The seven books of Paulus Ægineta, volume 2 (of 3) : $b translated from the Greek: with a commentary embracing a complete view of the knowledge possessed by the Greeks, Romans, and Arabians on all subjects connected with medicine and surgeryPaulus, Aegineta
History
The seven books of Paulus Ægineta, volume 2 (of 3) : $b translated from the Greek: with a commentary embracing a complete view of the knowledge possessed by the Greeks, Romans, and Arabians on all subjects connected with medicine and surgery
Paulus, Aegineta
Medicine; Medicine, Arab; Medicine, Greek and Roman
Enterocele is a descent of the intestine into the scrotum, and is
occasioned either from rupture of the peritoneum which takes place in
the groin, or from stretching of the peritoneum. Both these, I mean
rupture and stretching, are occasioned by previous violence, such as a
blow, a leap, or loud crying, but that from stretching in particular is
connected with relaxation and other weaknesses of the body. The common
symptoms of both are a marked swelling in the scrotum, which is increased
by exercise, heat, retention of the breath, and other exertions; and
its symptoms are, that it goes up slowly upon pressure, and quickly
falls down again, and that while the person affected with it lies in a
recumbent posture it remains in its proper place until he stands again
erect. The retention of fæces in the region of the scrotum often brings
on dangerous symptoms; for it is attended with pain, and sometimes
with rumbling of wind upon pressure. The peculiar symptoms of hernia
from distension are, that it does not occur suddenly, but gradually;
that it falls down occasionally from any ordinary causes; that the
swelling appears equable and deep-seated, the protruded intestine being
surrounded by the peritoneum. In those from rupture the descent at
first is sudden, and happens only from violence; the swelling is very
large, and appears seated superficially immediately under the skin,
owing to the intestines having burst through the peritoneum. If the
omentum alone falls down to the scrotum in rupture of the peritoneum the
affection is called epiplocele, but if intestine descend along with it,
it is named epiploenterocele; and if water be contained in the tunica
vaginalis it receives an appellation compounded from all the three. But
neither these nor the intestinal hernia from rupture of the peritoneum
are proper subjects for surgery, but we operate upon enterocele alone
from distension, in the following manner: after placing the patient in
a recumbent posture, and getting the skin in the groin stretched by an
assistant, we make a transverse incision, cutting as in the operation of
angiology (but some make the incision not transverse but longitudinal),
then having transfixed it with hooks we stretch out the incision to such
a degree as to afford room for the testicle to pass through; then passing
through the inner skin a number of hooks proportionate to the size of
the wound, and dissecting the membranes and fat with a blind hook or
scalpel we cut them across. When the peritoneum is everywhere laid bare,
introducing the index-finger at the back part of the scrotum between
the darti and peritoneum, we free the posterior process (epididymis?);
and then with the right hand doubling its extremity to the inside of
the scrotum, and at the same time stretching the peritoneum in the left
hand, we bring the testicle with the vaginalis tunica to the incision,
and give directions to one assistant to stretch the testicle, whilst
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