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Of Medicine, in Eight Books

Chapter 169: CHAP. XVII. OF A RUPTURE OF THE PERITONAEUM.
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About This Book

It gathers medical knowledge into eight concise books that combine clinical observation, diagnosis, prognosis, and practical treatment. Chapters cover diet and regimen, descriptions of internal diseases and external injuries, medicinal preparations, and operative techniques with instructions for wound care and minor surgery. The text emphasizes careful observation and clear symptom description, pairing theoretical causes with hands-on remedies and measurements. Explanatory notes and technical detail support immediate clinical use, making the collection a practical reference for assessing, managing, and treating a broad range of conditions.

CHAP. XVII. OF A RUPTURE OF THE PERITONAEUM.

Sometimes either from a blow, or keeping in the breath too long, or by the pressure of a heavy load, the internal membrane of the abdomen breaks, when the skin above is whole: which also frequently happens to women from pregnancy; and it generally occurs about the ilia. The consequence is, that the flesh above being soft, does not bind the intestines strongly enough, and the skin distended by them forms an indecent tumour. And this disease is cured in different ways. For some passing a needle with two threads into the base of the tumour, tie it on both sides in the same manner described in the cases of the navel and the staphyloma, that whatever is above the ligature may mortify. Others cut out the middle of it in the form of a myrtle leaf (according to the rule before laid down for all cases of a like nature) and then join the lips by a suture. However, the best method is to lay the patient on his back, and try by the hand, in what part the tumour yields most, because the membrane must necessarily be ruptured there, and resist more, where it is sound: then, where it appears to be ruptured, incisions are to be made in two lines(21) by a knife, that the part betwixt them being cut out, the internal membrane may have a recent wound on both sides; because what has been long disunited does not unite by a suture. The place being laid open, if the membrane in any part should appear not to be fresh wounded, a small slip must be cut off, only to ulcerate its edges. What else relates to the suture, and the remaining part of the cure, has been above directed.

Of varices in the belly.

Besides these, some people have varices in their bellies; but as the method of cure here does not differ from that which is practised in the legs, and being about to describe it by and by, I shall refer it to that place.