages
Walsh, James J. (James Joseph)
Medicine, Medieval; Physicians
In the chapter immediately following this, XXXIII, there is a
description of the method of opening the larynx or the trachea, with the
indications for this operation. The surgeon will know that he has opened
the trachea when the air streams out of the wound with some force, and
the voice is lost. As soon as the danger of suffocation is over, the
edges of the wound should be freshened and the skin surfaces brought
together with sutures. Only the skin without the cartilage should be
sutured, and general treatment for encouraging union should be employed.
If the wound fails to heal immediately, a treatment calculated to
encourage granulations should be undertaken. This same method of
treatment will be of service whenever we happen to have a patient who,
in order to commit suicide, has cut his throat. Paul's exact term is,
perhaps, best translated by the expression, slashed his larynx.
One of the features of Paul's "Treatise on Surgery" is his description
of a radical operation for hernia. He describes scrotal hernia under the
name enterocele, and says that it is due either to a tearing or a
stretching of the peritoneum. It may be the consequence either of injury
or of violent efforts made during crying. When the scrotum contains
only omentum, he calls the condition epiplocele; when it also contains
intestine, an epiplo-enterocele. Hernia that does not descend into the
scrotum he calls bubonocele. For operation the patient should be placed
on the back, and, the skin of the inguinal region being stretched by an
assistant, an oblique incision in the direction in which the blood
vessels run should be made. The incision should then be stretched by
means of retractors, until the contents of the sac can be lifted out.
All adhesions should be broken up and the fat be removed, and the hernia
replaced within the abdomen. Care should be taken that no loop of
intestine is allowed to remain. Then a large needle with double thread
made of ten strands should be run through the middle of the incision in
the end of the peritoneum, and tied firmly in cross sutures. The outer
structures should be brought together with a second ligature, and the
lower end of the incision should have a wick placed in it for drainage,
and the site of operation should be covered with an oil bandage.
Public-domain text, read in full here on John Shaqi.
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