OCR Text |
Show 16% or The LIGA'I‘URE or THE coax). ened, and the part below the ligature is to slough off. The ligature is apt only to diminish the mass of the cord, and not to cut it through, the consequence of which is, that it hangs about the extremity of it like a ring, whilst the extremity of the cord granulates and enlarges. The drawing of this ligature is attended with severe pain, of the most sickening and EXTIRPA'I‘ION OF THE TESTICLE. //7/////~g/4'" X / Cq/g/ ,,/"// a; / 7/ I subduing nature. But if we take up the arteries separately, I conceive we should still retain, till the second dressing, the large ligature for the cord lying in the upper part of the wound. Although I conceive the manner of operating, which I have already described, to be preferable in some respects ; that it gives less pain, and is more rapidly done; yet I am not wedded to it, nor do I think it a matter of very essential importance, whether the cord be out first, or after the dissection of the testicle. It is frequently done in the following manner. we shall suppose that part of the integuments are diseased, or that a fungus has proceeded from the ulcer of the body of the testicles . .udcwr. «1w- --~ MM". The parts being shaved, and the patient seated, the sun geon grasps the testicle with the left hand, so as to make the. skin tense on the fore-part of the scrotum. Then, well observing the extent of the diseased skin, he begins his incision A, over the cord, at that place where, by careful examination, he has found that it is sound. Drawing his knife down, so as to cut through the integuments, he carries it on the outside of the diseased attachment of the skin, as at B; and having en‘ circled the diseased portion of skin, the incision terminates in the bottom of the scrotum, C. Commencing his second cut at E, where he first diverged from the right line, he makes it a counterpart to the last, E D C, so as to include within his incisions the ulcer, fungus, and diseased skin F G. He now proceeds to dissect back the scrotum upon both sides, and to detach the testicle and its coats tom the scrotum all around. |