These things being premised, we must descend to the particular species. And if the intestine comes down in a young child, a bandage must be made trial of before the knife: for this purpose a roller is sewed, to which in one part a bolster is used made of cloths, which is applied under the intestine to repel it; and then the rest of the roller is bound tight about him: by means of which, the intestine is often forced in, and the coats are agglutinated together. Again if the patient be advanced in years, and from the largeness of the tumour it appears, that much of the intestine has fallen down, and the case is attended with pains and vomiting (which generally proceeds from the excrements getting down into that part by a crudity) it is plain that the knife cannot be used without fatal consequences; the complaint is therefore only to be alleviated; and the intestine evacuated by other methods.

The patient ought to be bled in the arm: and then if his strength will admit, abstinence must be enjoined for three days; if he cannot bear that, at least as long as his strength will allow. At the same time must be kept upon it a cataplasm of lintseed boiled in mulse. After these both barley meal with resin must be applied, and the patient put into a bath of warm water mixed with oil; and some light and hot food must be given. Some even administer clysters. These may carry something into the scrotum, but cannot evacuate any thing from thence. The disease being mitigated by the methods above prescribed, if the pain returns at any time, the same course must be pursued.

If a great portion of the intestine has fallen down without pain, it is also needless to make an incision; not but that it may be removed from the scrotum (unless an inflammation prevent) but because when repelled thence, it stops at the groin, and raises a tumour there; and thus there is not a termination, but a change of the malady.

But where the use of the knife is proper, as soon as the wound made in the groin shall reach to the second coat, that must be taken hold of near the lips with two small hooks, while the physician disengages it by taking out all the small membranes: for that, which is to be cut, cannot be injured without danger, as the intestine must lie below it. When it shall be separated, an incision must be made from the groin to the testicle, care being taken not to wound the last; then it must be cut out. For the most part however this operation is only practicable in children, and in a moderate degree of the malady.

But if it be a robust man, and the disorder be more considerable, the testicle ought not to be taken out, but to remain in its place. The operation is performed in this manner. The groin is opened in the same way by a knife, as far as the middle coat; and this coat in like manner is taken hold of with two hooks, and the testicle is held by an assistant(24), so as to prevent its coming out at the wound; then an incision must be made downward in this coat with a knife; and below it the fore finger of the left hand is introduced to the bottom of the testicle, which it forces up to the wound: then the thumb and fore finger of the right hand separate the vein and artery, and their nerve, and coat from the external coat. And if any small membranes obstruct this, they are divided by the knife, till the coat be wholly exposed to view. When all is cut out, that requires excision, and the testicle is replaced, a pretty broad habenula is to be taken from the lip of the wound in the groin, that the wound may be the larger, and generate the more flesh.