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THE
_Compleat Surgeon_:
OR,
The whole Art of _Surgery_ explain'd in a most familiar Method.
Containing
An exact Account of its Principles and several Parts, _viz._ Of the
_Bones_, _Muscles_, _Tumours_, _Ulcers_, and _Wounds_ simple and
complicated, or those by _Gun-shot_; as also of _Venereal Diseases_, the
_Scurvy_, _Fractures_, _Luxations_, and all sorts of Chirurgical
Operations; together with their proper Bandages and Dressings.
To which is added,
A _Chirurgical Dispensatory_; shewing the manner how to prepare all such
Medicines as are most necessary for a Surgeon, and particularly the
_Mercurial Panacaea_.
* * * * *
Written in _French_ by _M. le Clerc_, Physician in Ordinary, and
Privy-Counsellor to the _French_ King; and faithfully translated into
_English_.
* * * * *
LONDON,
Printed for _M. Gillyflower_, in _Westminster-Hall_; _T. Goodwin_, and _M.
Wotton_, in _Fleet-street_; _J. Walthoe_, in the _Middle-Temple_ Cloysters;
and _R. Parker_, under the _Royal-Exchange_, in _Cornhill_, 1696.
* * * * *
THE
PREFACE.
_So great a number of Treatises of Surgery, as well Ancient as Modern, have
been already publish'd, that a plenary Satisfaction seems to have been long
since given on this Subject, even to the Judgment of the most curious
Inquirers: But if it be consider'd that a young Surgeon ought always to
have in view the first Principles of this Noble Art explain'd after a
familiar and intelligible manner, it will be soon acknowledg'd that there
is good reason to set about_ _the Work anew: For besides that the Writings
of the Ancients being so voluminous, are not portable, they are also very
intricate and confus'd; nay the whole Art has been so far improv'd and
brought to perfection by able Masters in the present Age, that they are now
almost become unprofitable._
_Some Modern authors have set forth certain small Tracts, which only
explain a few Chirurgical Operations, and on that account deserve only the
Name of Fragments. Indeed the Works of some others seem to be sufficiently
compleat, but are printed in so large Volumes, and contain so many
Discourses altogether foreign from the principal Subject, that they have
almost the same Inconveniences with those of the Ancients. Therefore the
Reader is here presented with a small Treatise of Surgery, yet very plain
and perspicuous, in a portable Volume; being free from a Multiplicity of
impertinent Words, and containing every thing of moment that has been
producd by the most approv'd Authors both Ancient and Modern._
_An Introduction is made into the Matter by small Colloquies or Dialogues,
to the end that the young Student may be at first lead as it were by the
Hand; but as soon as he has attain'd to a considerable Progress in these
Studies, this innocent and puerile manner of speaking is abandon'd, to
conduct him in good earnest to the most sublime Heights of so admirable an
Art; to which purpose, after having penetrated into its first Rudiments and
Grounds, he is well instructed in Anatomy, and furnish'd with a general
_Idea_ of Wounds and Tumours, which are afterward treated of in particular:
He is also taught a good Method of curing Wounds made by Gun-shot, the
Scurvy, and all sorts of Venereal Diseases: From thence he is introduced
into the Practice of all manner of Chirurgical Operations in Fractures and
Luxations; together with the use of their respective Dressings and
Bandages._
_At the end of the Work is added a _compleat Chirurgical Dispensatory_,
shewing the Method of preparing such Medicinal Compositions as are chiefly
us'd in the Art of Surgery; so that upon the whole Matter, it may be justly
affirm'd, that this little Manual has all the Advantages of the Ancient and
Modern Writings on the same Subject, and is altogether free from their
Superfluities and Defects._
* * * * *
{1}
THE
_Compleat Surgeon:_
OR, THE
Whole ART
OF
SURGERY
Explain'd, _&c._
* * * * *
CHAP. I.
_Of the Qualifications of a Surgeon, and of the Art of Surgery._
_Who is a Surgeon?_
A Person skill'd in curing Diseases incident to Humane Bodies by a
methodical Application of the Hand.
_What are the Qualifications of a good Surgeon in general?_
{2}
They are three in Number: _viz._ Skill in the Theory, Experience in the
Practical part, and a gentle Application of the Hand.
_Why ought a Surgeon to be skilful?_
Because without a discerning Faculty he can have no certainty in what he
doth.
_Why must he be experienc'd?_
Because Knowledge alone doth not endue him with a dexterity of Hand
requisite in such a Person, which cannot be acquir'd but by Experience, and
repeated Manual Operations.
_Why must he be tender-handed?_
To the End that by fit Applications he may asswage those Pains which he is
oblig'd to cause his Patients to endure.
_What is Chirurgery or Surgery?_
It is an Art which shews how to cure the Diseases of Humane Bodies by a
methodical Manual Application. The Term being derived from the _Greek_ Word
[Greek: Cheir], signifying a Hand and [Greek: Ergon], a _Work_ or
_Operation_.
_After how many manners are Chirurgical Operations usually perform'd?_
Four several ways.
_Which be they?_
I. _Synthesis_, whereby the divided Parts are re-united; as in Wounds. II.
_Diaeresis_, that divides and separates those Parts, which, by their Union,
hinder the Cure of Diseases, such is the continuity of Abscesses or
Impostumes which must be open'd to let out the purulent Matter. III.
_Exaeresis_, which draws out of the Body whatsoever is noxious or hurtful,
as Bullets, Arrows, _&c._ IV. _Prosthesis_ adds some Instrument or Body to
supply {3} the defect of those that are wanting; such are Artificial Legs
and Arms, when the Natural ones are lost. It also furnishes us with certain
Instruments to help and strengthen weak Parts, such as _Pessaries_, which
retain the _Matrix_ in its proper place when it is fallen, Crutches to
assist feeble Persons in going, _&c._
_What ought to be chiefly observed before the undertaking an Operation?_
Four things; _viz._ 1. What the Operation to be perform'd is? 2. Why it is
perform'd? 3. Whether it be necessary or possible? And 4. The manner of
performing it.
_How may we discern these?_
The Operation to be perform'd may be known by its Definition; that is to
say, by explaining what it is in it self: We may discover whether it ought
to be done, by examining whether the Distemper cannot be cur'd otherwise:
We may also judge whether it be possible or necessary, by a competent
Knowledge of the Nature of the Disease, the Strength of the Patient, and
the Part affected: Lastly, the manner of performing it may be found out, by
being well vers'd in the Practice of Surgery.
_What are the Fundamental Principles of Surgery?_
They are Three in number: _viz._ 1. The knowledge of Man's Body. 2. That of
the Diseases which require a Manual Operation. 3. That of proper Remedies
and Helps upon every Occasion.
_How may one attain to the Knowledge of Humane Bodies?_ {4}
By the study of Anatomy.
_How may one learn to know the Distempers relating to Surgery, and the
Remedies appropriated for them?_
Two several ways; _viz._ 1. By the reading of good Books, and Instructions
receiv'd from able Masters of that Art. 2. By practice and the Observation
of what is perform'd by others upon the Bodies of their Patients.
_What are the Diseases in general that belong to Surgery?_
They are Tumours, Impostumes, Wounds, Ulcers, Fractures, Dislocations, and
generally all sorts of Distempers whereto Manual Operations may be applyed.
_What are the Instruments in general which are commonly used in Surgery for
the curing of Diseases?_
They are Five; _viz._ the Hand, Bandages, Medicines, the Incision-Knife,
and Fire.
_What is the general Practice which ought to be observ'd in the Application
of these different helps?_
_Hippocrates_ teacheth us, in saying, that when Medicines are not
sufficient, recourse may be had to the Incision-Knife, and afterward to
Fire; intimating that we must proceed by degrees.
_Are there any Distempers that may be cured by the Surgeon's Hand alone?_
Yes, as when a simple and small Dislocation is only to be reduced.
* * * * *
{5}
CHAP. II.
_Of Chirurgical Instruments, portable and not portable._
_What do you call portable and not portable Instruments?_
Portable Instruments are those which the Surgeon carries in his Lancet-Case
with his Plaister-Box; and not portable are those that he doth not carry
about him, but is oblig'd to keep at home; the former being appointed for
the ready help which he daily administers to his Patients, and the others
for greater Operations.
_What are the Instruments which a Surgeon ought to have in his
Plaister-Box?_
These Instruments are a good pair of _Sizzers_, a _Razor_, an
_Incision-Knife_ streight and crooked, a _Spatula_, a greater _Lancet_ to
open Impostumes, and lesser for letting Blood. They likewise carry
separately in very neat Lancet-Cases, a hollow _Probe_ made of Silver or
fine Steel; as also many other Probes, streight, crooked, folding, and of
different thickness; a _Pipe_ of Silver or fine Steel, to convey the
cauterizing _Button_ to a remote Part, without running the hazard of
burning those that are near it; another _Pipe_ or _Tube_ serving instead of
a Case for _Needles_, which have Eyes at one end for sowing; a _Carlet_, or
thick triangular Needle; a small _File_; a Steel Instrument to cleanse the
Teeth; a {6} _Fleam_; a pair of crooked _Forceps_ to draw a Tooth; a
_Pelican_; a _Crow's Bill_; several sorts of _Raspatories_; a _Hook_ to
hold up the Skin in cutting, _&c._
_What are the Instruments which a Surgeon ought to keep in his Repository
to perform the greater Operations?_
Some of them are peculiar to certain Operations, and others are common to
all. The Instruments appropriated to particular Operations, are the
_Trepan_ for opening the Bones in the Head, or elsewhere: The _Catheters_
or Probes for Men and Women afflicted with the Stone, or difficulty of
making Water. _Extractors_, to lay hold on the Stone in _Lithotomy_, and to
gather together the Gravel; large crooked _Incision-Knives_, and a _Saw_,
to make Amputations of the Arms or Legs; great _Needles_ with three Edges,
to be used in making _Setons_; small _Needles_ to couch Cataracts; other
_Needles_; thin _Plates_ and _Buckles_ to close a Hair-Lip, _&c._
_May not the Salvatory be reckon'd among the portable Instruments?_
Yes, because the Balsams, Ointments, and Plaisters contain'd therein, are
means whereof the Surgeon makes use to restore Health.
* * * * *
{7}
CHAP. III.
_Of Anatomy in general; and in particular of all the Parts whereof the
Humane Body is compos'd._
_What is Anatomy?_
It is the _Analysis_ or exact Division of all the Parts of a Body, to
discover their Nature and Original.
_What is requisite to be observ'd by a Surgeon before he goes about to
dissect a Body?_
Two things; _viz._ The external Structure of the Body, and the Proportion
or Correspondence between the outward Parts, and those that are within.
_Why so?_
Because without this exterior and general Knowledge, the Surgeon wou'd be
often mistaken in the Judgment he is to pass concerning a Dislocation or
Wound, inasmuch as it is by the Deformity which he perceives in the Member,
that he knows the Dislocation, as it is also by the means of the
Correspondence which the outward Parts have with the inward, that he is
enabled to draw any certain Consequences relating to a Wound, which
penetrates into the Body.
_What is a Part?_
It is that whereof the whole Body is compos'd, and which partakes of a
common Life or Sensation with it. {8}
_How many sorts of Parts are there in a Humane Body?_
We may well reckon up Fifteen distinct Parts, which are the Bone, the
Cartilage, the Ligament, the Tendon, the Membrane, the Fibre, the Nerve,
the Vein, the Artery, the Flesh, the Fat, the Skin, the Scarf-Skin, the
Hair, and the Nails.
_What is a Bone?_
It is the hardest and driest Part of the whole Body, and that which
constitutes its principal Support.
_What is a Cartilage or Gristle?_
It is a yielding and supple Part, which partakes of the Nature of a Bone,
and is always fasten'd to its Extremities, to mollifie and facilitate its
Motion.
_What is a Ligament?_
It is a Membranous Contexture usually sticking to the Bones to contain
them; as also sometimes to other Parts, to suspend, and retain them in
their proper place.
_What is a Tendon?_
It is the Tail or Extremity of the Muscles, made by the re-union of all the
Fibres of their Body, which serves to corroborate it in its Action, and to
give Motion to the Part.
_What is a Membrane?_
It is a Nervous Part, the use whereof is to adorn and secure the Cavities
of the Body on the inside, and to wrap up or cover the Parts.
_What is a Fibre?_
They are fleshy Lines of which the Body of a Muscle is compos'd.
_What is a Nerve?_
It is a long, white, and thin Body, consisting {9} of many Fibres, enclos'd
within a double Tunick, and design'd to carry the Animal Spirits into all
the Parts, to give them Sense and Motion.
_What is an Artery?_
It is a Canal compos'd of Four Coats, that carreyth with a kind of Beating
or Pulse even to the very Extremity of the Parts, the Blood full of
Spirits, which proceeds from the Heart, to distribute to them at the same
time both Life and Nourishment.
_What is a Vein?_
It is a Canal made likewise of Four Tunicles, which receives the Arterial
Blood, to carry it back to the Heart.
_What is Flesh?_
It is a Part which is form'd of Blood thicken'd by the natural Heat; and
that constitutes the Body of a Muscle.
_What is Fat?_
It is a soft Body made of the Unctuous and Sulphurous part of the Blood.
_What is the _Derma_ or Skin?_
It is a Net compos'd of Fibres, Veins, Arteries, Lymphatick Vessels and
Nerves, which covers the whole Body to defend it from the Injuries of the
Air, and to serve as a universal Emunctory: It is very thin in the Face,
sticking close to the Flesh, and is pierc'd with an infinite number of
imperceptible Pores, affording a Passage to insensible Transpiration.
_What is the _Epiderma_, or Scarf-Skin?_
It is a small fine Skin, transparent and insensible, having also
innumerable Pores for the discharging of Sweat, and other Humours by {10}
imperceptible Transpiration: It is extended over the whole inner Skin, to
dull its too exquisite Sense, by covering the Extremities of the Nerves
which are there terminated. It also renders the same Skin even and smooth,
and so contributes very much to Beauty.
_What is the Hair?_
The Hairs are certain hollow Filaments planted in the Glandules of the
Skin, from whence their Nourishment is deriv'd. They constitute the
Ornament of some Parts, cover those which Modesty requires to be conceal'd,
and defend others from the injury of the Weather.
_What is a Nail?_
The Nails are a Continuity of the Skin harden'd at the end of the Fingers,
to strengthen and render them fit for Work.
* * * * *
CHAP. IV.
_Of the general Division of a Humane Body._
_How is the Humane Body divided before it is dissected, in order to
Anatomical Demonstration?_
Some Anatomists distinguish it into _Similar_ and _Dissimilar_ Parts,
appropriating the former Denomination to all the simple Parts of the Body
taken separately, as a Bone, a Vein, a Nerve, _&c._ but they attribute the
Name of Dissimilar to all those Members that are compos'd of many Similar
or Simple Parts together; such are the Arms, {11} Legs, Eyes, _&c._ wherein
are contain'd all at once, Bones, Veins, Nerves, and other parts.
Others divide it into _containing_ and _contained_ Parts, the former
enclosing the others, as the Skull includes the Brain, and the Breast the
Lungs; whereas the contained Parts are shut up within others; as the
Entrails within the Belly, the Brain within the Skull, _&c._
Others again divide the whole Body into _Spermatick_ and _Sanguineous_
Parts; the former being those which are made at the time of Formation; and
the latter all those that are grown afterward by the Nourishment of the
Blood.
_Are there not also other Methods of dividing the Humane Body?_
Yes: Many Persons consider it as a Contexture of Bones, Flesh, Vessels and
Entrails, which they explain in four several Treatises, whereof the first
is call'd _Osteology_, for the Bones; the second _Myology_, for the
Muscles; the third _Angiology_, for the Veins, Arteries and Nerves, which
are the Vessels; and the fourth _Splanchnology_, for the Entrails.
But lastly, the most clear and perspicuous of all the Divisions of the Body
of Man, is that which compares it to a Tree, whereof the Trunk is the Body,
and the Branches are the Arms and Legs. The Body is divided into three
_Venters_, or great Cavities, _viz._ the Upper, the Middle, and the Lower,
which are the Head, the Breast, and the lower Belly. The Arms are
distributed into the Arms properly so called, the Elbow and Hands; and the
Legs in like manner into Thighs, Shanks, {12} and Feet: The Hands being
also subdivided into the _Carpus_ or Wrist, _Metacarpium_ or Back of the
Hand, and the Fingers; as the Feet into the _Tarsus_, _Metatarsus_, and
Toes. This vision is at present follow'd in the Anatomical Schools.
* * * * *
CHAP. V.
_Of the Skeleton._
_Why is Anatomy usually begun with the Demonstration of the Skeleton, or
Contexture of Bones?_
Because the Bones serve for the Foundation Connexion, and Support of all
other Parts of the Body.
_What is the Skeleton?_
It is a gathering together, or Conjunction of all the Bones of the Body
almost in their Natural Situation.
_From whence are the principal differences of the Bones derived?_
They are taken from their Substance, Figure, Articulation, and Use.
_How is all this to be understood?_
First then, with respect to their Substance, there are some Bones harder
than others; as those of the Legs compared with those of the Back-Bone.
Again, in regard of their Figure, some are long, as those of the Arm; and
others short, as those of the _Metacarpium_. Some are also broad, as those
of the Skull and {13} _Omoplatae_ or Shoulder-Blades; and others narrow, as
the Ribbs. But with respect to their Articulation, some are joined by thick
Heads, which are received into large Cavities, as the Huckle-Bones with
those of the Hips; and others are united by the means of a simple Line, as
the Chin-Bones. Lastly, with relation to their Use; some serve to support
and carry the whole Body, as the Leg-Bones, and others are appointed to
grind the Meat, as the Teeth; or else to form some Cavity, as the
Skull-Bone, and those of the Ribs.
_What are the Parts to be distinguished in the Bones?_
They are the Body, the Ends, the Heads, the Neck, the _Apophyses_, the
_Epiphyses_, the _Condyli_ or Productions, the Cavities, the _Supercilia_
or Lips, and the Ridges.
The Body is the greatest Part, and the middle of the Bone; the Ends are the
two Extremities; the Heads are the great Protuberances at the Extremities;
the Neck is that Part which lies immediately under the Head; the
_Apophyses_ or Processes are certain Bunches or Knobs at the Ends of the
Bones, which constitute a Part of them; the _Epiphyses_ are Bones added to
the Extremities of other Bones; the _Condyli_ or Productions are the small
Elevations or Extuberances of the Bones; the Cavities are certain Holes or
hollow places; the _Supercilia_ or Lips are the Extremities of the Sides of
a Cavity, which is at the End of a Bone; the Ridges are the prominent and
saliant Parts in the length of the Body of the Bone. {14}
_How are the Bones join'd together?_
Two several ways, _viz._ by _Articulation_ and _Symphysis_.
_How many sorts of Articulations are there in the Bones?_
There are generally two kinds, _viz._ _Diarthrosis_ and _Synarthrosis_.
_What is Diarthrosis?_
_Diarthrosis_ is a kind of Articulation which serves for sensible Motions.
_How many kinds of Diarthroses, or great Motions are there?_
There are Three, _viz._ _Enarthrosis_, _Arthrodia_, and _Ginglymus_.
_Enarthrosis_ is a kind of Articulation which unites two Bones with a great
Head on one side, and a large Cavity on the other; as the Head of the
Thigh-Bone in the Cavity of the _Ischion_ or Huckle-Bone.
_Arthrodia_ is a sort of Articulation, by the means whereof two Bones are
join'd together with a flat Head receiv'd into a Cavity of a small depth.
Such is the Head of the Shoulder-Bone with the Cavity of the _Omoplata_ or
Shoulder-Blade; and that of the Twelfth _Vertebra_ of the Back with the
first of the Loins.
_Ginglymus_ is a kind of Articulation which unites two Bones, each whereof
hath at their Ends a Head and a Cavity, whereby they both receive and are
received at the same time, such is the Articulation in the Bones of the
Elbow and the _Vertebrae_.
_What is _Synarthrosis_?_
_Synarthrosis_ being opposite to _Diarthrosis_, is a {15} close or
compacted Articulation, destitute of any sensible Motion.
_How many sorts of _Synarthroses_, or close Articulations are there?_
There are Three. _viz._ _Sutura_, _Harmonia_, and _Gomphosis_.
A _Suture_ is that which joins together two Bones by a kind of Seam or
Stitch, or by a Connexion of their Extremities dispos'd in form of a Saw,
the Teeth whereof are reciprocally let one into another: Such are the
Sutures of the Skull-Bones.
_Harmonia_ is the uniting of two Bones by a simple Line; as the Bone of the
Cheek with that of the Jaw.
_Gomphosis_ is a kind of close Articulation, which unites two Bones after
the manner of Nails or Wooden Pins fixt in the Holes made to receive them:
Such is that of the Teeth in their Sockets.
_What is _Symphysis_?_
_Symphysis_ is the uniting of two Bones by the interposition of a _Medium_,
which ties them very streight together, being also threefold: Such is the
Connexion of the Knee-Pan or Whirl-Bone of the Knee, and the _Omoplata_ or
Shoulder-Blade.
_Are not these three kinds of Articulations or _Symphyses_ distinguish'd
one from another?_
Yes; for tho' they are all made by the means of a third Body intervening,
which joins them together; nevertheless every one of these various Bodies
gives a different Denomination to its respective Articulation: Thus the
Articulation which is caus'd by a Glutinous and {16} Cartilaginous
Substance, is properly call'd _Synchondrosis_; as that of the Nose, Chin,
_Os Pubis_, _&c._ But an Articulation which is made by a Ligament is termed
_Synncurosis_, as that of the Knee-Pan. Lastly, that which is wrought by
the means of Flesh, bears the Name of _Syssarcosis_; as the Jaw-Bones, the
_Os Hyoides_, and the _Omoplata_ or Shoulder-Blade.
_Have the Bones any sense of Feeling or Motion?_
They have neither; for their sense of Pain proceeds from nothing else but
their _Periostium_, or the Membrane with which they are cover'd, and their
Motion is perform'd only by the Muscles that draw them.
_Doth the Marrow afford any Nutriment to the Bones?_
No, all the Bones are nourish'd by the Blood, as the other Parts; but the
Marrow is to the Bones what the Fat is to the Flesh; that is to say, it is
a kind of Oil or Unctuous Substance, which moistens, and renders them less
brittle.
_Are all the Bones of the same Colour?_
No, they follow the Temperament and Constitution of the Persons.
_How many in number are the Bones of the Humane Skeleton?_
There are two hundred and fifty usually reckon'd, _viz._ 61 in the Head, 67
in the Trunk or Chest, 62 in the Arms and Hands, and 60 in the Legs and
Feet; but the true Number cannot be exactly determin'd, by reason that some
Persons have more, and others fewer; for some have more _Ossa Sesamoidea_,
Teeth and {17} Breast-Bones than others: Again, some have many indentings
in the _Lambdoidal_ Suture, and others have none at all.
_Can you rehearse the Number of the Bones of the Head?_
There are Fifteen in the Skull, and Forty six in the Face.
The Fifteen of the Skull are the _Coronal_ for the fore-part of the Head;
the _Occipital_ for the hinder-part; the two _Parietals_ for the upper-part
and each side; the two _Temporals_ for the Temples; the _Os Sphenoides_ or
_Cuneiforme_, which closeth the _Basis_ or bottom of the Skull; the _Os
Ethmoides_, or _Cribriforme_, situated at the Root of the Nose; and the
four little Bones of the Ear on each side, _viz._ the _Incus_ or Anvil; the
_Stapes_ or Stirrup; the _Malleolus_ or Hammer; and the _Orbiculare_ or
Orbicular Bone.
Of the Forty six of the Face, Twenty seven are counted in the Upper-Jaw,
_viz._ the two _Zygomatick_, or the two Bones of the Cheek-Knots; the two
_Lachrymal_ in the great Corners of the Eyes toward the Nose; the two
_Maxillar_, that receive the Upper-Teeth, and which form part of the Palate
of the Mouth, and the Orbits of the Eyes; the two Bones of the Nose; the
two Palate-Bones which are at its end, and behind the Nostrils; the last
being single is the _Vomer_, which makes the Division of the lower part of
the Nostrils; and there are generally Sixteen Upper-Teeth. The Lower-Jaw
contains Nineteen Bones, _viz._ sixteen Teeth; two Bones that receive them;
and the _Os Hyoides_, which is single, and fix'd at the Root of the Tongue.
{18}
_How are the Teeth usually divided with respect to their Qualities?_
Into _Incisive_ or Cutters, _Canine_ or Dog-Teeth, and _Molar_ or Grinders:
There are eight Incisive, and four Canine, which have only one single Root;
as also twenty Molar, every one whereof hath one, two, or three Roots.
_Can you recite the Number of the Bones of the Trunk or Chest?_
There are generally thirty and three in the _Spine_ or Chine-Bone of the
Back, _viz._ seven _Vertebra's_ in the Neck, twelve in the Back, five in
the Legs, five, six, and sometimes seven in the _Os Sacrum_, three or four
in the _Coccyx_, and two Cartilages at its end.
There are twenty nine in the Breast, _viz._ twenty four Ribs, two Clavicles
or Channel-Bones and commonly three Bones in the _Sternum_. The Hip-Bones
are likewise divided into three, _viz._ _Ilion_, _Ischion_ and _Os Pubis_.
_Do you know the Number of the Bones of the Arms?_
There are thirty and one Bones in each Arm, that is to say, the _Omoplata_
or Shoulder-Blade; the _Humerus_ or Shoulder-Bone; the two Bones of the
Elbow call'd _Ulna_, and _Radius_; eight little Bones in the _Carpus_ or
Wrist; five in the _Metacarpium_ or Back of the Hand; and fourteen in the
Fingers, three to every one except the Thumb, which hath only two.
_Can you give us a List of the Bones of the Leg in their Order?_
There are thirty Bones in each Leg, _viz._ the _Femur_ or great Thigh-Bone,
the Knee-Pan or {19} Whirl-Bone on the top of the Knee; the _Tibia_,
_greater Focile_, or Shin-Bone; and the _Perone_ or _Fibula_, or _lesser
Focile_, which are the two associated Bones of the Leg; seven little Bones
in the _Tarsus_; five in the _Metatarsus_; and fourteen in the Toes; that
is to say, three to every one, except the great Toe, which hath only two.
Thus the Number of Bones of the Humane _Skeleton_ amounts to two hundred
and Fifty, without reckoning the _Sesamoides_, the Indentings of the Skull,
and some others which are not always to be found.
* * * * *
CHAP. VI.
_Of Myology, or the Anatomy of the Muscles of a Humane Body._
_What is a Muscle?_
It is the principal Organ or Instrument of Motion; or it is a Portion of
Flesh, wherein there are Veins, Arteries, Nerves, and Fibres, and which is
cover'd with a Membrane.
_How many parts are there in a Muscle?_
Three, _viz._ the Head, the Belly, and the Tail: The Head is that part
thro' which the Nerve enters; the Belly is the Body or Middle of the
Muscle; and the Tail is the Extremity, where all the Fibres of the Muscle
are terminated to make the Tendon or String which is fasten'd to the Part
whereto it gives Motion. {20}
_Have all the Muscles their Fibres streight from the Head to the Tail?_
No, some have them streight, others transverse, and others oblique or
circular, according to the several Motions to which they are appropriated.
_How many sorts of Muscles are there with respecting to their Action?_
There are two different kinds, _viz._ the _Antagonists_ and the
_Congenerate_; the former are those that produce opposite Motions; as a
_Flexor_ and an _Extensor_, a _Depressor_ and a _Levator_. The Congenerate
are those that contribute to one and the same Action; as when there are two
Flexors or two Extensors, and then one supplies the defect of the other;
whereas when one of the Antagonist Muscles is cut, the other becomes
useless, and void of Action.
_How is the Action of a Muscle perform'd?_
It is done by Contraction and Extension; the former causeth the Antagonist
to swell, and the other compels it to stretch forth in length.
_What is _Aponeurosis_?_
It is the continuity of the Fibres of a Tendon which makes a Connexion that
serves to strengthen the Muscle in its Motion.
* * * * *
{21}
CHAP VII.
_Of the Myology, or Anatomy of the Muscles of the Head._
_How many Muscles are there appointed to move the Head, and which be they?_
The Head is mov'd by the means of fourteen Muscles, seven on each side; of
these, two serve to depress it, eight to lift it up, and four to turn it
round about.
The two Depressors are call'd _Sternoclinomastoidei_; they take their Rise
in the _Sternum_, at the Clavicles, and proceed obliquely to join the
_Apophysis Mastoides_.
Of the four Elevators on each side the first is the _Splenius_, which
begins at the five _Vertebrae_ of the Back and the three lower ones of the
Neck, and ascending obliquely, cleaves to the hinder part of the Head. The
second, named _Complexus_ or _Trigeminus_, having its beginning as the
_Splenius_, sticks in like manner to the hinder part of the Head, and they
form together a figure resembling that of S. _Andrew_'s Cross. The third is
the _Rectus Major_, which proceeding from the second _Vertebra_ of the
Neck, shoots forward to join the hinder part of the Head. The fourth is the
_Rectus Minor_, which begins at the first _Vertebra_ of the Neck, and ends
likewise in the hinder part of the Head.
The two Muscles on each side, which move the Head circularly, are the
_Obliquus Major_ and {22} _Minor_; the _greater Oblique_ taking its rise
from the second _Vertebra_ of the Neck, goes to meet the first; but the
_lesser Oblique_ hath its Origine in the hinder part of the Head, and
proceeds to join the other obliquely in the first _Vertebra_.
_How many Muscles are there in the Lower-Jaw, and which be they?_
The Lower-Jaw hath twelve Muscles which cause it to move; that is to say,
six on each side, whereof four serve to close and two to open it.
The first of the Openers is the _Latus_, which beginning at the top of the
_Sternum_, Clavicle, and _Acromion_, cleaves on the outside to the bottom
of the Lower-Jaw-Bone. The second of the Openers is the _Digastricus_,
which takes its rise in a Fissure lying between the Occipital Bone and the
_Apophysis Mastoides_, from whence it passeth to the bottom of the Chin on
the inside.
The first of the Shutters is the _Crotaphites_ or Temporal Muscle, which
hath its Origine at the bottom, and on the side of the _Os Coronale_, the
_Os Parietale_, and the _Os Petrosum_, from whence it is extended till it
cleaves to the _Apophysis Coronoides_ of the Lower-Jaw, after having passed
above the _Apophysis_ of the _Zygoma_: Its Fibres are spread from the
Circumference to the Center, and it is covered again with the
_Pericranium_, which renders its Wounds very dangerous; so that the least
Incisions as can be, ought to be made therein.
The second is the _Pterygoideus_ or _Aliformis Externus_, whose rise is in
the _Apophysis Pterygoides_, from whence it sets forward till it stick
between the _Condylus_ and the Coronal of the Lower-Jaw.
The third is the _Masseter_, which hath two {23} Sources or Beginnings, and
as many Insertions; the first Source thereof is at the Cheek-Knot or Ball
of the Cheek, and the second at the lower part of the _Zygoma_. The first
Insertion is at the outer Corner of the Jaw, and the second in the middle
part, by that means forming the Figure of the Letter X.
The fourth is the _Pterygoideus_ or _Aliformis Internus_, which hath its
beginning in the _Apophysis Pterygoides_, and is terminated in the inner
Corner of the Jaw; so that Mastication or Chewing is perform'd by the means
of these four Muscles.
_How many Muscles are there in the Face, and which be they?_
There are two for the Forehead, call'd _Frontal_, whose Origine is in the
upper part of the Head, from whence they descend by streight Fibres, until
they are fasten'd in the Skin of the Forehead near the Eye-Brows, where
they are re-united: Their Action or Office is to draw the Skin of the
Forehead upward, whereto they stick very close.
There are also two others call'd _Occipital_, which have their Beginning in
the same place with the preceeding, but they descend backward, and cleave
to the Skin of the hinder part of the Head, which they draw upward.
There are two Muscles to each Eye-Lid, one whereof is termed the
_Attollens_ or _Elevator_ and the other the _Depressor_. The Elevator takes
its rise in the bottom of the Orbit of the Eye, and is fastned by a large
_Aponeurosis_ to the edge of the upper Eye-Lid. The Shutter or Depressor,
call'd also the _Orbicular_, hath its Origine in the great _Canthus_, or
Corner of the Eye, passeth over the {24} Eye-Lid upward, and is join'd to
the lesser Corner of the same Eye, being extended along its whole Compass.
The Eyes have each six Muscles, _viz._ four _Recti_ and two _Obliqui_; the
_Recti_ or streight Muscles are the _Elevator_, the _Depressor_, the
_Adductor_, and the _Abductor_. The first of these call'd _Elevator_, or
_Superbus_, draws the Eye upward, as it is pull'd downward by the
_Depressor_ or _Humilis_; the _Adductor_ or _Bibitorius_ draws it toward
the Nose, and the _Abductor_ or _Indignarorius_ toward the Shoulder: All
these small Muscles have their Originals and Insertions in the bottom of
the Orbit through which the Optick Nerve passeth, and are terminated in the
Corneous Tunicle, by a very large _Tendon_.
The first of the Oblique ones is term'd the _Obliquus Major_, and the other
_Obliquus Minor_, because they draw the Eye obliquely. These Muscles cause
Children to squint when they do not act together. The _Obliquus Minor_ is
fasten'd at the outward part of the Orbit near the great Corner, and draws
the Eye obliquely toward the Nose: But the _Obliquus Major_ is fixt in the
inner part of the Orbit, and ascends along the Bone to the upper part of
the great Corner, where its Tendon passeth thro' a small Cartilage nam'd
_Trochlea_, and is inserted in the little Corner with the lesser _Obliquus
Minor_, to draw the Eye obliquely toward the lesser Corner.
The Ear, altho' not usually endu'd with any sensible Motion, nevertheless
hath four Muscles, _viz._ one above, and three behind; the first being
situated over the Temporal, and fasten'd to the Ear to draw it upward: The
three others have {25} their beginning in the _Mammillary Apophysis_, and
are terminated in the Root of the Ear, to draw it backward.
There are also three Muscles in the inner part of the Ear, whereof the
external belonging to the _Malleus_ or Hammer lies under the exterior part
of the Bony Passage which reacheth from the Ear to the Palate of the Mouth,
being fixt in a very oblique Sinuosity which is made immediately above the
Bone that bears the Furrow, into which is let the Skin of the _Tympanum_ or
Drum. The internal Muscle lies hid in a Bony Semi-Canal, in the _Os
Petrosum_; one part of which Semi-Canal is without the Drum, and clos'd on
the top with a Passage that leads from the Ear into the Palate. But the
other part within the Drum advanceth to the _Fenestra Ovalis_, and is
inserted in the hinder part of the Handle of the _Malleus_. The Muscle of
the _Stapes_ or Stirrup is also hid in a Bony Tube, almost at the bottom of
the Drum, and fixt in the Head of the _Stapes_.
The Nose hath seven Muscles, that is to say, one common and six proper; the
common constitutes part of the orbicular Muscle of the Lips, and draws the
Nose downward with the Lip. Of the six proper Muscles of the Nose, four
serve to dilate it, being situated on the outside, and two to contract it,
which are placed in the inside.
The two first Dilatators of a Pyramidal Figure, take their rise in the
Suture of the Forehead, and are fasten'd by a large Filament to the _Alae_
of the Nose. The two other Dilatators resembling a Myrtle-Leaf have their
Source in {26} the Bone of the Nose, and are inserted in the middle of the
_Ala_.
The two Restrictors are Membranous, beginning in the internal part of the
Bone of the Nose and adhering to the inner _Ala_ of the Nostril.
The Lips have thirteen Muscles, _viz._ eight proper, and five common: Of
the proper there are four for the Upper-Lip, and as many for the Lower:
with two common for each, and the odd one.
The first of the proper of the Upper-Lip bears the Name of the _Incisivus_,
its Origine being in the Jaw, in the place of the Incisive Teeth and its
Insertion is in the Upper-Lip.
The second is the _Triangulis_, Antagonist to the former; its Rise is on
the outside, at the bottom of the Lower-Jaw; and it is implanted in the
Upper-Lip, near the Corner of the Mouth.
The third being the _Quadratus_, springs from the bottom of the Chin
before, and cleaves to the edge of the Lower-Lip.
The fourth is the _Caninus_, Antagonist to the _Quadratus_, beginning in
the Upper-Jaw-Bone and being terminated in the Lower-Lip near the Corner of
the Mouth.
The first of the common is the _Zygomaticus_, the Origine whereof is in the
_Zygoma_ and its Insertion in the Corner of the Mouth, to draw it toward
the Ears; so that it is the Muscle which acts when we laugh.
The second of the common is the _Buccinator_ or Trumpeter, which is swell'd
when one sounds a Trumpet. It hath its rise at the Root of the Molar Teeth
of both the Jaws, and is extended quite round about the Lips. {27}
The odd Muscle, or the thirteenth in number, is the _Orbicular_, which
makes a _Sphincter_ round about the Lips to close or shut them up.
The _Uvula_ or Palate of the Mouth hath four Muscles, whereof the two first
are the _Peristaphylini Externi_, taking their rise from the Upper-Jaw,
above the Left Molar Tooth, and being ty'd to the Palate by a thin
_Tendon_.
The two others are the _Peristaphylini Interni_, which have their beginning
in the _Apophysis Pterygoides_ on the inside, and likewise stick to the
Palate.
The Tongue, altho' all over Musculous and Fibrous, yet doth not cease to
have its peculiar Muscles, which are eight in Number.
The first of these is call'd _Genioglossus_, taking its rise in the lower
part of the Chin, from whence it is extended till it cleave to the Root of
the Tongue before, to cause it to go out of the Mouth.
The second is term'd _Styloglossus_, its Rise being in the _Apophysis
Styloides_, from whence it passeth to the side above the Tongue, to lift it
up.
The third bearing the Name of _Basiglossus_, commenceth in the _Basis_ or
Root of the _Os Hyoides_, and thence insinuates it self into the Root of
the Tongue, to draw it back to the bottom of the Mouth.
The fourth is the _Ceratoglossus_, deriving its Original from the Horn of
the _Os Hyoides_, and cleaving to the side of the Tongue to draw it on one
side: The Action of these Muscles of both sides together, causeth an
Orbicular Motion in the Tongue. To these some add a fifth {28} Pair of
Muscles, call'd _Myloglossus_, which serves to draw it obliquely upward.
_What is the Action of the _Os Hyoides_ in the Throat, and how many Muscles
hath it?_
The use of the _Os Hyoides_ is to consolidate the Root of the Tongue; and
it hath five Muscles on each side, which keep it as it were hung up.
The first of these, call'd the _Geniohyoideus_ hath its beginning in the
Chin on the inside, and adheres to the top of the _Os Hyoides_, which it
draws upward.
The second is the _Mylohyoideus_, whose Origine is in the inner side of the
Jaw, from whence it cleaves side-ways to the Root of the _Os Hyoides_,
which it draws upward, and to one side.
The third is the _Stylohyoideus_, which after it hath taken its rise in the
_Apophysis Styloides_, is fasten'd to the Horn of the _Os Hyoides_, to draw
it toward the side.
The fourth is the _Coracohyoideus_, which springing up from the _Apophysis
Coracoides_ of the _Omoplata_, cleaves to the Root and side of the _Os
Hyoides_, to draw it downward and to the side.
The fifth is the _Sternomohyoideus_, that hath its beginning in the Bone of
the _Sternum_ on the inside and is inserted in the Root of the _Os
Hyoides_, which it draws downward.
_How many Muscles hath the _Larynx_?_
There are fourteen, _viz._ four Common, and ten Proper. The first Pair of
the Common is the _Sternothyroideus_ or _Bronchycus_, which proceeding from
the inside, and the top of the _Sternum_, ascends along the Cartilages of
the Wind-Pipe, and is terminated in the bottom of the {29} _Scutiformis_ or
Buckler-like Cartilage, which it draws downward. The second is the
_Hyothyroideus_, which ariseth from the Root of the _Os Hyoides_, and is
inserted in that of the _Scutiforme_. This Muscle serves to lift up the
_Larynx_, as also to dilate the bottom of the _Scutiformis_, and to close
its top.
The first Pair of the Proper is the _Cricothyroideus Anticus_, which
deriving its Original from the hinder and upper part of the _Cricoides_, or
Ring-like Cartilage, is fixt in the upper and lateral part of the
_Scutiformis_, to close or shut it up.
The second is the _Thyroides_.
The third is the _Cricoarytenoideus Lateralis_, which proceeds from the
side of the _Cricoides_ within, and is fasten'd to the bottom and side of
the _Arytenoides_, which it removes to dilate the Mouth of the _Larynx_.
The fourth is the _Thyroarytenoideus_, which arising from the fore-part on
the inside of the _Scutiformis_, is terminated on the side of the
_Arytenoides_, to close the Orifice of the _Larynx_.
The fifth is the _Arytenoideus_, which having its Source in that place
where the _Cricoides_ is united to the _Arytenoides_ is inserted in its
upper and lateral part, to close the _Larynx_.
_How many Muscles hath the _Pharynx_?_
It hath seven, the first whereof is the _Oesophagieus_, which takes its
rise from the side of the _Scutiformis_ or Buckler-like Cartilage, and
passing behind the _Oesophagus_ or Gullet, is fasten'd to the other side of
the Cartilage. It thrusts the Meat down by locking up the _Pharynx_ as a
_Sphincter_.
The second named _Stylopharingaeus_, springs from within the Acute
_Apophysis_ of the _Os Sphenoides_, or _Cuneiforme_, and is inserted
obliquely {30} in the side of the _Pharynx_, which it dilates by drawing it
upward.
The third, call'd _Sphenopharyngaeus_, proceeds from the _Apophysis
Styliformis_, and is terminated in the side of the _Pharynx_, which it
dilates by drawing its sides.
The fourth Pair is the _Cephalopharyngaeus_ which ariseth from the
articulation of the Head with the first _Vertebra_, and closeth the
_Larynx_.
_How many Muscles are there in the Neck, and which be they?_
There are four Muscles in the Neck on each side, _viz._ two Flexors, and
two Extensors. The _Flexors_ are the _Scalenus_ and the _Rectus_ or
_Longus_; and the Extenders are the _Spinatus_ and the _Transversalis_.
The _Scalenus_ or _Triangularis_ hath two remote Sources, _viz._ one in the
first Rib, and the other in the Clavicle, and is fasten'd to the third and
fourth _Vertebra_ of the Neck.
The _Rectus_ or _Longus_ begins in the side of the four upper _Vertebra's_
of the Back, and is join'd to the upper _Vertebra's_ of the Neck, and the
hinder part of the Head.
The _Spinatus_ hath its Origine in the fourth and fifth upper _Vertebra's_
of the Back, and is fasten'd to all the six lower _Vertebra's_ of the Neck.
The _Transversalis_ springs forth out of the upper _Vertebra's_ of the
Back, and cleaves to the Extremity of the four _Vertebra's_ of the Neck.
* * * * *
{31}
CHAP. VIII.
_Of the Myology or Anatomy of the Muscles of the Chest; or of the Breast
Belly, and Back._
_How many Muscles are there in the Breast, and which be they?_
The Breast hath fifty seven Muscles, that is to say, thirty that serve to
dilate it, twenty six whose Office is to contract it, and the _Diaphragm_
or Midriff, which partakes of both Actions.
The thirty which dilate the Breast are equally plac'd to the number of
Fifteen, _viz._ the _Subclavius_, the _Serratus Major Anticus_, the two
_Serrati Postici_, and the eleven external _Intercostals_.
The twenty six which contract the Breast are likewise equally rank'd to the
Number of thirteen on each side, _viz._ the _Triangularis_, the
_Sacrolumbus_, and eleven internal _Intercostals_.
The _Subclavian_ takes up the whole space between the Clavicle and the
first Rib: Its Original being in the internal and lower part of the
_Clavicula_, and its insertion in the upper part of the first Rib.
The _Serratus Major_ is a large Muscle having seven or eight Indentings or
Jaggs. It takes its rise in the interior Basis of the _Omoplata_ or
Shoulder-Blade, and its Jaggings are inserted in {32} the five lower true
Ribs, as also in the two upper spurious Ribs.
The _Serratus Posticus Superior_, begins with a large _Aponeurosis_ in the
_Apophyses_ of the three lower _Vertebrae_ of the Neck, and of the first of
those of the Back; then passing under the _Rhomboid_, it is join'd
obliquely by four Indentings to the four upper Ribs.
The _Serratus Posticus Inferior_, commences in like manner with a large
_Aponeurosis_ in the _Apophyses_ of the three lower _Vertebra's_ of the
Back, and of the first of those of the Loins, and is afterwards fasten'd by
four Digitations to the four lower Ribs.
The eleven _External Intercostal_ Muscles are situated in the spaces
between the twelve Ribs passing obliquely and on the outside from the back
part to the fore part. They take their rise below the Upper Rib, and have
their Insertion above the lower Rib.
The _Triangularis_ is the first of those that contract the Breast, and
possesseth the inward part of the _Sternum_: Its Original is in its lower
part, and its Insertion in the top of the Cartilages of the two upper Ribs.
The _Sacrolumbus_ hath its Source in the hinder part of the _Os Sacrum_, as
also in the _Vertebra's_ of the Loins, and ascending from thence,
insinuates it self into the hinder part of the Ribs, to every one of which
it imparts two _Tendons_, one whereof sticks on the outside, and the other
on the inside. This Muscle is fleshy within, and fibrous without.
The Eleven _Internal Intercostals_, contrary to the External, derive their
Original from the {33} top of every lower Rib, and ascend obliquely from
the back-part to the fore-part, till they are join'd to the lower Lip of
every upper Rib: Thus these Internal Muscles, with the External, form, by
the opposition of their Fibres, a Figure resembling a _Burgundian_ Cross.
The Diaphragm or Midriff is esteem'd as the fifty seventh Muscle of the
Breast, and serves as well for its dilatation as contraction. It separates
the _Thorax_ or Chest from the lower Belly, and is tied circularly to all
the Extremities of the Bastard Ribs, immediately under the _Xiphoides_, or
Sword-like Cartilage.
Modern Anatomists have discover'd that the Diaphragm is compos'd of two
Muscles, _viz._ one Upper, and the other Lower; so that the Upper cleaves
to the Extremities of the Spurious Ribs, and is terminated in a flat
_Tendon_ in the middle, which hath been always taken for its Nervous part.
The Lower begins with two Productions, the longest whereof being on the
right side, ariseth from the three upper _Vertebra's_ of the Loins, and the
other on the Left from the two _Vertebra's_ of the Back, till it is lost in
the _Aponeurosis_ of the Upper Muscle.
_How many Muscles are there in the Back and the Loins, and which be they?_
There are three in each side, _viz._ one for Flection, and the other for
Extension.