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Of Medicine, in Eight Books

Chapter 173: CHAP. XXI. OF THE CURE OF A RUPTURE OF THE OMENTUM INTO THE SCROTUM.
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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. XXI. OF THE CURE OF A RUPTURE OF THE OMENTUM INTO THE SCROTUM.

But if the omentum descends, the groin must be opened, and the coats separated in the same manner as directed before. And it must be considered whether it be a large or small part of it. For when it is very small, it must be forced back over the groin into the abdomen by a finger or the broad end of a probe: if it is large, whatever has fallen out of the abdomen must be allowed to remain there; and it must have escharotic medicines laid on it, till it mortify and fall off. Some in this case pass through it a needle with two threads, and tie the two ends of each contrary ways; by which it mortifies with equal certainty, but not so soon. The effect is accomplished sooner, if the part of the omentum above the ligature be rubbed with eating medicines, but not corrosive; they are called septica by the Greeks. There have been others, who have cut off the omentum with scissars: which is not necessary, where the quantity is small; and if large, it may occasion an hemorrhage; for the omentum is also connected by veins, and some of them large. Neither can this practice be justified by an example drawn from the cases of the belly opened by a wound, where the part of the omentum, which falls out, is cut away by the scissars: since in this case, it is both mortified, and cannot be taken off in any other way more safely. If the omentum be reduced, the wound ought to be stitched; or if it has been large and has mortified externally, the lips must be cut off, as proposed before.

Of a hydro­cele.

If there be a fluid within the membranes, an incision must be made, in boys upon the groin, unless too large a quantity of fluid forbid the operation in that place; but in men, and where-ever there is a large quantity, the scrotum must be opened. Then if the incision be made in the groin, the coats must be drawn out at that part, and the humour evacuated; if at the scrotum, and the disease be immediately below that coat, there is no more required but to evacuate the humour, and cut away any of the membranes, that happen to contain it; then it must be washed with water, and an addition either of salt, or nitre: if the disease lie within the middle or innermost coat, they must be taken entirely out of the scrotum and cut off.