Ex Libris Jonathani Elmer
Ipromet manu Jeripris




Jonathn. Elmer’s




A Course
of
Anatomical Lectures
Delivered
By Dr. William Shippen junr.
Professor of Anatomy & Surgery
in the College of Philadelphia
Anno 1766
Quanta autem existerent consilii
solertissimi indicia, su tota hominis
fabrica perspecta foret? si corporis totius
species et dignitas? Sensuum organa
subtillissime fabricata, et aptissime locata.
Synop: Meta:
Anatomia fundamentum est Medicinae
Anomal

















Anatomical Lectures
Lecture 1st:
Anatomy avatouia in Greek signifies
cutting & by it antiently was meant only
the dissecting of bodies, but at present it
is implied in a more general sense.
Anatomy in respect of its object is divided 
into human and comparative.
Human Anatomy is that which is
employed on the human body; and comparative
Anatomy is that which is employed upon
the bodies of other animals, these serving
for the more accurate descriptions of several
parts, and supplying the defects of human
bodies.
Anatomy from its various ends may
be said to be of four kinds viz: Theological,
Medical, Juridical, and Judicial.
The




The first consists in an acquaintance with
the works of the creator in the human frame;
according to Fontanel the study of Anatomy
& Autonomy afford the strongest arguments
against Atheism.
Medical Anatomy is ultimately health,
for the presentation of which, restoring it when
impaired, by diseases, or even preventing
their access, nothing surely is more necessary
than a true knowledge of the structure of that
frame so liable to be injured.
Juridical Anatomy is the determining
the causes of suspicious deaths, impotency,
barrenness, the true times of pregnancy and
delivery, the mortality of Wounds and a
multitude of other causes of great importance
to be adjusted in account of Judicature.
Judicial Anatomy is the determining
the cause and manner of the death of diseased
persons from a subsequent dissection of the
body




body; this is of the utmost use in the practice
of Physic.
Upon the whole then the use of Anatomy
in very great, nor is it confined to the bounds
of Medicine alone; the Philosopher and
Theologist, the Magistrate, Painter and
Sculptor are in their respective employments
more or less qualified in proportion to the progress
they have made in this science; but the
physician and Surgeon are the people to 
whom it is most immediately necessary
and who without a perfect knowledge of it
cannot do justice to the world in their
professions. What the needle is to the
mariner, Anatomy is to both these, and
we may venture to say that without its
assistance, they would be rather detrimental 
than beneficial to mankind.




The Anatomy of the solid parts is by Heister
called Osteology and that of the soft parts
Sarcology, each of these are subdivided.
Osteology or the anatomy of the Solid
parts is divided into the anatomy of the 
Bones called Osteology; Chondrology or the
anatomy of the Cartilages; and Syndesmology
or the anatomy of the Ligaments.
Sarcology or the anatomy of the soft parts
is divided into Dermatology or the anatomy of
the Teguments; Splanchnology or the anatomy
of the Viscera; Myology or the anatomy of
the Muscles; Neurology or the anatomy of
the Nerves; Angiology or the anatomy of the 
Veins and Arteries and Adenology or the
Doctrine of the Glands.
In the human body as a complex hydraulic machine
a double inquiry must be made 1st. Into the structure of
the parts, this is called Anatomy, 2d. Their functions & the
laws of their motion which is termed Physiology





Lecture 2d.
As the solids are formed out of one
principal fluid chiefly, called the Blood
it is proper to begin therewith.
Of the Blood
Blood in Scripture is called the life of
the Animal; according to some it is the
primum vivens ultemum moriens, its
a heterogeneous mass, as is evident from the
variety of ingredients of which it is made up,
and the various forms it assumes in the
animal machine.
The blood is composed of three substances
viz: Serum, Gravamentum & a coagulable
Lymph: We shall consider these in three
different manners; first when ocularly
examined, 2d. Viewed with a Microscope,
and
B





3dly: The chemical Analysis thereof.
Blood fresh drawn from a sound
living animal, upon landing, part of
it congeals into a hard coagulum suspended 
in a yellowish Serum, the
upper surface being of a florid color
while the bottom is black; the reason
of the blood appearing bright and
florid at the top is from its being in
contact with the Air; this is confirmed
by an experiment of Dr. Hunter’s who put
a quantity of blood fresh drawn into a
vial, & stopt it close; upon standing it
all turned of an uniform black color,
except a little spot upon the top with which
a globule of Air had got in contact.
Blood stirred round with a probe
whilst




Whilst warm, a fibrous elastic substance
is obtained, which, put in water turns of
a whitish color; this is the coagulable
Lymph, is strongly elastic, & is the cause
of cohesion in the particles of the Blood,
as is evident from the extravasation of
the blood after death by dissolution
of the cohering particles. The coagulable
Lymph is sometimes discharged from
the Uterus and by Nurses taken for
an Abortion; this error they are sometimes
led into from a desire that it should be
so. If spirits of Wine be added to
Serum, or the same made boiling hot,
it rises up, emits fumes, and turns into
a coagulum similar to the White of an egg:
the fibrous part of the blood is what forms
Polypuses




Polypuses concretions &c:
Blood viewed by a microscope appears 
to consist of a number of globules,
the larger ones being those that tinge
it of a red color, &c: therefore chiefly
make the crassamentum, are of a certain
determinate magnitude being of the
same bigness in all animals, in a Sheep
as in an Ox, in an eel as in a man.
These globules are composed of six
smaller or ceruminous ones; and these
ceruminous ones are composed of smaller
or lymphatic ones; and it is probable there
are still lower orders of globules of blood.
These globules of blood are of a
lenticular form and elastic the largest
kind being less than the 1/3000 part of an
inch




Inch. the crassamentum is supposed
to contain 1/3 of the mass and the
Serum to make up the other 2/3.
Blood chemically analyzed; upon
distillation with a slow fire a quantity
of Phlegm arises, with the fire increased
next arises an Oil and a volatile Salt,
the caput mortuum being a fixed
alkali and a cretaceous Earth.
The chemical proportions of the
blood are by Dr. Martin & Boyle recvd.
as follows viz: of Phlegm 5/6 of
Oil 1/15, of Salt 1/25, of Air 1/20, &
of Earth 1/75, part of the whole mass.
The specific gravity of the blood
to that of rain water is by Dr. Jurin
and




and Martin reckoned as follows,
by Jurin as 1000 to 1054 by Martin
as 1000 to 1056 or 1057 or as 10 to 19.
The density of blood in living animals 
is to its density when reduced to
the coldness of temperate Air as 134
to 135 or 992 1/2 to 1000.
The color of blood is for the most
part red, but redness is not a constituent
quality in blood, for some Animals
have white blood. In the human
body the blood is redder & more florid
in the Arteries than in the Veins,
oweing to the action of the Lungs upon
it, for by shaking fresh blood in a vial
taken from a vein, it appears of the
color of arterial blood. That the blood
is




is reder in the Arteries than in the
Veins. Dr. Hunter proved by the following
experiement: he opened the Thorax of a
live Dog and kept his Lungs working
with a pair of Bellows; and drew a
spoonful of blood from each side of the
Heart is, from the Vena Cava & Aorta 
the latter of which appeared the reddest.
From the accurate experiements it is
found that a cubic inch of rain Water
weighs 253 1/3 grains, a cubic inch
of warm blood 264 3/4 grains.
An Ounce of Blood contains 1,813
Inches, an avoirdupois ounce weights
437 1/2 grains equal to 1,727 inches
of water and 1,6526 of warm blood.
Lect.


*Among these we may reckon Boerhaave instit. vol. 2
the colour of the Arteries are of aligamentous substance
and not muscular as is evident from their white appearance 
and their of elasticity both of which is contrary to the general
characteristic of a muscle however we are informed that
Dr. Cullen has lately discovered that there are muscular
fiber in the coats of the arteries the action of which he
thinks assists in propelling the blood onward.
J. Cullen likewise says that there is a muscular coat
to the arteries as well as Boerhaave & many others.
&c physiology [illegible].


Lecture 3d.
Of the Arteries & Veins
An Artery is a strong, membranous,
ramifying, elastic Tube, endowed with
pulsation; arising from the left side 
of the Heart, and terminating in every
part of the body. The Arteries are composed 
of three coats, tho’ some have
reckoned four and some five.* The
first external coat is very thin the fibres of x
which going longitudinal & circular;
the second coat is thickest and the fibres
of it go in a circular direction; the 3d.
coat is very compact and its inside
very smooth and even, this smoothness 
and compactness of the inner coat
serves two purposes. 1st. to allow the blood
to




to pass without hindrance & 2d. to
prevent its exudation.
The pulsatory motion of the Arteries
is a dilatation and contraction of them;
the former called Diastole, and the latter
Systole, which precedes proceeds from
the Heart, besides which they have a
sort of aperistaltic motion, as is evident
from an experiement of Dr. Hunter’s,
who opened alive Dog and cutting off
the mesenteric Artery, injected it wth. 
a warm milk, which he could plainly
perceive the Artery to carry along wth. a
vernicular motion; to confirm is the
more he injected the mesenteric Vein
but the milk went no farther than
the
&




the force of the injecting propelled it.
There are but two Arteries in the
body viz: the pulmonic, which carries
the blood through the small circulation,
and the Aorta, which carries it to all
the parts of the body.
The coats of the Arteries are very
elastic, and are furnished with blood
vessels for their nourishment; the
Arteries mostly and all except the
Epigastric ramify at acute angles.
The commonest diseases the
Arteries are subject to, are, Aneurisms
and Ossification.
Aneurisms proceed from a preternatural 
dilatation of the coats of the Artery’s
and are of two kinds 1st. When the blood
is


x it is sometimes found in young subjects and is
oweing perhaps to a disposition of the constitution
to form bony matter.


is contained within the coats of the
Artery. 2d. when the Artery is burst &
the blood extravasated into a membranous 
bag.
Ossification happens mostly to
Old people from a weak & slow circulation 
of the Blood. x
Veins are elastic, ramifying Tubes,
like the Arteries; except smaller. their
coats thinner, and without motion.
Phisiologically speaking the Veins
begin at the extremities of the Arteries,
or more properly speaking they are a
continuation of the Arteries reflected
back toward their Origin the Heart;
but anatomically speaking the Veins
arise from the Heart.
There




There are 7 Veins in the body from
which all the rest arise viz: The 2 Venae
Cava ascendans and decendans; 4
pulmonary Veins (two from each lobe
of the Lungs) and Vena Portarum.
The veins are mostly ramified in
the same manner as the Arteries, exct.
the Vena Portae, and the cutaneous
Veins of the extremities, & other parts.
The veins of the extremities have
valves, but not those of the Viscera;
the reason of which is because there
is no Muscles in the viscera; hence
the use of those valves in the Veins
of the extremities is to prevent the
blood from going backward as well
as


x Bellini especially is of this opinion


as well as for, to push it forward when
the muscle is contracted and the Vein
compressed.
Of Venesection & Hemorrhages.
In bleeding, the blood is supposed to 
x
flow out faster at the orifice than it
circulates in common, and to increase
the circulation to the part, hence the
doctrine of revulsion & derivation is
easily understood; thus we find in
a Cephalalgia bleeding in the foot
causes a derivation to the feet and
a revulsion from the Head &c:
In Hemorrhages the antients
used Ligatures round the joints,
wc. stopping the return of of the blood
to the Heart checked its impetus,
but









but by Venesection his ends are answered:
e,g, supposing an Hemorrhage at the
Nose, Lungs, Uterus &c: bleeding
takes off the impetus of the blood &
causes a revulsion, at the same time.
Dr. Haller thinks this latter method much the [illegible]
the Veins are some of them subject 
to Varices, which are an obstruction,
or destruction of the valves thereof.
The muscular coat of both the
Arteries and Veins are somewhat
subject to inflammation & suppuration,
but not near so much as the other
muscles of the body; this is very wisely
adapted to their function, for suppuration 
of their coats would be attended
with fatal consequences often.
Lecture




Lecture 4th.
Of the Lymphatics.
Lymphatic or absorbent vessels are
those fine ramifying vessels which contain 
a clear diaphanous Liquor; they
take their rise internally from the cavities, 
as the stomach, intestines, and
externally from the surfaces of the
skin. The antients supposed the
Lymphatics were a continuation of
the Arteries dividing them into three
classes, sanguineous, venous, and
Lymphatic, but, it has very lately
been discovered that the Lymphatics
are an entire system of vessels by
themselves, having no affinity or communication with
either the arteries or veins.
this




This is proved 1: by injections not passing into them from the arties 2: by
the motion of the fluid in them and the valves they
have; they are called absorbents from
their office, which is to absorb the Lymph
and other matters and carry it into the
thoracic duct or Receptaculum Chyli;
where they are all supposed to terminate.
Those vessels called lacteals
belong to this system; and called Lacteals
only, from their carrying a milky chyle:
their origin termination and course of
their fluids being the same. That the
lymphatics are absorbents is evident from
their absorbing moist substances rubbed
on the skin, as Mercury, Turpentine,
Garlic &c: but in a more obvious manner
in the venereal Disease, where absorbing
D the




virus they carry it to the adjacent
Lymphatic Glands and cause them to
tumify, hence Buboes &c: sometimes the
virus causing the glands to tumify and
inflame, constricts the vessels beyond
the same and prevents the infection
from going any farther; hence the cure
of the venereal disease sometimes by
the suppuration and discharge of a Bubo.
Of the Glands.
A Gland is a secretory Vessel — the
antients called only those Glands which
we feel hard movable kernels under the
chin and other were until Malpighius
by his microscope found the Liver and
other substances to be of the same texture,
and therefore termed them all Glandular.
A




A Gland he thought to be made up of
little fine round bodies consisting of
Follicles which contained the secreted
fluid and between which was a parynchemical 
substance; but Ruysch by
his injections found that the Glands
were vascular or made up of fine vessels
which has been further confirmed by
later anatomists. The vessels of the
Glands are Arteries, Veins, secretory
and to some excretory Vessels Nerves & lymphatics
Of Secretion
Some have imagined that the secretions
were performed by the diameters of the
secretory vessels, supposing them to be
of the size of the particles secreted;
but this theory is subject to these two
objections, viz: that the smaller particles
will




will go off with the larger ones and to the
secretion be confounded and in a Jaundice, 
when once the Bile had got into the
Blood it would continually remain [illegible] &
the Jaundice could not be cured; others supposed 
a particular fermentation happened
in the veneral glands, & from thence 
arose the difference in the veneral secreted 
fluids, and likewise was the cause of
the secretion; this theory is liable to the
same objections with the former, and
therefore the most received opinion is, that
the secretions depend upon the particular
disposition of the vessels, to the particular 
fluid it is to secrete; hence arises
these Axioms. 1st. That the secretions are
carried on uniformly in a living sound Animal.
2d. One secretion increased another is diminished &c:
Lect.




Lecture 5th.
Of the Muscles & Tendons.
A Muscle is a fleshy, fibrous, [crossed out]
substance, consisting of Veins, Arteries, &
Nerves; besides fleshy fibers &c; having
more nerves in proportion than another
part of the body serving to give notice to the
brain of any external stimulus or irritation.
The redness of the muscles is not
inherent in the fibres thereof, but only
oweing to the blood contained in them, of
which there is a great quantity, more
than is sufficient for their nourishment
and may possibly be subservient to their
motion.
A Tendon is a white compact fibrous
unelastic substance. most muscles terminate 
in Tendons, and the Tendons are by
some reckoned a continuation of the fibres
of




of the muscles to which they belong,
only more compacted together so as not
to admit the red globules of blood between 
their interstices: but Dr. Hunter
thinks the fibres of the Tendons are
not a continuation of those of the muscles,
but distinct fibres someway cemented
thereto.
The muscular fibres are cemented
together by the cellular membranes and
an intervening glue, & serve for the
moving of the solid parts of the body.
The Tendons are for the better
insertion of the muscles, and of great
use in motion; eg: in the Perforans and
Perforations of the hand, the muscle arises
from the inferior part of the Humerus, and
if that was continued down to its insertion
muscular, it would render the hand troublesome




some and unwieldy, whereas now, the
Tendons, being compact & taking up but
little space, remedy that inconvenience.
Round many of the Joints as the Wrist 
Ancle &c: there is a capsular Ligament or
Frenum which serves to keep these tendons
in their right places, and facilitate their
regular motion; likewise over some of the
Muscles there is a tendinous expansion
called Aponeurosis, of much the same use
as the preceding Ligament.
The muscles may be reckoned of
three kinds first Oblong as those of the
Arm, 2d. Convex as those of the Heart,
Stomach, Bladder &c. 3d. mixt as those of
the Abdomen the Pectoral muscles &c:
Muscles have their names from
their Origin, Insertion, Use Appearance &c:
Lect




Lecture 6th.
Of the Nerves.
The Nerves are now by every body
allowed to be a system of the vessels, and
they are a fasciculi of white fine fibres,
arising from the Medulla Oblongata &
Spinalis, egressing in pain.
Over the Brain are the Meninges, or,
1st. The Dura Mater which is externally, &
a thick vascular substance within this &
adhesive to the Brain is, 2d. The Pia Mater,
which is a thinner membrane; between
these two, some anatomists reckon another
membrane, extremely fine & reticular which
they call Tunica Arachnoides.
The Brain is divided into three
portions called, Cerebrum, Cerebellum,
and Medulla Oblongata, the latter 
being





being continued thro’ the spine of the back 
is called Medulla Spinalis.
The Brain is supposed to be vascular,
& its substance of two cortex; external of an
Ash color is called Corticalis; internal of a 
white color called Medullaris. The Nerves
are of the same substance with the Brain,
and are properly aportion thereof continued
to all the parts of the body. The Nerves
as they arise in pairs soon after decussate,
or change sides as in the Optic Nerves,
the left going to the right Eye, & the right
to the left; hence a wound, on one side of
the head affects the contrary of the body.
The Nerves are distributed thro' the
body in much the same manner as the
Arteries; the one proceeding from the Brain
the other from the Heart, but with this
difference
&





difference, that the trunks of the Arteries grow
less the more they are ramified together with
the ramifications ad infinitum; but the
capacity of a constituent Nerve never decreases
they being imperceptible, but the number of the
likes of the Fascicule decreases in proportion as the bundle
ramifies, thus the cords of the Nerves wc. as they
egress from the Brain contain an innumerable
number of constituent Nerves, decrease in No.
but not in capacity ad infinitum in proportion
as they are ramified.
The Nerves anastomose, but not in the
same manner as the blood vessels do, by
uniting their tubes but only by their coming
in contact with each other; these anastomoses
are called Plexuses. sometimes little knots
appear in Nerves called Ganglions, some
imagine these knots proceed from pressure &
inflammation, but this cannot be as they are
found




found in the Viscera, & in a Foetus where no
pressure could happen.
Lancesi, reckons the use of these Ganglions
is for an an additament to the Brain; because
he says more nerves go from them than go to
them, but from the substance of these knots
not being the same wth. the brain, that cannot
be. others think they serve to stop the nervous
fluid from flying out at the end of the Tube
without the impulse of the will by means
of muscular fibres, they being only in
those nerves destined for voluntary motion;
this also appears to be false.
The termination of the nerves is but
little known, but supposed to be in every
part of the body.
The use of the Nerves is for sensation,
motion, nutrition, &c: the Brain being called
the sensorium Comune to wc. the Nerves
carry all the sense communicated to them
Voluntary





Voluntary motion is acquired by experience,
as is evident from a child whose will is
frequently contrary to the Act performed.
Of the cellular Membrane.
The cellular membrane is of two kinds,
the one adipose containing fat, the other
reticular without fat; it is a net like
substance, vascular, very thin and tender,
consisting of many cells & its fibres very
fine: the cellular membrane is continued
throughout all the body, except some of
the viscera & is called by some the membrana
Musculorum Comunis. The cells of the
reticular part of the cellular membrane
communicate with each other, as is evident
from an Anasarca which is a transudation
of Phlegm into the cells, & so from the one to
the other, as is evident from the Legs swelling
by walking & subsiding when lying
down


x See the Londn: med: observations vol: 2


down; hence Eccymosis from a false
Aneurism, Diaeresis, Contusion &c: by
which the blood insinuates itself into the
cellular membrane; hence also the great
quantity of water evacuated from a
scarification in an Anasarca.
An Emphysema is a remarkable
proof of the communication of these cells;
this is caused by the air distending these
cells & often happens from a fractured
rib puncturing the Lungs by w.c the
Air gets into this membrane; a remarkable
instance of this happened in London,
by w.c the patient swelled to that degree that
his eyes could not be seen; Dr. Hunter x made
a puncture at the Eye by w.c the air gushed
out, & by puncturing & rubbing he was cured.
Putrefaction will cause an Emphysema,
from the fermentation generating air;
hence





hence a drowned person will after a while
rise to the surface of the water.
The fat contained in the adipose cells
differs in different bodies; in a Foetus
the fat is soft, and gelatinous; in children
of a year or two old, the fat is chiefly next
to skin; hence the fatness observed in
children; & in adults the fat is solid and
mostly internal.
The cellular membrane serves for
easy smooth motion, for a defence to the
body, to keep the parts warm & preserve
the figure of the body, & blunt acrimony.
some animals we reckoned to be
nourished in the Winter by their fat.




Lecture 7th
Of the Bones.
Here we shall, 1st. describe the external
conformation of the Bones, 2d. examine
their internal structure, 3d. their connection,
& 4th. Explain their use.
A Bone is a hard fibrous compact
substance. various Bones have various
shapes & conformations, some are cylindrical
& long, others flat, & broad, irregular &c:
bones are said to be made up of Fibres
forming Lamellae, fastened together by means
of oblique or transverse fibres.
Bones have processes and Cavities.
Processes have different names from their
different forms, & appearance: thus, a
Condyle is an oblong process arising from
the extremity of a bone; a Corone is an oblong
process





process terminating in a point; Spine is
the sharp ridge of a Bone; Supercilia is
a brim round a cavity; a protuberance is a
rough process of a bone. Processes are of
two kinds viz Apophysis, & Epiphysis;
Apophysis is a process growing out from
the body of a bone. Epiphysis is a process
growing to the body of the bone, being originally
separate therefrom  by a different Ossification.
The cavities in bones are of two kinds,
one for Articulation, & the other for the lodgment
of soft parts; cavities for Articulation are
of three kinds, 1st. Round & deep called Catyloid,
2d. round but superficial called Glenoid, and
3d, deep & narrow called Alveoli, the Articulation
of Bones is by Galen called [illegible] Joint
& by him is reckoned of 2 kinds, 1st. With motion
called





called Diarthrosis. 2d, without motion called
Synarthrosis; each of these are of 3 kinds.
Diarthrosis, are. 1st: Enarthrosis, 2d:
Arthrodia, 3d: Ginglymus.
Synarthrosis are, 1st: Suture or Raphe,
2d: Harmonia, 3d: Gomphosis.
The connection of bones is termed their
Symphysis, & is of two kinds: the one wth.
and the other without an intervening substance:
the first is that of the Cranium by mutual
Indentation. the second are of 3 kinds viz:
Synchondrosis, Syneurosis & Sysarcosis. 
Periosteum is an elastic fine membrane,
that covers the bones except at the joints teeth &c:
its case is for the insertion of vessels, to strengthen
the Epiphysis &c: the cylindric bones
are all hollow, & so are most others & contain
Marrow, the ends of the bones are cellular.
F Lect.





x see Edinburgh med: Essays.



Lecture 8th
Osteogonea.
In a Foetus, the first months, there are
no bones, nothing but a gelatinous fluid;
then it gradually grows cartilaginous, &
in time becomes boney; some imagine
Bones are formed of Cartilages only by
an expulsion of the redundant fluids;
but Dr. Nisbet x says, & it is now general recd.,
that in Ossification, there is in the blood, or
a fluid secreted therefrom, an ossifying
juice; consisting of particles wc. are not apparent;
that wherever nature designs an ossification
between membranes, or a cartilage she occasions
a more than ordinary afflux of fluid which
distends so much the vessels wc. were before
invisible as to make them capable of
receiving the red globules of blood wc. is always
to






to be seen near to where ossification is begun.
In this blood gritty particles are to be felt by
the point of a knife, which have been formed
by the attraction & cohesion of the particles
of the ossifying juice obstructed along with
the other grosser fluids in the beginning of
the vessels, prepared to receive the influent
juices. The membranes or cartilages some
as alied between wc. or within wc. the bony
particles are deposited or shoot; but without 
any any intermixture of the particles of the
bone & cartilage, or continuation of the fibres
of one substance to those of the other as is
evident in bones made perfectly clean, the
cartilage dropping from it as easy or easier
than an acorn from its cup, & there is a
smoothness of the parts of both cartilage
and




and Bone which show that there is no
conjunction or union of the fibres of the
two substances.
While bones are increasing within
Cartilages, the cartilages are extended
& spread out, by wc., with the pressure they
suffer & the great influx of various fluids,
& the nutritious matter being kindred to
flow freely into them, they decrease
continually & at last may truly be void
to be entirely destroyed.
Bones digested in Acids for sometime
grow flexible & gelatinous like a tendon,
by which it appears the great quantity
of Earth they contain makes them hard
rigid. Bones are furnished with Arteries
and Veins, as is evident from the drops of
blood





blood seen in sawing bones lengthwise, &
upon their appearing tinged of a red color
after the animal has eaten Madder.
Dr. Havers divides the blood vessels
into sanguiferous, & medullan the latter
enter the bones mostly near their
center in an oblique manner.
Bones have Nerves as is evident
from their exquisite sensibility where
amputated, or exfoliated, & granules of flesh
have sprouted out.
Diseases of bones are 1st: a softness & 
rickety disposition. appearing generally from [illegible] to the 3d.
year after birth, though the habit may continue thro' life.
It seems to be owing to an Idiosyncrasy or a want of bony
matter in the constitution. Sometimes it is said to arise 
from the pox & scurvy, but probably less frequent than from
the other cause. We have the history of a species of Scurvy
in France that affected the Bones & separated the Epiphysis.
In Anson’s voyage we are told the Callus of bones wch. 
had been fractured & united again for may years were disposed
by this Scurvy ~




Softness from a venereal Taint can be nothing more
than a Caries of the bone. the disease first affecting the
Periosteum & then communicating itself to ye. subject bone.
As to softness from Idiosyncracy as its called; or from
a particular state of the solids & fluids. Mr. Goodye furnishes
us with a history of a woman whose bones without any apparent
cause grew soft; her body shortened, & at last she died, & he
found that he could easily cut through the limp bone & all.
The academy of Paris give a more remarkable history of
a woman whose bones were so soft that at length they had
not solidity enough to gird  the muscles action—no kind of a
scorbutic or pocky taint could be observed. see Vanss 4h:423.
Mr. Gooch had a case of this kind under his care, when
the patient died he found the bones so soft that he split the
thigh bone, the Tibia & bones of the foot the whole length
very easily with his knife. Dr. Tilton of Dover relates the like
Bones may likewise loose of their bulk like other
parts from a loss of juices as in alveolar & vessels of old people.
2dly: Fractures. All bones have a tendency to
unite again after being disjoined w:ch is effected by means of
a Callus this was formerly supposed to be unorganized, but is 
now known to be vascular by injections & being tinged with 
madder. When a Callus is broke it will unite again only
to the opinion of some authors. A pupil of Dr. Haller’s
in a Thesis he wrote on the subject say that the Callus is
first a bloody matter, then slimy, next gelatinous & then
vessels from the bone & meditullium shoot out thro' it & ossifications
begin directing themselves quaquavenum & thus the
Callus


Lecture 9th
Of the Cartilages & Ligaments.
Cartilages are compact, opaque, & a little
elastic: of wc. there are 3 kinds, 1st: such as
supply the place of bones as the Nose,
Trachea Artena &c: these preserve the
structure of the part & admit of motion.
2d. such as supply the place of bones before
they are formed as in a Foetus. 3d.
such as serve for the Articulation of
bones. Cartilages differ from bones
in not having Fibres nor blood vessels
to be siphoned, tho’. they are imagined
to be vascular; they serve at the Articulation 
by their smoothness to prevent
abrasion; they won’t granulate nor
exfoliate but may be corroded.
Ligaments


is compleat. sometimes the bones won’t unite but with great
difficulty.
3dly: Caries. A caries in alone is similar to an ulcer
in the flesh it has circulation but it is unsound &
often shoots out irregularly as the fungus of an ulcer
See more so in med:[illegible] 2:h:k0 [illegible] [4?377].
4thly: Spina ventosa – this is a caries beginning
on the inside of the bone & affecting it clear thro', hence
Surgeons bow into the bone to let out the matter, but
in general the limb is to be taken off. See Van Swieten 4 p 377
A node by some is said to be an Exostosis of
the bone, but for the most part if not always it begins
in the Periosteum. should be open'd before it affects the bone
5ly: Anchylosis is a stiff joint having little
or no motion. from the bones running into each other &
the cartilages being eroded. Van swieten vol 4 p 457
gives several curious cases of Anchylosis of all
the joints in the Body. See also Le Bran’s
Surgery.
x where it covers the Cartilage. it is calld. Perichondrium 
the external lamina of the capsular ligament goes
from the substance of one bone to the other over the articulation
& is inserted beyond the Epiphysis &: Friction
6th. Exostosis is a tumefaction of a Bone
or an excrescence growing out of the bone. It
may proceed from a redundancy of ossifying particles
in the system or in the part only from a morbid
cause see Van swieten 4 p 424. See the case of 9: Scott 
of the Pennsylvania Hospital in my Adversar: med:
See Cheselden p 5.


Ligaments are firm, compact, unelastic,
membranes; serving to connect the joints,
prevent luxation &c:
The Ligament, Bones, Cartilages,
Tendons & Dura Mater are now reckoned
none of them to have much sensibility
in a natural state. v: Whytt & Haller
The capsular ligaments are very
strong & compact, & made up of hard
Lamella, the inner lamella being a 
reflected membrane going over the
head of the joint. cover the Cartilage x
& so coming to join the external lamella,
which is firmly inserted near the joint.
These capsular ligaments forming
a sac in wc. is contained, a mucilaginous
liquor serving to lubricate the joint:
for




for in all Joints; for motion there are synovial
glands which discharge the above
synovia, this is subject to be disordered:
1st. to become thin & Icorous, 2d thick and
inspissated &c:
It is generally received of late, that the
capsular ligament is lacerated in a 
Luxation of a joint unless from internal
cause, or a relaxation; & violent extension
is unnecessary in reduction of the same;
no more being necessary than to bring
the ends even, and then coax them
into their proper places, & there keep
them by proper dressings & bandage.
For as particular description of the Bones
vide Monro’s Osteology, and of the muscles
Douglas’s Myographia




Lect. 40th:
In the Osteology we divided the body
into three parts, viz: Head, Trunk, and
Extremities; the Trunk of the Skeleton
we subdivided into, the spine, Thorax,
and Pelvis, but in a fresh subject we
divide the Trunk differently, viz: into
The Thorax, and Abdomen, or upper, &
lower belly. The Viscera of the Thorax
are only the Heart, and Lungs, & therefore
not necessary to be subdivided.
The Abdomen is separated from the
Thorax by the Diaphragm.
The Abdomen by reason of its largeness
and the many Viscera contained
therein, has been divided into several
parts, by imaginary lines, for the readier
knowing the particular situation of each
Viscus. The divisions are as follows,
1st
G 


 


1st. That which lies under the Cartilage
Xyphoides, is called Scrobiculus Cordis,
2d. From the Scrobiculus Cordis down to
within 2 or 3 inches of the Umbilicus
is called Regio Epigastrium, circumscribed,
and on each side there of it is called
Regio Hypochondrium. 3d. From the
Regio Epigastrium to 2 or 3 fingers
below the Umbilicus is called Regio
Umbilicus, circumscribed, and each
side Regio Lumborum, 4th. From the
Umbilical Region to the Os Pubis is
called Regio Hypogastrium, and
on each side the Regio Hiaea 5th. The
lowest part is called the Regio Pubis.
As we are sometimes called to open
the body of a deceased person before
their friends, particularly if they died
of a violent death; we should endeavor
to




to do it with regularity & decency.
The antients opened the Abdomen by
beginning at the Sternum & directing
the knife along the False Ribs to the
Loins, then along the spine of the Ilium
to the Os Pubis; and laying the loose
part over on the contrary side.
Others begin at the Xephoid
Cartilage & make a straight incision down
to the Umbilicus, then dividing the incision
directing one to the spine of the right, &
the other to the spine of the left Ilium,
and turning each part back.
But the best method is to begin
the incision at the Xephoid Cartilage
and going straight down to the Olsa Pubis
and then another transverse from the
Navel to the Loins each way.
The Thorax is opened by pushing off the
Teguments & Cutting the Cartilages by the Sternum.
Lect.



All the internal superficies of the cavity of the
Thorax, the ribs, cartilages of the ribs & convex side of the
Diaphragm except where the pericardium lies in contact wth.
it are lined with one continued, thin, nervous, very strong
membrane, internally very smooth called Pleura.
On the external superficies of this every where is the
cellular membrane wc. in very fat animals is often so enlarged
with fat as to lessen the capacity of the Thorax & these cause
a shortness of breath.
The Pleura when it gets round to the vertebra elevates itself
perpendicularly lowd. frenum wc. with the one on the other side
from a doable pleura called Mediastinum dorsale.
The same duplication is made of the Sternum when it is
called mediastinum pectorale.
The pleura likewise covers all the muscular circumference of
the diaphragm above the cellular membrane wc. arising up together
with the orb of the septum from the back sternum, from
the external membrane of the pericardium wc. is the third
cavity of the Thorax in the middle between the 2 cavities of
the pleura containing the Lungs & formed a conjunction of them
This membrane of the pericardium is lined internally with
a thin membrane wc. is a branch of the external membrane of
the Heart. The great vessels from the Heart as they pass
thro' the pericardium & go on beyond it or move also at above
the cellular one from the external membrane of the pericardium.
this membrane forming about to the pulmonary arteries & using wc. 
when they arise at the Lungs is expanded out & forms the extenal coat
of the Lungs. Kaan de Perspi Hippocrat. 


Lect. 41st:
Of the Pleura.
The Pleura is a fine membrane, which
lines all the cavity of the Thorax and
is reflected back over the Lungs.
There are two Pleura one on each
side, like two bladders beginning as we may
suppose at the sternum and going round
within the Ribs to the Vertebra of the
Back, then reflected back upon the
outside of the Lung (making the coat
of the Lungs) to the sternum; there
running in or uniting with the first
Fibres of the same and so on the other
side; where the two Pleura meet at
the sternum; they are not quite in
contact with each other, but there is
a small space left between which is
filled up with cellular Membrane.
Of


Constat pulmo duplici vasorum genere,
aerifero scilict & sanguifero.
Aerifera omnia vasa ortum ducunt ex una
trachea, quo mox a faucibus intitium capiens,
ante oesophagum, descendit, thoracem post
thymum intiat; post cavem descendentem & pericardii
apicem, as quartam thoracis vertebram, qua
est a superiore una tertia pars ipsius pulmonum
longitusinis divaricatur.
Hujus dein crura tendunt ad utrumque pulmonem,
& statim dividuntur, in homine dextrum in tres,
sinistrum in binos ramos, qui tune bronchia dicuntur,
as totidem pulmonum lobos, quos ubi ingressa funt,
disperguntur statim in ramos minores, & minores;
qui omnes ad obtusum angulum, respectutrancorum,
oviuntur.
Remi autum majors ingressi pulmones, pro
maxime parte, descendunt, pauci recti procedunt,
ubi ingrediuntur; aliivero adscendunt aeriferorum
truncorum, & horum ingressum est. quod
prater Eustachium meminen observasse video.
Ultimi


Of the Lungs.
The Lungs are Vascular Substances
composed chiefly of Air Vessels, and
Blood Vessels; the Air Vessels are
Ramifications of the Trachea Arteria,
and are called Bronchia; the blood
Vessels are ramifications of the Vena
and Arteria Pulmonalis; beside-which
they have an Artery wc. serves
to nourish them, called the Bronchial
Artery coming from the Ascending
Aorta together with Nerves and
Lymphatics, and some say also
Parenchyma which is perhaps no
more than cellular Membrane.
Some Anatomists suppose there are
little follicles or cells at the extremity
of the small Bronchial Vessels, which
if there is are not discernable.


Ultimi autem ramuli ommitunt cartilagineam
indolem, & expanduntur in vesiculas oblongas,
membranaceas, cavas, qua Malpighiana dicuntur,
ox quibus fiunt area, & lobuli, qui tandem pulmonum
lobos efficiunt.
Comitantur aerifera hac vasa, in omni decurser,
ad vesiculas usque, vasa Sanguifera, qua omnia
oriuntur ex arteria pulmonali, qua cordis dextro
ventriculs egressa, qua parte superiore ventriculs
sinistro jungitur, adscendit, mox se incurrat, arcum
facit, & sub aorta decumit. Descendit
The inside of the Trachea arteria is lined with a
membrane in which are small glands that secrete mucus 
for lubricating the its internal surfaces; in cold, this means
is sucked into great quantity—sometimes inspissated 
is spit up very thick especially in the morning.
Dissection has taught us that this membrane is the
seat of that disease in children called the Hives & is
found separated from the cartilages – nothing proves so useful
in this disease as large doses of 8. I have known 10 g of calom: given to 
a child 2 years old produced 2 copious stools & disease immediately vanished


The Lungs are divided into two Lobes,
by means of the Mediastinum and
Heart. The right Lobe is divided into
three Lobuli by fissures; and the
left Lobe is divided into two Lobuli.
In a natural state, the Lungs are
every were in contact with the Ribs,
so that there is no vacuity left.
The Trachea Arteria is composed of
cartilaginous Rings, which behind are not
quite shut but a small membrane between;
each of the cartilages are connected likewise
by membranes.
The Lungs are liable to inflammation,
and Ulceration. In inflammation of the
Lungs we should use plentiful bleeding,
oiluants, fomentations externally and
the steams of warm liquors particularly 
Vinegar, into the Lungs thro' the mouth.


x The ventricles are divided by a middle partition
called Septum Cordis.


Lect. 42d:
Of the Hearts.
The Heart is a strong muscular substance,
situated obliquely to the left
side, more than the right; part of the
inferior and or Apex in contact with
the Diaphragm, and pointing between
the sixth and seventh Ribs on the left
side; the Apex being likewise nigher
the sternum than the Basis.
The Heart is the Origin of the Veins
and Arteries.
There are four cavities in the Heart,
two Auricles, and two Ventricles; x one right
and one left, at the right Auricle the
Vena Cava enters, and at the left: the
Vena Pulmonalis; at the right Ventricle
the Arteria Pulmonalis egresses, and
the Aorta from the left.
M


x these cordae Tendineae arise from the Carnae 
Columnae.

At the entrance of the Vena Cava into
the right Auricle of the Heart are three
Valves called Valvula nobilis, and about
the middle of the Auricle there is a little
knob called Carna Sesamoidea: At the
entrance out of the right Auricle into the
right Ventricle and two valves called Valvulae 
bicuspides, connected by sou:e small tendinous
cords called Cordae Tendineae x; the internal
part of this Ventricle is rough & muscular
having many muscular Pillars, called
Carnae Columnae which serves for to
strengthen the motion of the Heart
and to work the blood so as to prevent
its concretion & forming Polypuses,-
which however sometimes happens.
After the blood has passed out of
the right Ventricle into the pulmonary Artery
it is prevented from returning by three
valves




Valves named Valvulae Semilunares.
There are likewise Valves at the
entrance between the left Auricle and
Ventricle named Valvulae Mitrales
fastened by the final Cordae Tendineaes
on the left side of the Heart.
The left Ventricle is larger and a
stronger & much thicker muscular bag
than the right Ventricle, its internal
part tougher and the Carnae Columnae
bigger. As the entrance out of the
left Ventricle into the Aorta are likewise
three Semilunar Valves.
The Heart is contained in a strong
Membranous bag called Pericardium
the internal part of which bag is very
smooth and lubricated with a juice
that continually transudes through the
same
H.




Same
Dr. Plott in  his History of Staffordshire
attests of his own knowledge the case of one
Mary Eagle who drew two quarts of
milk from her breasts every day besides
what her child sucked and that she
could make two pounds of butter
every week ever since she was
brought to bed which was above
five months when the Dr. saw her.
Borellus in his Hist: & Absence:
physioc-med: related an instance of
the like native in one Mary Caron
a Taylor’s wife of Bologna who afforded
milk enough for two children & made
Butter besides
Biog Dictionary Led: Esq:






Lect. 43d:
Of the Diaphragm
The Diaphragm is a large Muscle
between the Thorax and Abdomen, the
muscular fibres of which arise from the
internal part of all the ribs below the
sternum, and from the lower end of
the sternum, these fibres terminate in
a tendinous expansion which is nearly
in the middle of the Diaphragm, and
which is of an oblong figure coming
very nigh the sternum upon which
part the Apex of the Heart lies, and
from thence turning down towards
the Angle of the Ribs and is called
the oval tendon of the Diaphragm
the lower part of the Diaphragm is
likewise muscular and on each side
of the Vertebra are muscular Fibres
sent





Sent down some distance called the Crura
of the Diaphragm, these terminate
near the Origin of the Psoas muscles
which arise at the internal part of
the Vertebra of the Loins and pass out
of the Abdomen at the Inguen to be
inserted into the Os Femoris. it is
by making way through these muscles
that Abscesses of the Loins sometimes
fall down to the Thigh and are opened
and discharge their contents there.
There a three Apertures thro'
the Diaphragm, one of the right side
of the Vertebra through which the
Vena Cava goes, a second contiguous
to the Vertebra inclining a little to the
left thro' wc. goes the Aorta, a third
over the Aorta & exactly over the Vertebrae
through wc. the Oesophagus goes.
Of





Lecture 44th:
Of Respiration
Respiration is an alternate dilatation and
contraction of the Thorax the former performed
by Inspiration and the latter by Expiration.
The parts subservient to Respiration
are divided into Active and Passive
The active parts are the Ribs, Sternum,
Heart &c: acting upon the the passive
which are the Lungs themselves.
The dilatation of the Thorax happens
both in length and diameter; in length
by means of the Lungs pressing upon
the Diaphragm and thereby rendering
its convexity more plane, the diameter
is increased by the motion of the
intercostal muscles &c: Thus the
capacity




Capacity of the Thorax is increased
and as there is no vacuum between
the Lungs and ribs allowed of in a
natural state, the capacity of the Lungs
will also be increased and there will
be a vacuity in the Lungs wc. nature
not admitting of and by the pressure
of the Atmosphere rushing through
the Aspera Arteria they are soon
filled with Air making Inspiration.
The fresh Air that is drawn in
by Inspiration stretching the Bronchiae
and stimulating the same cause
them to contract and expel the Air
making Expiration, some Authors
imagine these are small Muscles
between




Between the cartilaginous Rings of
the Bronchiae which they call Musculi
Mesenchrondroeci serving to contract the
the same in Expiration.
The uses of Respiration are four,
1st For the circulation of the Blood, thus
in Inspiration the Lungs are distended
and the fine contorsions of the Arteries are
are elongated so as to allow, blood to pass
through them whereas in a collapsed state
the blood cannot pass through them.
in Expiration the Lungs collapsing push
the Blood through the Veins into the left
Auricle of the Heart.
2d. For sanguification by communicating
the Blood making it more florid & denser
3. For cooling the blood
4th. For Vocification, exclusion of [illegible] &c:




Of the Peritoneum
This membrane is similar to the pleura, being smooth
on one side & connected by cellular membrane on the other; it is
reflected from the contained path to the containing. It makes
a compleat bag 1st: covering the viscera by intimate connection,
& then covering the abdominal muscles loosely on the
inside. The peritoneum has been considered
as a double membrane true or false, the last is no
more than cellular membrane wch. connects the peritoneum
to the external parts. We may conceive that all
the viscera are behind or without the peritoneum, wch. 
running up on one side of a viscus is reflected back
on another so as to form an almost compleat 
cover to each viscus separately, so that by a very
nice dissection the peritoneum may be taken out
in a compleat bladder having no perforation at
all, leaving all the viscera undisturbed.




Lecture 45th:
Of the Stomach
The stomach is a large muscular bag
situate Obliquely from the Left Hypochondrium
to the Epigastrium and serves for
the reception of our food & digestion of
the same, it has an upper & lower curvature
called the lesser and greater curvatures
of the stomach.
There are two Orifices to the stomach;
the superior one called the Cardia which
enters it from the Oesophagus don't open
at the fundus of the same but obliquely,
at the side an inch or more from the
end. Towards the inferior end the
stomach grows smaller & turns up
opening into the Duodenum by an
Orifice called the Pylorus where there
is
J


The Nerves of the stomach come from the
par vagum.



Is a partial kind of a valve which does not
prevent the regurgitation of fluids into
the stomach being only a thickness of
the internal coat of the stomach.
The stomach is furnished with
Nerves and blood vessels. x
Some Anatomists say there are
small glands in the stomach, but if
so they are not easily discovered, there
is however a fluid discharged into the
stomach from the extremities of the
Arteries called the Gastric lymph
from the gastros the Greek name for the
stomach, there is likewise Lymphatics
which absorb the redundant fluids
& carrys it into the blood.
The coats of the Stomach are three
1st. coming from the peritoneum and is
called




called the Peritoneal Coat. 2d. Muscular
being composed of thin muscular fibres
running longitudinal and transversely
by which the capacity of the stomach
is decreased the readier, to expel its
contents. & 3d: Villous or internal Coat
which is thin.
Of the Intestines
The first Intestine next the stomach
is the Duodenum beginning at the
Pylorus and ascending two or three
Inches, has then two or three inflections
pulsing down & across the Vertebrae —
being all the way tied fast by a
duplicature of the Peritoneum to the
back, having no mesentery.
The Ductus Choledocus & ductus
Pancreaticus both enter the Duodenum
several




Several inches from the Pylorus, not
both by one Orifice but by two very
near together, next the Duodenum is
the Jejunum, & then the Ilium which
is the last of the small instestines.
The coats of the Intestines are
three the same as the Stomach, and
in the small intestines are anular
duplicatures of the internal Villous coat
forming what is called Valvulae Coniventes
which serve for two purposes, first to
make the passage rough & prevent
the Faeces, from passing on too fast
and secondly to give more capacious origin.
to the Lacteals
The Ilium enters the Caecum 
not at the end but about an Inch
there from obliquely the blind end only
being




Being called Caecum, where there is
an appendage called Apendicula Vermiformis.
At the entrance of the Ilium
into the great Intestines, there is a
Valve formed by the inner coat of the
Colon & called Valvula Colli which
in a sound state entirely prevents the
regurgitation of the Faeces or any fluids
passing, injected per Anum.
The Colon runs up the right
side then along under the stomach
and down the left side, surrounding
all the Abdomen, hence Clysters
beside discharging the Faeces serve
the purpose of a fomentation to the
contents of the Abdomen.
The Intestines are furnished with
blood vessels from the two mesenteries 
except


 


except the Rectum which receives
its from the Hemorrhoidals.
The Mesentery is a double membrane
formed by a duplicature of the Peritoneum
serving to connect the Intestines. & through
which which the blood vessels go to be distributed
to the Intestines, through it
likewise goes the Lacteals which are fine
Lymphatic or absorbent vessels arising
from the villous coat of the Intestines
and passing through the mesentery, they
terminate in the Receptaculum
Chyli, to be described hereafter, there
is also a great number of Glands in
the Mesentery through which the
Chyle passes, and by which it is
supposed to receive some alteration.
These glands are very small.




Lect. 46th
Of the Lacteals & Thoracic Duct
The Lacteals are an innumerable number
of small vessels arising as before said
from the villous coat of the Intestines &
running through the mesentery in the
duplicature of the same and through
many fine glands and terminate in the
Thoracic Duct serving to convey the Chyle
The Thoracic Duct is a small
canal running up the Vertebra of the
Spine between the Aorta & Vena Azygos
and under the Vena Cava until it gets
above the Heart then it turns a little to
the left and ascending empties itself in
to the subclavian Vein.
The lowest end of this Duct has been
called Receptaculum Chyli but improperly
as its no larger than the rest of the Duct
neither do all the Lacteals enter there, but some higher






Of Digestion
Digestion is that change of the Aliments
whereby they are filled for the nourishments
of the body, this is different from the
different juices mixed therewith and in
the different parts of the body.
The first change that happens to the
Aliments is in the mouth by means of
Mastication and mixing with the Saliva
by which it is somewhat dissolved and
fitted for more easy Deglutition
Saliva is a clear mucous transparent
fluid secreted by the Glands of the
Mouth in the great plenty, and is of great
use in digestion.
After the Aliments is sufficiently
masticated & mixed with the Saliva they
are by the Tongue pressing against
the roof of the Mouth forced into the
Pharynx




Pharynx and from thence through the
Oesophagus into the Stomach. The
Muscles employed in this act of deglutition
are very many, serving chiefly to
pull up the Oesophagus and to press the
food down through the same, and we
may very well conceive of the act of
Deglutition by that of drawing a stocking
on the Leg, part of the muscles drawing
up the Oesophagus as we draw up
a stocking upon the leg, and the rest
pushing down its contents as we push
down our leg into a stocking.
The manner in which our food is
digested in the stomach was by some
of the Antients reckoned to proceed from
heat
K




Heat, others reckoned it was performed
by means of trituration, and others again
from the different juices there mixed
imagined it was performed by Fermentation,
but modern Physiologists from
many observations, think it is performed
by all three jointly viz: Heat, friction
and Fermentation.
After the Aliments are sufficiently
digested in the stomach, by the contraction
thereof which is the beginning of the
peristaltic motion of the Intestines, they
are forced through the Pylorus into the
Duodenum, where it continues some
time and receives another change by
having the Bile and pancreatic juices
mixed therewith.
The







The Bile is an oily bitter, and attenuating
substance endued also with
a saponaceous virtue it will incorporate
with Oils and when so mixed they are
both soluble in water, it unites with
salt forming a green color. by which
it appears that the Bile is of great—
use in attenuating the viscid part of
the Aliments, and stimulating the—
Intestines, the latter we are assured—
of by this that Bile secreted and—
discharged into the Intestines in too great
a quantity causes a Diarrehea, and in
a Jaundice where the Bile returns into
the Blood and is not sent into the
Intestines a Costiveness happens
with while stools, and Boerhaave
says






Says the Gall of Animals is of use
in this case to supply the want of Gall
DeGraaf collected great quantities
of the Pancreatic juice from Animals
which he says is subacid it is reckoned
to be somewhat of the nature of the
Saliva, some reckoned it serves to
sheath the Acrimony of the Bile but
this in a natural state is not too Aerid
These two fluids being mixed with
the Aliments in the Duodenum the
fluid and nutritious particles of the
same are absorbed by the Lacteal vessels
and by them carried into the Thoracic
Duct to be conveyed into the Blood.
These Lacteals are in all the intestines,
but in the small ones in the 
Greatest 




Greatest plenty, That there are also
Lacteals in the Colon seems evident
1st. From the rout the colon makes round
the Abdomen, for if that is not for
absorbing the particles that may chance
to be not taken up by the vessels in
the small Intestines why did it not
go out strait like the Rectum and
immediately terminate in Ans?
2. From persons being known to have
lived a long time by Glysters, not being
able to get any thing thro' the Oesophasgus,
& it is known that they cannot
pass by the Valve of the Colon.
The contents of the Intestines are 
carried along by the Peristaltic motion
thereof




thereof. Vomiting is an inversion of
the peristaltic motion and is performed by
means of a deep inspiration which presses
the Diaphragm against the stomach &
a convulsive contraction of the stomach
by which its contents are thrown up
hence we learn that Emetics are good
in Fluxes by inverting the peristaltic
motion they stop the same.




Of the Bile
Bile is secreted in the Liver. It is
8 times as viscid as water. More
subject to concrete than any other
humour in the body. Its specific
gravity to water is as 010 to 795.
In a such quadrupeds & in the human
species the bile is very bitter, but
most so in carnivorous animals.
Recent bile easily mixess with water.
It mixes with oil by triture. Mixed
with water it partakes of the property
of Soap, dissolves oil so that it will
mix with water & takes out grease
spots. It dissolves resins & mixes
with balsams. It dissolves Myrrh
Bdellium & Wax like the yolk of
an Egg, & is supposed to dissolve
the Blood when mixed with it as
in a Jaundice.




The Ductus Choledochus may
may be compressed & stopped by
the Duodenum being distended with
flatus. Eating Mushrooms has
been known to distend the duodenum
greatly & trangulate the ductus
choledocus as it were with a
ligature. It may also be obstructed
by the contractions of the fibres of the 
intestine from stimuli as happens
in the Colica pictonum, biliosa,
inflammation of the duodenum, acrid
purges, glass of Antimony & poisons.
Hither we may refer the Jaundice
in Infants which is removed by
Rhubarb. Storck has seen the ductus
choledochus obstructed with a cheesy
coagulum. Hillary says this is
frequent in the warm Islands.
See Monro Ed: Ess: v. p 247 Baglivi
prax: med: Haller tom: 6. p 590


x about 4 fingers breadth below the pylorus.


Lect. 47th Of the Liver
The Liver is a large Viscus situated
immediately under the diaphragm mostly in
the right Hypochondrium extending over the Stomach
into the Epigastrium it is convex
above and concave below suspended by three
Ligaments one above to the Diaphragm one
broad on the upper part of the round ligament
from the Umbilicus which was the Umbilical
Vessel in a foetus state. There are several
fissures in the Liver 1st. Divide the great lobe
from the lesser one. 2d. divides the Lobulee
spigeli & the third where the Hepatic
Vessels enter;
The Vesica Fellis lies in a depness in
between the two lobes of the Liver from
where goes a duct remarkably contorted to
appearance about two inches when it joins
the hepatic duct, both of them united
form the Ductus comunis Cholidochus
which terminates in the Duodenum. x
The Coat of the Liver comes from
the
L

x sometimes called Tunica Glissoniana
*The hepatic Artery divides a little before it enters the
Liver one branch going to one lobe & the other to the other
Lobe; it serves to nourish the liver & is said to secrete a
small part of the Bile, some few of its evanescent frame has
terminating in the pori biliarii as is proved by injections.


The Peritoneum x beside which some Authors
describe another coat wc. is scarce to be
seen, The Gall Bladder has three coats
1st. from the Peritoneum, 2d: Muscular
& The 3d. Villous, appearing like a honey
comb inside. The Liver is furnished with
Veins Arteries & Nerves.
The Blood Vessels are the Hepatic *
Artery & Veins & the Vena Porta.
The Vena Porta is like an Artery first
in its Office & 2dly. in the thickness of its
coats; it arises from all the Viscera of the
Abdomen terminating in the Liver and
is supposed to carry the blood for the
secretion of the bile, 1st. From the longness
thereof & the smallness of the hepatic Artery.
2dly: By injections passing from it
into the biliary Duets &c:
It is certain however that the blood
being carried into the Liver, part of it is
converted


x The general opinion of the ancient
Anatomists was that the bile was conveyed
into the Gall Bladder by little ducts
running from the liver immediately
into the bladder which they called
ducti hepaticistics. Pechlin was the 
first who denied the existence of these ducts
in the human body, then Ruysch,
Cowper, Bidlow, Berger, Morgagni,
Heister, Ludwig, Carsons, Lieutaud, Ceyer,
& Cheselden. who says if a ligature be
applied round the cystic duct, or if it
be obstructed the gall bladder does not
become turgid. Bohnius emptied the
gall bladder of bile then tied a ligature
round the cystic duct & upon examining
the same several days afterwards found
no bile in the cyst itself but the part of
the duct between the ligature & liver was
greatly distended. Bianchus & Haller
have done the same. This clearly proves
that there is no communication between the
Liver & Gall bladder but by the cystic duct.
What was supposed to be Hepatocystic ducts
is demonstrated to be only blood vessels
by Ruysch, Guntz, Haller Morgagni & others.


converted into Bile & carried by the pori
Biliarii which all meeting together form
the hepatic duct though the hepatic duct
to the cystic then regurgitates into the Gall
Bladder; that the Bile regurgitates thus x
into the reservoir is proved 1st. by there being
no other passage though some supposed there
was by little ducts wc. they called cysto hepatic
ducts, but there is no such is evident from
the injections not passing through that way
 into the Cyst, & in a Viper the Gall Bladder
is vitiate some distance from the Liver.
Horses & Deer have no Gall Bladder.
That the Bile goes through the hepatic Cystic
Ducts into the Gall Bladder is proved 2dly:
by blowing into the hepatic duct the wind
passes free into the cystic than through
the ductus cholodochus.
The remainder of the Blood is received
by the Veins & carried back to the Heart
Diseases


x more frequently if not always the Jaundice
arises from an obstruction of the
Ductus communis Cholidocus
An obstruction of the cystic duct
alone will not occasion a Jaundice.


Diseases of the Liver are:
1st. Hydatides these are of two sorts
the first tumors composed of several lesser
cysts filled with a gelatinous matter, the
other a kind of vascular Cysts, the fluid
circulating through it.
2d. Inflammation this is best relieved
by plentiful bleeding warm relaxing and
stimulating applications &c: It sometimes
suppurates & even grows cancerous.
3d Scirrhi like other Glandular parts
4th. It gives origin to the Jaundice wc.
proceeds from an obstruction in the Cystic x
duct by wc. means the Bile is prevented
from going into the Gall bladder and
therefore returns into the Liver where it
is absorbed by the Veins or lymphatic
Vessels & carried into the blood & by that
means tinges the shin, the cystic duct
may be stopped by concretions tumors compressing
the




The same or more commonly by means of a
stone lodged therein: a stone or concretion
is best removed by Vomits which agitating
the parts serves to remove it or by friction
stimulating the same.
Some have imagined that a Jaundice
proceeds from a scirrhus Liver, but this
is proved to not be the cause as no Jaundice
can be unless the bile is absorbed after
it is perfectly made
Transient Jaundices sometimes
happens to Children from a spasm of the
Duodenum from acidities or otherwise
hinders the Bile from passing therein &
which is relieved as soon as the spasm
is removed.
Durable Jaundices happen when
the Obstruction of the Cistic duct cannot
be removed
Lect. 40th:
Pancreas is a long slender conglomerate
Gland situate obliquely under the stomach
between the spleen & Duodenum. each
little


x Haller supposes the pancreas secretes three times
as much fluid as the salival Glands.
* a costiveness and a pain in the region where this
gland is seated is the common symptoms of its being
obstructed.


little acini or knot supposed to be the extremity
of an Artery wound up in a knot and
the whole vascular like the liver and all
the other Glands of the body. from each
acini goes a small excretion Duct which
terminates in a larger duct in the middle
of the Pancreas & called the pancreatic
Duct & through which the pancreatic
juice flows into the duodenum, the
glands of the pancreas being the same
with those that discharge the Saliva
are supposed to secrete the same juice
and for the same Use. x
Diseases of the Pancreas are
Inflammation, Cancer, & Schirri, which *
are very difficult to be known until past
cure they are however removed much
in the same same manner as the same
Diseases on other parts, Soap is a very
good thing in this case which not only seen


x This appears very reasonable though it was
never taken notice of by any author before Mr. Monro.


Is a good resolvent but supplies the place
of this juice in digestion.
Sometimes a Diarrhea happens in a
Salivation and proceeds from a too great a
secretion of the pancreatic juice which being
the same with that of the saliva is supposed
to be effected in the same manner with
Mercury & is only to be removed by removing the cause. x
Omentum is a fatty double membrane
composed or formed by a duplicature of
of the Peritoneum it has an appendage
between the Liver & stomach called the
Omentum minor & may be inflated.
Uses of the Omentum are to lubricate
& keep the Intestines warm, and it is
supposed to supply oily particles to the
Bile and also the blood.
It is sometimes much distended with
Fat and in very lean subjects quite
reticular. Spleen




Of the Spleen
The Spleen is a roundish lobulated
Gland situated in the left Hypochondrium
it is furnished with blood Vessels and
but very few Nerves.
The Antients supposed its use
was to counterbalance the Liver, others
thought it contained a fluid called the
Atrabilis, but the moderns mostly
think that it is subservient to the
Liver, it has been taken out of several
animals without any apparent damage
and is not therefore a vital viscera.
It is subject to very few diseases,
scarce ever being inflamed schirrius or
cancerated, by reason of the fewness
of the nerves, its only subject to a
viscidity of its fluid and an enlargement
therefrom.
Lect.


x The arteries generally divide into three branches
and the vein into two before they enter the Kidneys.


Lect. 49th
Of the Kidneys
The Kidneys are two Glandular bodies
situate between the false ribs & Ilium.
the situation of the right Kidney is somewhat
lower than that of the left oweing
to the Liver being on that side. The
blood vessels of the Kidneys are an Artery
and a Vein called Renales or Emulgents
the right emulgent Artery is longer than
the left & the left Vein than the right.
These vessels enter at the Pelvis and
are distributed through the same. x
The external part of the Kidney is called
Cortical the thickness of which is irregular
and in this the Urine is secreted and
emptied into little ducts in the inner
part  
M


x the pelvis is an enlargement or expansion of the
of the upper part of the ureter where it enters the
Kidney or rather where the united urinary Tubes regress
out of it.


part of the same, which is called the
Mamillary part of the Kidneys.
The little ducts into which the Urine
is secreted are called Tubuli Urinarii
and are in number about a dozen,
these all unite in the Pelvis x forming the
Ureter which is a membranous canal
conveying the Urine from the Kidneys
to the Vesica Urinaria. The Ureter
as it enters the Pelvis of the Kidney
divides into three parts one going towards
each end and the other through
the middle. The coats of the Kidneys
are two, the first called Adipose and the
second Membranaceous.
There is an appendage to the 
Kidney called Glandula Renales or
Gland




Glandula Succentriari situate at the
top of the Kidneys its particular use
not known but supposed to be subservient
to the Kidneys.
Diseases of the Kidneys are,
Inflammation, Diabetes from a too
great laxness of the Vessels allowing
the red particles of the blood to pass
through them, gravel, Scirrhi &c:
Lect. 50th:
Of the Bladder
The Bladder is a membraneous Bag
situate in the Pelvis the upper part of
which is covered with the Peritoneum
but when it is very much distended it
protrudes about an Inch above the
Pelvis & being there covered with the
Peritoneum




Peritoneum & in this place is the upper
Operation for the Stone performed by
making an Incision into the Bladder
without cutting the peritoneum the doing
which would be of dangerous consequence.
The coats of the Bladder are three,
1st: the common coat 2d: muscular and
3d: Villous, the muscular coat at the
neck of the Bladder is thick & circular
and is called Sphincter.
The Ureters enter the Bladder one
on each side about an Inch from the
neck thereof by a small Orifice obliquely.
The situation of the Bladder is between
the Rectum & Olsa Pubis in men and 
between the Uterus & Pubis in women 
its use is a Reservoir to the Urine




Parts of Generation
Lect 51st
1st In a Male.
These are the spermatic Cord, Testes
Scrotum, Vesica Seminales, Prostate
Gland, and Penis.
The spermatic cord is composed of
the spermatic Artery and Vein, Nerves,
Lymphatics, & Vas deferens all included
in acellular coat and some have
supposed a muscular wc. they called
Cremaster wc. is not visible except where
it passes out of the Abdomen wc. it does
in an oblique manner through the rings
of the Abdomen, by which the Intestines
and Omentum sometimes falls thro' 
forming an Herniae Inguinalis or Jerotalis
along the side of the spermatic Cord
The


x Caput Gallinaginis


The vas deferens empty themselves somewhat
like the biliary ducts there being a passage
from them immediately into the Urethra, but
it commonly regurgitates into the Vesicula
Seminales & there kept till used.
Vesicula Seminales are two Glands situate
under the neck of the Bladder, composed of
little cells which communicate with each
each other, being reservoirs for the semen,
from each of these there goes a small duct
which opens into the Urethra at the 
Caput Galaginis, x where is a large Gland called
the Prostate Gland which secretes a fine
mucus to defend the Urethra from the acrimony
of the Urine.
The Scrotum is composed of skin Cellular
Membrane &c: next to which has been reckoned
a muscle called the Dartos which is not to be
discerned




discerned, and the first obvious Coat
is that wc. surrounds the Testicle much
as the Pleura or Peritoneum does the
contents within them this is called the
Tunica Vaginalis propria Testes, and
within that is a coat which adheres to
the substance of the Testicle called the 
Tunica Albuginea,
The substance of the Testicle is
wholly Glandular, the spermatic Artery
entering in at the side of the same and
distributed through the same terminating
in fine secretory ducts and these again
in excretory ducts which uniting into one
form the Vas deferens, The Epididymus
is an Appendage to the Testicle formed by
numerous convolutions of the excretory duct,
reckoned 6 times as long as the Spermatic Cord.




Lect. 52d:
Parts of Generation in Females.
These are either external or internal, the
external are the Mons Veneris on which
hair grows at a certain age
Labia or External Lips of the Orifice
at the upper part of wc. is a small body
called the Clitoris under which in a
small groove is the Iter ad Urinam
thro' which the urine passes & into which
the Catheter must be introduced in a
suppression of Urine, & we should be well
acquainted with this Orifice as the modesty
of women often denies us a sight of the
part, so that we must introduce the Catheter
by feeling, at the lower part where the
Labia unite is formed a Fraenum or
Fushet or Foushette.



x Iter externum ad Uterum



Nymphae are two spongy bodies
within the Labia within these in Virgins
is a circular membrane called Hymen
within these is the Iter externum ad Uterum x
Vagina is a membranous substance
furnished with rugae by wc. the Penis is
more titillated in Coitus, there is likewise
many small glands in the Vagina wc.
secrete a liquor to lubricate the same and
during the Venereal orgasm whether real
or imaginary there is sometimes so much
mucus secreted by these glands that
it has been discharged, in great quantities
so as to wet all the external parts, this
by some is reckoned the Female semen.
At the bottom of the Vagina is the
Iter internum ad Uterum, the Os Uteri or
Os Tincae. N Between


x or young Puppy



Between the Fushet and Anus, there is
a seam called Perinaeum, this in
difficult deliveries is sometimes lacerated
by the largeness of the Foetus & it is
necessary to prevent this accident for to
support the Perinaeum with the hand
while the Foetus advances
Uterus is a small body situate
obliquely between the Bladder & Rectum
its coats size near half an Inch thick
& its internal cavity very small; the
Neck of the Uterus is full of rugae wc. 
serve to allow the same to dilate for the
expulsion of the Foetus. The Os Tincae
resembles the mouth of a Tench x situate
at the bottom of the Vagina tho' not a
continuation thereof the Vagina being
inserted



x An demande si le corps de la matrice
etant renverse, & ayant tente inutiliment
va induction, elle montroit quilque
disposition a ve gangrener, e il conviendroit
pour lors de l’eactirper, apris
avoir porte une ligature le plus haut
qu’il veroit possible. En parsil cas
on ne devroit point balancer de faire
cette operation pour empecker que la
gangrene faisant du progres du cote
des parties interieures, elle ne causat
la mort a la malade. L'extirpation
de la matrice, quoique rare, never sit
point en cette occasion une operation
temeraire, son succes etant prour a
par plusieurs observations
Verdeer's Anal: v: 22 p 66
Rousset, dans son Traite de
Partes Caesares, dit qu'une femme
a la suite de pluesieurs accouchemens
laborieux, eut une precipitation de
matrice qui ne pouvant etre


inserted round the Os Tincae. From the
Fundus of the Uterus there goes off nearly
transversely on each side, a tube called the
Fallopian Tubes lying loose & growing
larger toward the further end wc. is fimbricated.
The Uterus is suspended by the
ligament lata & rotunda x
Ovaria are two glandular bodies
situate on each side of the Uterus inclosed
in cellular membrane in each of these
Ovaria are near 20 small Ova
Of Generation
This is perfomed per Coitus by the
Male’s introducing his Penis into the
Vagina, & perhaps into the Os Uteri tho'
this is denied by some at which time the
parts grow turgid by the venereal Orgasm
the Os Tincae opens & receives the male Semen
in which are Anamalcules, immediately
attended.


reduite, se gangrena, & tomba
d’elle-meme. La femme ne daigna
pas garder le lit, & elle Jouit d’une
parfaite vante’ pendant trois ans,
au bout desquels, etant morte d'uno
fievre continue, louverture de fon
corps fid voir que c’ etoit veritablement
le corps de la matrice, qui
par pourriture s’etoit s’epare
de lui-meme
Ibidem p168.


afterwards the Os Tinca closes
During the Orgasm the fallopian Tubes
grow erect & the Timbria seize the Ovaria
at wc. time some one or more of the Animalcule
ascend through the Fallopian Tubes & enter
the first ripe Ovum wc. has now burst
the cellular membrane by its turgidity, then
the Ovum is disengaged & carried by the
Fallopian Tube into the Uterus, and the
place where the Ovum was in the Ovarium
is soon after filled up by a yellowish substance
called Corpus Luteum, this I proved by
opening a Bitch in the Hornes of the Uterus
were 7 whelps in one three & the other four
& in the Ovaria were the same number of
Corpora Lutea, by alike experiment upon a
Bitch opened while the Dog was fastened
thereto, for dogs have no Vesicula Feminalis
are obliged to remain fastened to the Bitch
a




a long time while the Semen is excreted and
carried from the Testes by the Vas deferens
into the Uterus I found that the semen
was ejected immediately into the Uterus.
Though the preceeding Hypothesis seems
incredible and almost impossible, yet it
answers all the Phenomena of Generation
the best of any system yet advanced:
however the subject is extremely intricate
& no doubt is one of the Arcana natura
which the omniscient Jehovah of his
infinite goodness sees fit to hide from us.




Lect: 53d.
Of the Foetus its Nutrition &c.
The Ovum of the female wc. is foecundated in
the preceeding manner by the semen Masculinum is supposed
to contact also the membranes that envelop the foetus
with the Placenta, Umbilical Chord &c:
The Ovum lies in the Uterus 9 months, but for
the first two or three months the Placenta does not
adhere to the Uterus
The Chorionis the external coat of the Foetus it
is a thick spongy membrane.
The Amnios is within the Chorion it is very
thin and smooth, between these two membranes
some have described another called Alantois wch.
includes the Urine of the foetus carried there from ye. bladder by the
Urachus, this is found in some brutes but cannot
be discerned in the human species
The Placenta is made up of a congress of vessels.
How does the Placenta adhere to the Uterus? How is
the Foetus nourished? is it by the Mouth; the
Umbilical Vein, or by both together? Does red 
blood go immediately from the uterine Vessels of 
the


As first this want of Navel String, 2d: a diminution 
of the the Liquor Amnii, 3d. Mucus being found in the mouth
& stomach & meconium &c:
# 1st. A want of mouth or any passage into the
chylopoetic organs, 2d a corruption of the Liquor Amnii
3d. That the liquor Amnii is an exudation from the
foetus & consequently not fit for its nourishment &c:


the mother through the Placenta to the Foetus &
vice versa? from whence comes the Liqour of
the Amnios? these are question, that have been
differently solved by physiologists.
Some have imagined that the placenta adheres
to the Uterus by its vessels inosculating with those of
the Uterus, others imagine there is no continuation of
vessels by inosculation from the placenta to the
Uterus, but that the placenta adheres thereto by
a kind of cement; for (say they) if  it adhered otherwise
there must be a laceration (& consequently an inflammation & suppuration)
wc. does not happen when it is bro.' away.
As to the Nourishment of the foetus many have
imagined that it rec'd. nourishment by the mouth
& bring many arguments to prove it*, on the contrary
others deny that the Foetus receives any nourishment
by the mouth but wholly by the umbilical Chord -
this is the most viewed Opinion, but for a particular
acc't. of the Nutrition of the Foetus in Utero side
Med: Essays of Edinburgh and Dr. Shippen’s
Thesis for the connection of the Placenta to the Uterus
A




It was the rec'd. Opinion till of late by all who
allowed the foetus to be nourished by the umbilical
Chord that red blood was immediately conveyed from
the mother to the foetus; Their arguments for it are 1st.
that if the mother bleeds to death the Foetus will
be deprived of blood also. 2d. Injections pass from
the mother to the Foetus. 3d. that hemorrhages happen
upon a separation of the placenta from the
uterus. 4th that the umbilical Chord will bleed a
great quantity when cut &c: but the most modern
doctrine that now prevails & wc. answers all the
phenomena best is that red blood does not pass
immediately from the mother to the Foetus, for
before the placenta adheres to the Uterus it certainly
cannot, & then it must be nourished by absorption
of the Placentine vessels as well before as after
its adhersion to the Uterus; we have said
before that the placenta does not adhere to the
Uterus by inosculation of the Vessels, but by a
slight cementation, thence we suppose that
the


   


the small ends of the placentine Vessels open into
the mouths of the uterine ones, and as the mouths
of the uterine Vessels are so large near the
time of delivery as to admit a goose quill
whereas the mouths of the placentine Vessels
are so small as not to admit red blood
its very probable there are many of the
placentine vessels open into one of those of
the uterus.
These small placentine vasculae are part
of them supposed to absorb the chylous & ferrous
nutritious part of the blood in the uterine
vessels which the placenta forms into red
blood before it is conveyed to the Foetus;
The manner how the placenta acts in forming
this nutritious fluid into blood is
unknown, but it is supposed to perform
the office of Lungs in that particular.
The placentine vessels having absorbed
the nutritious particles of the mother’s blood
and


   


and the placenta formed it into red blood
it is conveyed by the umbilical Vein into
the Foetus, for its increase & nourishment,
while the superfluous & unnutritious part is reconveyed
by the umbilical Arteries into the
placenta & is absorbed by the uterine Vessels
and mixed with the blood of the mother;
thus instead of a reciprocal circulation between
the Foetus & Mother which was formerly Supposed,
and is still by some, there is only a
secretion of the fluids which pass from one
to the other. The Arguments brought to Support
this new doctrine are, 1st: That upon the mother’s
bleeding to death, the Foetus will not be deprived
of any of its blood this Dr. Shippen proved by
an experiment he made in Edinburgh before
Alexander Monro jun'r he bled a Bitch to
death then opened her and took out her whelps
which appeared to have lost not one drop of
blood




blood. 2d. That the umbilical Cord when cut
will not bleed but very little, no more than
the blood contained in the Placenta, this most
Midwives know & it is mentioned by Smellie:
but 3d. Lastly the greatest argument of all
is that Injections cannot be made to pass
from the placenta into the Vessels of the
uterus nor vice versa tho' it has been
repeatedly tried by the greatest Anatomists
notwithstanding what has been said by some
to the contrary.


   


   


   


   


   


   


   


   


   


   


   


A Course of Bandages
Bandages are very necessary to confine dressings
upon any external part of the body, injured either
by accident or by a necessary Operation.
Lect: 54th:
Bandages of the Head.
1st: Handkerchief doubled & made 3 square
put round the head & tied behind
2d: Grand Covre Chef a large square
handkerchief doubled to ab.t 2/3 the way &
laid on the head the single part so as to
reach the Nose, the double part the forehead,
wc. double part being uppermost must be
fastened under the Chin, the other then
turned up & tied behind in the nape of Neck
3d: Poormans Bandage of Galen
a piece of linen cut into 6 tails & laid
on the top of the head, the middle tails
fastened


   


fastened under the Chin the hind ones before
& the fore ones at last behind.
4th: Capaline a long doubleheaded bandage
4 or 5 fingers breadth wide to put round
the head
5th: Uniting Bandage double headed &
like the former with a slit near the middle
to be applied to a wound of the forehead.
6th: Scapha for bleeding in the frontal
vein going several times round the head
at last the first end turned over & tied behind
7th: Kiaster double headed for bleeding in
the Temporal Artery going several times
round the head then twisted round to a hard
knot over the Orifice & then part one end
over the crown the other under the Chin
and fastened.
8&9 Monos- & Bi-Ocular double headed
the first covering one Eye the last both Eyes
Lect.


   


Lecture 55th:
10 Accipiter a T Bandage for the Nose
going round & tail tied over the head.
11 A four tailed sling bandage for the
upper Lip.
12 A four tailed sling bandage for the
Chin the under half being the broadest.
13 Capistrum double headed bandage passing
from under the Chin to top of the head
then to neck & round to the Chin &c:
14. Divisive along double headed
rowler to keep up the head.
Bandages of the Trunk
15 Spica double headed for the shoulder
16 Star Bandage for a fracture of
the Clavicle a single headed rowler & if
necessary the Capaline may be applied
with it for greater safety.
17






17 For the Thorax the Jenriette or Napkin
& Scapulier the first going round the
body the latter slit going over the head &
fastened thereto.
18 Suspensor of Heliodorus for a diseased
Breast a X bandage
19 For Paracentesis a broad flannel roller
to go round & compress the Abdomen.
Lecture 56th:
20 Spica Inguinis double headed
for any disorder in the inguen.
21 T Bandage or Suspensor Scroti
beside wc. there are several others of less
note to these parts particularly the Truss
Bandages of the Extremities
22 Deloer for the Wrist
23 Spica Pollicis for the thumb.
24 Gauntlet ~ } for the fingers
25 Denigantlet 26




26 Eight tailed bandage for a broken
Patella &c:
27 For a simple Fracture Thypodesmus 
going round under the splints a single
headed roler & Epidesmus going over
the splints one roler very long may
serve for both.
28 For a compound Fracture where there
is a Wound &c: the 18 tailed bandage
together with splints Tape &c: and
lastly Junchs, Box, or Cradle &c:
if it is one of the Legs.




A Course of Operations
Lecture 57th:~
Of Sutures
There has been many sutures invented
most of which are out of use.
We ought to observe that a wound made
longitudinally in the direction of the ~
Fibres requires no sutures be it ever so
great, for by means of a bandage the
sides of the Wound is easily brought
together without suture.
But a wound made obliquely or
transversely requires a suture as no
Bandage can be made to keep the wound
together.
The intention of Sutures is to bring
the likes of a fresh wound in apposition, that the
vessels may inosculate & heal by the
first intention, the chief sutures are 
The




Glovers stitch, The interrupted suture,
The quilled suture, & the Gastroraphy,
The Glovers stitch is performed with
a strait needle & waxed thread single,
turned over and over.
The interrupted Suture is
made with a crooked needle & single waxed
thread the lips of the wound being brought
together first make a stitch in the middle the
Rule for which is to begin as far from the
edge of the wound as the wound is deep
making the needle come out at the bottom
of the wound & continued thro' on the contrary
side then tied not over the wound but on
one side, then make two other stitches near
each end wc. is mostly sufficient.
Quilled Suture is made with
a crooked needle as before with a double cord &
tied at the end with a quill on each side the Wound.
The




The Gastroraphy is performed when
the parietes of the Abdomen & Intestines
are cut. The intestine is to be saved up
with the Glovers stitch leaving a piece of
the thread at each end to lie out of the
wound of the Abdomen, then the Parietes
is to be stitched with the interrupted
Suture in a particular manner viz: on each
end of a waxed cord must be put a crooked
Needle, then take one needle & from within
the wound push it out then take the
other needle & do the same on the other side
of the wound, bringing them together
& tying the same, do so until you have
as many stitches as you think is
necessary




Of Trepaning
When it is necessary to perform this Operation
we should consider first the places where the Trepan
may be applied; there are 3 places where it is
improper to apply it viz: to the Sagital Suture,
the frontal Sinuses, & the Os Accipitis.
In Operating, an Incision must be made
of a good length through the scalp, the same opened
& the Cranium scraped, than having fixed upon
the place apply first the perforator & after that
the Trepan secundum Artem.
Of Fistula Lacrymalis
This operation is performed when the ductus
as Nasum is stopped & has formed in the
Lacrymal Sac &c: Sometimes compression
alone will cure this disease but when the Operation
is necessary its performed by making an incision
over the Sac at the bottom of the Orbit & half
the length of the same, into the Sac & cleaning
out





out the matter & if necessary making an Aperture
through the Os Unguis with a strong Probe or a
Trocar into the Nose.
Of the Polypus of the Nose
This is an excrescence growing in the Nose
in the Schneiderian Membrane, has different
degrees of firmness, in a recent state it is very
tender but by degrees grows harder until it gets
to a great firmness; the best time for extracting
it is when its so hard as not to break easily
with the Forceps but not so hard as to adhere
to the Schneiderian membrane too strongly.
Its extracted by taking hold of it with the
polypus Forceps & working it to one side and
the other backwards & forwards &c: until it is
loosened.




Extirpating the Tonsils.
This is best done by Ligature for fear of an
Hamorrhage if the Tonsils are largest at the
apex its an easy matter with proper Instruments
to pass the Ligature round its basis & make it
tight, but, it often happens that the Basis
is largest in this case a ligature put round woud
slip off therefore with a proper needle it must
be run through the middle of the Tonsils & tied on
each side cum node Chirurgica &c:
Of Amputation
Amputation is sometimes necessary but not near
so often as has been thought; all agree that it is
necessary in a Mortification, but then it must
not be performed until the mortification is stopped
& even new flesh begins to granulate.
In Amputating the Leg we must stand
between the legs that the saw may take the
Fibula before the Tibia is quite cut off.
we




We first apply the Tourniquet to the thigh
to stop the blood, then with a strait knife wc. 
is the best we make a circular incision with
two cuts round the leg or thigh through the
skin cellular membrane & fat about an Inch
below where we intend to cut off the Bone,
then an Assistant must pull up the skin
as high as possible, after wc. the Operator
must make a second Incision through the
muscles to the bone then if it’s the leg or
forearm the double edged scalpel must be
run between the bones to cut the interosseous
Ligament & Muscles, lastly the bone itself
must be cut off with the saw. & then the Arteries
taken up &c:
The Fingers are Amputated contrary to all
other parts at the Joins by cutting the flesh
as before then stretching it up & with the
scalpel beginning on the side take off the Joint.




Of Empiema
This is an operation for letting Pus Water or
Blood out of the cavity of the Thorax, oftenest
Pus, wc. comes from an inflammation & Suppuration,
when this is in but small quantities, the Lungs
by then great power of Absorption often carries
it off by Expectoration as we see in Pleurisies;
but when in great quantities the operation
must be performed very carefully for fear of
hurting the Lungs between the 6 & 7 or 7 & 8
Ribs with a common scalpel.
Of Bubonocele
This is the dangerousest operation in Surgery,
& not to be performed but when absolutely necessary;
when so it is done by making a long incision
from above the rings of the abdominal Muscles
almost to the bottom of the scrotum carefully
in to the Intestine thro' the Peritoneum or
Herniary Sac then dilate the passage by incision
& carefully reduce the Intestine.




Of Couching
This Operation is performed for the removal of a
Cataract or opacity of the crystaline Lens; there are
two ways of doing it, the old way of depressing the Lens
with a needle to the bottom of the Eye into the
vitreous humor wc. is done by running the needle abt.
1/10 of an Inch below the Cornea into the posterior
Chamber behind the Iris & depressing the Lens.
The other method, wc. is the new way, much in
vogue at present, & I think the best is to cut the
Cornea & extract the the crystalline Lens. In the
Old way the Lens is very apt to use after it has been
depressed wc. makes this new way preferable; it is
performed by a small knife with but one Edge wc.
is to enter near the place where the Needle enters & 
pushed thro' into the anterior chamber above the
Iris (taking care not to cut it) and out on the
other side cutting half or better of the Cornea, then
with the point of the knife cut the capsulae of the
Lens & its easily pressed out.




Of Lithotomy
This Operation is performed for extracting a 
stone out of the Vesica Urinariae; there has been
several methods invented to perform this operation
but the Lateral Operation or that invented by
Irene Jaques is the best & universally in use.
We are not to operate until we are certain
there is a stone in the Bladder & we can feel it
by sounding & all the other Surgeons present.
In Operating we first tye the patient on a
Table of a sufficient height lying on his back
by making a noose with a garter round the Wrist
then making him take hold of the bottom of
his foot with his hand putting the Garter round
his Instep & hand in form of 8 a sufficient number
of times, with an assistant to hold each knee
then introduce the Staff into the bladder, letting
a careful assistant hold the same bending the
top a little towards the right Groin is as that the
bend of the same may turn a little to the left
then




then the Operator setting down right before the
Patient must with a sharp scalpel make an incision
immediately upon the staff from the Base of the
scrotum to beyond the anus abt. an Inch to the
left of Cerines through the skin & fat, (this should
be made thus large that we may get at any Artery
if necessary) then make the incision shorter down
to the staff when we feel the staff bare we must
take the Gorget put the point of it into the Groove
of the staff then take hold of the staff from
your assistant & turn it over while you slip the
Gorget along the groove into the bladder, then
take out the staff, & introduce the Forceps upon
the groove of the Gorget, when they are in the
Bladder pull out the Gorget & gently feel for
the stone, when you find it take care to get good
hold of, it not being in too big a hurry; when you
have it fast extract it.
If the stone breaks take out what you can
with the Forceps & the rest with a scoop.
The wound must be drest gently wth. dry Lint.


Med. Hist.
MS.
B
158


Of Tapping












Of Injections
The ancients used to employ only
Ink for Injections (which answered the end
but very poorly) until the time of Ruysch 
who made his injections of wax, some of wc.
have since been improved; his method of
Injection was as follows viz. He first
laid open the hypogastrium & made two
incisions about an Inch long into the Aorta
& Vena Cava, then put the Subject in cold
water several days pressing out the blood
frequently. Next he put them in warm
water several days more & put two tubes
in the Artery one upwards & one downwards
& fastened them tightly.
His injection was only simple Suet
calomel with Cinnabar in cold weather &
in the Summer time he added a little white
wax & injected it gently when warm into
the vessels, then put the Subject into cold
water till the injection was cold, then dried
the preparation carefully or preserved it in
spirits of wine
Injections used by the modern are the follg:


Corroding Injection of Dr. Nicholls
Rx Wax 4 ounces Resin 3 ounces when
melted add Turpentine Varnish 3 ounces 
Dr. Hunter's Corroding Injections
Rx Wax 3 ounces Resin 3 ounces when melted
add Venice Turpentine 11 ounces 
Another
Rx Wax 4 ounces Resin 3 ounces when
melted add Oil of Turpentine 2 ounces 
Another
Rx Wax 4 ounces Resin 8 ounces or 10 ounces 
Tallow 3 ounces melt them together
The Injection is known to be of a
proper consistence by dropping some of
it when melted in water & when thoroughly
cold forming it into the shape of the Vessels
if upon Landing it breaks it is too hard
if it bends easily it is too soft & must
be mended. Those Injections which have
Turpentine Varnish, Venice Turpentine
or Oil of Turpentine in them must be
tried as above every time they are heated because
in heating they loose of their volatile oil


Of the Colours
To the foregoing Injections such a
quantity of colouring matter must be
added as will give them a bright colour
which must be determind by the Eye
Colours generally used are Vermillion
Kings Yellow, Blue Verditer & Flake
White. Other colours may be used.
They are generally to be mixed with the
Injections when they are melted; but
there are some objections to this rule
in some of the colours particularly the
blue Verditer & in some measure the Flake
White for Navy both ferment when mixed
with the foregoing Injections; to prevent
which it is necessary to melt some of the
Ingredients alone & add the colour to it before
the other Ingredients are added. The
following Experiments will particularize
these Exceptions
1 Blue Verditer with Tallow alone
causes no Fermentation
2 Blue Verditer with wax alone don’t
Ferment


3d. Blue Verditer with Resin alone
does ferment, therefore mix the blue
Verditer with the Tallow or Wax alone or
together & afterwards add the Resin
which causes a small froathing
If Turpentine Varnish, Venice
Turpentine or Oil of Turpentine be 
used mix your colour first with the
melted wax & then add either of these 
Ingredients with the Resin
These observations are equally true
of the Flake White
When we make a white Injection
instead of yellow Wax we use white.
It would seem that we have
not yet any Green Colour, but as blue
& yellow make a Green the blue Verditer
added to the yellow wax or Resin gives
us a fine green


Dr: Nicholls fine Injection
Rx Hard Brown Varnish & hard White
Varnish a 5 ounces Turpentine Varnish 2 ounces 
add the Colour & shake the Vial first
putting some shot therein to make them
mix. Either of the hard Varnishes will
do as well as both adding the same
proportion of Turpentine Varnish viz
1 to 5
Another
Rx Hard Brown Varnish & hard
White do. a 8 ounces Venice Turpentine 2 1/2 ounces 
mix these as the former
If we neglect being nice in our
proportions or from often heating these
Injections become too hard or Brittle.
We know when they are of a
proper consistence by the following
Experiment; Drop one drop of it upon
cold water which will immediately diffuse
itself over the whole surface when the
spirit will be immediately attracted by
the water & the gums with the Turpentine


will be left swimming on it, if this
will bear raising up without breaking
it is of a proper consistence, but if it
breaks its too hard & much be softened
till it is properly tenacious
Of Watery Injections
Glue dissolved in water alone makes
a good minute Injection; before it
is dissolved by heating its necessary
to steep it in water for 12 hours then
boil it upon the fire till the whole is
dissolved, afterwards strain it & drop
some of it upon a cold stone or any
cold substance to cool that you may
know its consistence; when it is somewhat
thicker than a common gelly
it is of a proper consistence
Isinglass & water prepared in
the same manner as the preceding ~
makes an Injection similar to it


Gum Arabic, Tragacanth, or
any of mucilaginous Gum dissolved
in Water to the consistence of Cream
& strained as the preceeding make a very
minute Injection
As the Colours mix difficultly with
with these watery Injections, they
ought first to be mixed well with
a little of the Injection & then the
remainder added to it.
Of Oily Injections
We often make Injections of almost
all Oils as Oil of Turpentine Hogs lard
Tallow &c: The oil of Turpentine is
rather too thin of itself but when added
to two parts Tallow is a good Injection
Butter or Hogs Lard make
of themselves a pretty good Injection


All fine Injections require more
Colours than coarse ones, for as it is to
run into much smaller vessels it of course
becomes more & more transparent and
therefore requires such a quantity of
colour as to render it opaque even
when it is most minutely separated on
diffused within in very small vessels or
on any surface
Of Common Injections
The corroding Injections are too hard
for several purposes & the fine ones
too soft therefore we need something
between them, some of which must
be softer than others
The hardest is Rx Resin 3 ounces Tallow 2 ounces 
Wax 1/2 ounce Colour sufficient for an Injectn.
is Rx Resin 2 ounces Tallow 2 ounces 
Colour sufficient for an Injection
These are generally used when
the part is intended to be dissected


Varnishes
Turpentine Varnish
Yellow Resin 14 lbs Oil of Turpentine
16 lbs, boil the water out of the Resin 
& then add the Oil of Turpentine from
the fire.
White Hard Varnish
Mastich & Gum Juniper a 1 grain 
Alcohol 8 grains ~
Brown Hard Varnish
Shell Lac & Seed Lac a 1 1/2 grains 
Gum Juniper 1 1/2 grains Alcohol Galls. 2 
clean the Gums from dirt & bruise
them pretty small then put them in
the spirits & dissolve them in a Sand heat
The Spirit of Sea Salt is the
corrosion commonly used by Anatomists


The part to be Injected must be
macerated in water blood warm 2 or 3
days so as to relax the vessels & soak
out all the blood in them, then having
a proper sized Syringe with pipes of
different sizes, fit one of the pipes
into the vessel & fasten it well with
a ligature bringing the ligature round
the cross piece to secure it the latter.
The part to be injected lying in the
warm water & the Syringe and
Injection being warm, the Syringe
is to filled with the Injection, the
end of it put into the pipe & kept fast
& the Embolus of the Syringe pressed
gently down with the breast till the
part is sufficiently injected or the
syringe when it is to be filled and
emptied as before if necessary ~
Med. Hist.
MS
B
158


















Med. Hist.
MS.
B
158








Ex Libris Jonathani Elmer
Ipromet manu Jeripris




Jonathn. Elmer’s




A Course
of
Anatomical Lectures
Delivered
By Dr. William Shippen junr.
Professor of Anatomy & Surgery
in the College of Philadelphia
Anno 1766
Quanta autem existerent consilii
solertissimi indicia, su tota hominis
fabrica perspecta foret? si corporis totius
species et dignitas? Sensuum organa
subtillissime fabricata, et aptissime locata.
Synop: Meta:
Anatomia fundamentum est Medicinae
Anomal

















Anatomical Lectures
Lecture 1st:
Anatomy avatouia in Greek signifies
cutting & by it antiently was meant only
the dissecting of bodies, but at present it
is implied in a more general sense.
Anatomy in respect of its object is divided 
into human and comparative.
Human Anatomy is that which is
employed on the human body; and comparative
Anatomy is that which is employed upon
the bodies of other animals, these serving
for the more accurate descriptions of several
parts, and supplying the defects of human
bodies.
Anatomy from its various ends may
be said to be of four kinds viz: Theological,
Medical, Juridical, and Judicial.
The




The first consists in an acquaintance with
the works of the creator in the human frame;
according to Fontanel the study of Anatomy
& Autonomy afford the strongest arguments
against Atheism.
Medical Anatomy is ultimately health,
for the presentation of which, restoring it when
impaired, by diseases, or even preventing
their access, nothing surely is more necessary
than a true knowledge of the structure of that
frame so liable to be injured.
Juridical Anatomy is the determining
the causes of suspicious deaths, impotency,
barrenness, the true times of pregnancy and
delivery, the mortality of Wounds and a
multitude of other causes of great importance
to be adjusted in account of Judicature.
Judicial Anatomy is the determining
the cause and manner of the death of diseased
persons from a subsequent dissection of the
body




body; this is of the utmost use in the practice
of Physic.
Upon the whole then the use of Anatomy
in very great, nor is it confined to the bounds
of Medicine alone; the Philosopher and
Theologist, the Magistrate, Painter and
Sculptor are in their respective employments
more or less qualified in proportion to the progress
they have made in this science; but the
physician and Surgeon are the people to 
whom it is most immediately necessary
and who without a perfect knowledge of it
cannot do justice to the world in their
professions. What the needle is to the
mariner, Anatomy is to both these, and
we may venture to say that without its
assistance, they would be rather detrimental 
than beneficial to mankind.




The Anatomy of the solid parts is by Heister
called Osteology and that of the soft parts
Sarcology, each of these are subdivided.
Osteology or the anatomy of the Solid
parts is divided into the anatomy of the 
Bones called Osteology; Chondrology or the
anatomy of the Cartilages; and Syndesmology
or the anatomy of the Ligaments.
Sarcology or the anatomy of the soft parts
is divided into Dermatology or the anatomy of
the Teguments; Splanchnology or the anatomy
of the Viscera; Myology or the anatomy of
the Muscles; Neurology or the anatomy of
the Nerves; Angiology or the anatomy of the 
Veins and Arteries and Adenology or the
Doctrine of the Glands.
In the human body as a complex hydraulic machine
a double inquiry must be made 1st. Into the structure of
the parts, this is called Anatomy, 2d. Their functions & the
laws of their motion which is termed Physiology





Lecture 2d.
As the solids are formed out of one
principal fluid chiefly, called the Blood
it is proper to begin therewith.
Of the Blood
Blood in Scripture is called the life of
the Animal; according to some it is the
primum vivens ultemum moriens, its
a heterogeneous mass, as is evident from the
variety of ingredients of which it is made up,
and the various forms it assumes in the
animal machine.
The blood is composed of three substances
viz: Serum, Gravamentum & a coagulable
Lymph: We shall consider these in three
different manners; first when ocularly
examined, 2d. Viewed with a Microscope,
and
B





3dly: The chemical Analysis thereof.
Blood fresh drawn from a sound
living animal, upon landing, part of
it congeals into a hard coagulum suspended 
in a yellowish Serum, the
upper surface being of a florid color
while the bottom is black; the reason
of the blood appearing bright and
florid at the top is from its being in
contact with the Air; this is confirmed
by an experiment of Dr. Hunter’s who put
a quantity of blood fresh drawn into a
vial, & stopt it close; upon standing it
all turned of an uniform black color,
except a little spot upon the top with which
a globule of Air had got in contact.
Blood stirred round with a probe
whilst




Whilst warm, a fibrous elastic substance
is obtained, which, put in water turns of
a whitish color; this is the coagulable
Lymph, is strongly elastic, & is the cause
of cohesion in the particles of the Blood,
as is evident from the extravasation of
the blood after death by dissolution
of the cohering particles. The coagulable
Lymph is sometimes discharged from
the Uterus and by Nurses taken for
an Abortion; this error they are sometimes
led into from a desire that it should be
so. If spirits of Wine be added to
Serum, or the same made boiling hot,
it rises up, emits fumes, and turns into
a coagulum similar to the White of an egg:
the fibrous part of the blood is what forms
Polypuses




Polypuses concretions &c:
Blood viewed by a microscope appears 
to consist of a number of globules,
the larger ones being those that tinge
it of a red color, &c: therefore chiefly
make the crassamentum, are of a certain
determinate magnitude being of the
same bigness in all animals, in a Sheep
as in an Ox, in an eel as in a man.
These globules are composed of six
smaller or ceruminous ones; and these
ceruminous ones are composed of smaller
or lymphatic ones; and it is probable there
are still lower orders of globules of blood.
These globules of blood are of a
lenticular form and elastic the largest
kind being less than the 1/3000 part of an
inch




Inch. the crassamentum is supposed
to contain 1/3 of the mass and the
Serum to make up the other 2/3.
Blood chemically analyzed; upon
distillation with a slow fire a quantity
of Phlegm arises, with the fire increased
next arises an Oil and a volatile Salt,
the caput mortuum being a fixed
alkali and a cretaceous Earth.
The chemical proportions of the
blood are by Dr. Martin & Boyle recvd.
as follows viz: of Phlegm 5/6 of
Oil 1/15, of Salt 1/25, of Air 1/20, &
of Earth 1/75, part of the whole mass.
The specific gravity of the blood
to that of rain water is by Dr. Jurin
and




and Martin reckoned as follows,
by Jurin as 1000 to 1054 by Martin
as 1000 to 1056 or 1057 or as 10 to 19.
The density of blood in living animals 
is to its density when reduced to
the coldness of temperate Air as 134
to 135 or 992 1/2 to 1000.
The color of blood is for the most
part red, but redness is not a constituent
quality in blood, for some Animals
have white blood. In the human
body the blood is redder & more florid
in the Arteries than in the Veins,
oweing to the action of the Lungs upon
it, for by shaking fresh blood in a vial
taken from a vein, it appears of the
color of arterial blood. That the blood
is




is reder in the Arteries than in the
Veins. Dr. Hunter proved by the following
experiement: he opened the Thorax of a
live Dog and kept his Lungs working
with a pair of Bellows; and drew a
spoonful of blood from each side of the
Heart is, from the Vena Cava & Aorta 
the latter of which appeared the reddest.
From the accurate experiements it is
found that a cubic inch of rain Water
weighs 253 1/3 grains, a cubic inch
of warm blood 264 3/4 grains.
An Ounce of Blood contains 1,813
Inches, an avoirdupois ounce weights
437 1/2 grains equal to 1,727 inches
of water and 1,6526 of warm blood.
Lect.


*Among these we may reckon Boerhaave instit. vol. 2
the colour of the Arteries are of aligamentous substance
and not muscular as is evident from their white appearance 
and their of elasticity both of which is contrary to the general
characteristic of a muscle however we are informed that
Dr. Cullen has lately discovered that there are muscular
fiber in the coats of the arteries the action of which he
thinks assists in propelling the blood onward.
J. Cullen likewise says that there is a muscular coat
to the arteries as well as Boerhaave & many others.
&c physiology [illegible].


Lecture 3d.
Of the Arteries & Veins
An Artery is a strong, membranous,
ramifying, elastic Tube, endowed with
pulsation; arising from the left side 
of the Heart, and terminating in every
part of the body. The Arteries are composed 
of three coats, tho’ some have
reckoned four and some five.* The
first external coat is very thin the fibres of x
which going longitudinal & circular;
the second coat is thickest and the fibres
of it go in a circular direction; the 3d.
coat is very compact and its inside
very smooth and even, this smoothness 
and compactness of the inner coat
serves two purposes. 1st. to allow the blood
to




to pass without hindrance & 2d. to
prevent its exudation.
The pulsatory motion of the Arteries
is a dilatation and contraction of them;
the former called Diastole, and the latter
Systole, which precedes proceeds from
the Heart, besides which they have a
sort of aperistaltic motion, as is evident
from an experiement of Dr. Hunter’s,
who opened alive Dog and cutting off
the mesenteric Artery, injected it wth. 
a warm milk, which he could plainly
perceive the Artery to carry along wth. a
vernicular motion; to confirm is the
more he injected the mesenteric Vein
but the milk went no farther than
the
&




the force of the injecting propelled it.
There are but two Arteries in the
body viz: the pulmonic, which carries
the blood through the small circulation,
and the Aorta, which carries it to all
the parts of the body.
The coats of the Arteries are very
elastic, and are furnished with blood
vessels for their nourishment; the
Arteries mostly and all except the
Epigastric ramify at acute angles.
The commonest diseases the
Arteries are subject to, are, Aneurisms
and Ossification.
Aneurisms proceed from a preternatural 
dilatation of the coats of the Artery’s
and are of two kinds 1st. When the blood
is


x it is sometimes found in young subjects and is
oweing perhaps to a disposition of the constitution
to form bony matter.


is contained within the coats of the
Artery. 2d. when the Artery is burst &
the blood extravasated into a membranous 
bag.
Ossification happens mostly to
Old people from a weak & slow circulation 
of the Blood. x
Veins are elastic, ramifying Tubes,
like the Arteries; except smaller. their
coats thinner, and without motion.
Phisiologically speaking the Veins
begin at the extremities of the Arteries,
or more properly speaking they are a
continuation of the Arteries reflected
back toward their Origin the Heart;
but anatomically speaking the Veins
arise from the Heart.
There




There are 7 Veins in the body from
which all the rest arise viz: The 2 Venae
Cava ascendans and decendans; 4
pulmonary Veins (two from each lobe
of the Lungs) and Vena Portarum.
The veins are mostly ramified in
the same manner as the Arteries, exct.
the Vena Portae, and the cutaneous
Veins of the extremities, & other parts.
The veins of the extremities have
valves, but not those of the Viscera;
the reason of which is because there
is no Muscles in the viscera; hence
the use of those valves in the Veins
of the extremities is to prevent the
blood from going backward as well
as


x Bellini especially is of this opinion


as well as for, to push it forward when
the muscle is contracted and the Vein
compressed.
Of Venesection & Hemorrhages.
In bleeding, the blood is supposed to 
x
flow out faster at the orifice than it
circulates in common, and to increase
the circulation to the part, hence the
doctrine of revulsion & derivation is
easily understood; thus we find in
a Cephalalgia bleeding in the foot
causes a derivation to the feet and
a revulsion from the Head &c:
In Hemorrhages the antients
used Ligatures round the joints,
wc. stopping the return of of the blood
to the Heart checked its impetus,
but









but by Venesection his ends are answered:
e,g, supposing an Hemorrhage at the
Nose, Lungs, Uterus &c: bleeding
takes off the impetus of the blood &
causes a revulsion, at the same time.
Dr. Haller thinks this latter method much the [illegible]
the Veins are some of them subject 
to Varices, which are an obstruction,
or destruction of the valves thereof.
The muscular coat of both the
Arteries and Veins are somewhat
subject to inflammation & suppuration,
but not near so much as the other
muscles of the body; this is very wisely
adapted to their function, for suppuration 
of their coats would be attended
with fatal consequences often.
Lecture




Lecture 4th.
Of the Lymphatics.
Lymphatic or absorbent vessels are
those fine ramifying vessels which contain 
a clear diaphanous Liquor; they
take their rise internally from the cavities, 
as the stomach, intestines, and
externally from the surfaces of the
skin. The antients supposed the
Lymphatics were a continuation of
the Arteries dividing them into three
classes, sanguineous, venous, and
Lymphatic, but, it has very lately
been discovered that the Lymphatics
are an entire system of vessels by
themselves, having no affinity or communication with
either the arteries or veins.
this




This is proved 1: by injections not passing into them from the arties 2: by
the motion of the fluid in them and the valves they
have; they are called absorbents from
their office, which is to absorb the Lymph
and other matters and carry it into the
thoracic duct or Receptaculum Chyli;
where they are all supposed to terminate.
Those vessels called lacteals
belong to this system; and called Lacteals
only, from their carrying a milky chyle:
their origin termination and course of
their fluids being the same. That the
lymphatics are absorbents is evident from
their absorbing moist substances rubbed
on the skin, as Mercury, Turpentine,
Garlic &c: but in a more obvious manner
in the venereal Disease, where absorbing
D the




virus they carry it to the adjacent
Lymphatic Glands and cause them to
tumify, hence Buboes &c: sometimes the
virus causing the glands to tumify and
inflame, constricts the vessels beyond
the same and prevents the infection
from going any farther; hence the cure
of the venereal disease sometimes by
the suppuration and discharge of a Bubo.
Of the Glands.
A Gland is a secretory Vessel — the
antients called only those Glands which
we feel hard movable kernels under the
chin and other were until Malpighius
by his microscope found the Liver and
other substances to be of the same texture,
and therefore termed them all Glandular.
A




A Gland he thought to be made up of
little fine round bodies consisting of
Follicles which contained the secreted
fluid and between which was a parynchemical 
substance; but Ruysch by
his injections found that the Glands
were vascular or made up of fine vessels
which has been further confirmed by
later anatomists. The vessels of the
Glands are Arteries, Veins, secretory
and to some excretory Vessels Nerves & lymphatics
Of Secretion
Some have imagined that the secretions
were performed by the diameters of the
secretory vessels, supposing them to be
of the size of the particles secreted;
but this theory is subject to these two
objections, viz: that the smaller particles
will




will go off with the larger ones and to the
secretion be confounded and in a Jaundice, 
when once the Bile had got into the
Blood it would continually remain [illegible] &
the Jaundice could not be cured; others supposed 
a particular fermentation happened
in the veneral glands, & from thence 
arose the difference in the veneral secreted 
fluids, and likewise was the cause of
the secretion; this theory is liable to the
same objections with the former, and
therefore the most received opinion is, that
the secretions depend upon the particular
disposition of the vessels, to the particular 
fluid it is to secrete; hence arises
these Axioms. 1st. That the secretions are
carried on uniformly in a living sound Animal.
2d. One secretion increased another is diminished &c:
Lect.




Lecture 5th.
Of the Muscles & Tendons.
A Muscle is a fleshy, fibrous, [crossed out]
substance, consisting of Veins, Arteries, &
Nerves; besides fleshy fibers &c; having
more nerves in proportion than another
part of the body serving to give notice to the
brain of any external stimulus or irritation.
The redness of the muscles is not
inherent in the fibres thereof, but only
oweing to the blood contained in them, of
which there is a great quantity, more
than is sufficient for their nourishment
and may possibly be subservient to their
motion.
A Tendon is a white compact fibrous
unelastic substance. most muscles terminate 
in Tendons, and the Tendons are by
some reckoned a continuation of the fibres
of




of the muscles to which they belong,
only more compacted together so as not
to admit the red globules of blood between 
their interstices: but Dr. Hunter
thinks the fibres of the Tendons are
not a continuation of those of the muscles,
but distinct fibres someway cemented
thereto.
The muscular fibres are cemented
together by the cellular membranes and
an intervening glue, & serve for the
moving of the solid parts of the body.
The Tendons are for the better
insertion of the muscles, and of great
use in motion; eg: in the Perforans and
Perforations of the hand, the muscle arises
from the inferior part of the Humerus, and
if that was continued down to its insertion
muscular, it would render the hand troublesome




some and unwieldy, whereas now, the
Tendons, being compact & taking up but
little space, remedy that inconvenience.
Round many of the Joints as the Wrist 
Ancle &c: there is a capsular Ligament or
Frenum which serves to keep these tendons
in their right places, and facilitate their
regular motion; likewise over some of the
Muscles there is a tendinous expansion
called Aponeurosis, of much the same use
as the preceding Ligament.
The muscles may be reckoned of
three kinds first Oblong as those of the
Arm, 2d. Convex as those of the Heart,
Stomach, Bladder &c. 3d. mixt as those of
the Abdomen the Pectoral muscles &c:
Muscles have their names from
their Origin, Insertion, Use Appearance &c:
Lect




Lecture 6th.
Of the Nerves.
The Nerves are now by every body
allowed to be a system of the vessels, and
they are a fasciculi of white fine fibres,
arising from the Medulla Oblongata &
Spinalis, egressing in pain.
Over the Brain are the Meninges, or,
1st. The Dura Mater which is externally, &
a thick vascular substance within this &
adhesive to the Brain is, 2d. The Pia Mater,
which is a thinner membrane; between
these two, some anatomists reckon another
membrane, extremely fine & reticular which
they call Tunica Arachnoides.
The Brain is divided into three
portions called, Cerebrum, Cerebellum,
and Medulla Oblongata, the latter 
being





being continued thro’ the spine of the back 
is called Medulla Spinalis.
The Brain is supposed to be vascular,
& its substance of two cortex; external of an
Ash color is called Corticalis; internal of a 
white color called Medullaris. The Nerves
are of the same substance with the Brain,
and are properly aportion thereof continued
to all the parts of the body. The Nerves
as they arise in pairs soon after decussate,
or change sides as in the Optic Nerves,
the left going to the right Eye, & the right
to the left; hence a wound, on one side of
the head affects the contrary of the body.
The Nerves are distributed thro' the
body in much the same manner as the
Arteries; the one proceeding from the Brain
the other from the Heart, but with this
difference
&





difference, that the trunks of the Arteries grow
less the more they are ramified together with
the ramifications ad infinitum; but the
capacity of a constituent Nerve never decreases
they being imperceptible, but the number of the
likes of the Fascicule decreases in proportion as the bundle
ramifies, thus the cords of the Nerves wc. as they
egress from the Brain contain an innumerable
number of constituent Nerves, decrease in No.
but not in capacity ad infinitum in proportion
as they are ramified.
The Nerves anastomose, but not in the
same manner as the blood vessels do, by
uniting their tubes but only by their coming
in contact with each other; these anastomoses
are called Plexuses. sometimes little knots
appear in Nerves called Ganglions, some
imagine these knots proceed from pressure &
inflammation, but this cannot be as they are
found




found in the Viscera, & in a Foetus where no
pressure could happen.
Lancesi, reckons the use of these Ganglions
is for an an additament to the Brain; because
he says more nerves go from them than go to
them, but from the substance of these knots
not being the same wth. the brain, that cannot
be. others think they serve to stop the nervous
fluid from flying out at the end of the Tube
without the impulse of the will by means
of muscular fibres, they being only in
those nerves destined for voluntary motion;
this also appears to be false.
The termination of the nerves is but
little known, but supposed to be in every
part of the body.
The use of the Nerves is for sensation,
motion, nutrition, &c: the Brain being called
the sensorium Comune to wc. the Nerves
carry all the sense communicated to them
Voluntary





Voluntary motion is acquired by experience,
as is evident from a child whose will is
frequently contrary to the Act performed.
Of the cellular Membrane.
The cellular membrane is of two kinds,
the one adipose containing fat, the other
reticular without fat; it is a net like
substance, vascular, very thin and tender,
consisting of many cells & its fibres very
fine: the cellular membrane is continued
throughout all the body, except some of
the viscera & is called by some the membrana
Musculorum Comunis. The cells of the
reticular part of the cellular membrane
communicate with each other, as is evident
from an Anasarca which is a transudation
of Phlegm into the cells, & so from the one to
the other, as is evident from the Legs swelling
by walking & subsiding when lying
down


x See the Londn: med: observations vol: 2


down; hence Eccymosis from a false
Aneurism, Diaeresis, Contusion &c: by
which the blood insinuates itself into the
cellular membrane; hence also the great
quantity of water evacuated from a
scarification in an Anasarca.
An Emphysema is a remarkable
proof of the communication of these cells;
this is caused by the air distending these
cells & often happens from a fractured
rib puncturing the Lungs by w.c the
Air gets into this membrane; a remarkable
instance of this happened in London,
by w.c the patient swelled to that degree that
his eyes could not be seen; Dr. Hunter x made
a puncture at the Eye by w.c the air gushed
out, & by puncturing & rubbing he was cured.
Putrefaction will cause an Emphysema,
from the fermentation generating air;
hence





hence a drowned person will after a while
rise to the surface of the water.
The fat contained in the adipose cells
differs in different bodies; in a Foetus
the fat is soft, and gelatinous; in children
of a year or two old, the fat is chiefly next
to skin; hence the fatness observed in
children; & in adults the fat is solid and
mostly internal.
The cellular membrane serves for
easy smooth motion, for a defence to the
body, to keep the parts warm & preserve
the figure of the body, & blunt acrimony.
some animals we reckoned to be
nourished in the Winter by their fat.




Lecture 7th
Of the Bones.
Here we shall, 1st. describe the external
conformation of the Bones, 2d. examine
their internal structure, 3d. their connection,
& 4th. Explain their use.
A Bone is a hard fibrous compact
substance. various Bones have various
shapes & conformations, some are cylindrical
& long, others flat, & broad, irregular &c:
bones are said to be made up of Fibres
forming Lamellae, fastened together by means
of oblique or transverse fibres.
Bones have processes and Cavities.
Processes have different names from their
different forms, & appearance: thus, a
Condyle is an oblong process arising from
the extremity of a bone; a Corone is an oblong
process





process terminating in a point; Spine is
the sharp ridge of a Bone; Supercilia is
a brim round a cavity; a protuberance is a
rough process of a bone. Processes are of
two kinds viz Apophysis, & Epiphysis;
Apophysis is a process growing out from
the body of a bone. Epiphysis is a process
growing to the body of the bone, being originally
separate therefrom  by a different Ossification.
The cavities in bones are of two kinds,
one for Articulation, & the other for the lodgment
of soft parts; cavities for Articulation are
of three kinds, 1st. Round & deep called Catyloid,
2d. round but superficial called Glenoid, and
3d, deep & narrow called Alveoli, the Articulation
of Bones is by Galen called [illegible] Joint
& by him is reckoned of 2 kinds, 1st. With motion
called





called Diarthrosis. 2d, without motion called
Synarthrosis; each of these are of 3 kinds.
Diarthrosis, are. 1st: Enarthrosis, 2d:
Arthrodia, 3d: Ginglymus.
Synarthrosis are, 1st: Suture or Raphe,
2d: Harmonia, 3d: Gomphosis.
The connection of bones is termed their
Symphysis, & is of two kinds: the one wth.
and the other without an intervening substance:
the first is that of the Cranium by mutual
Indentation. the second are of 3 kinds viz:
Synchondrosis, Syneurosis & Sysarcosis. 
Periosteum is an elastic fine membrane,
that covers the bones except at the joints teeth &c:
its case is for the insertion of vessels, to strengthen
the Epiphysis &c: the cylindric bones
are all hollow, & so are most others & contain
Marrow, the ends of the bones are cellular.
F Lect.





x see Edinburgh med: Essays.



Lecture 8th
Osteogonea.
In a Foetus, the first months, there are
no bones, nothing but a gelatinous fluid;
then it gradually grows cartilaginous, &
in time becomes boney; some imagine
Bones are formed of Cartilages only by
an expulsion of the redundant fluids;
but Dr. Nisbet x says, & it is now general recd.,
that in Ossification, there is in the blood, or
a fluid secreted therefrom, an ossifying
juice; consisting of particles wc. are not apparent;
that wherever nature designs an ossification
between membranes, or a cartilage she occasions
a more than ordinary afflux of fluid which
distends so much the vessels wc. were before
invisible as to make them capable of
receiving the red globules of blood wc. is always
to






to be seen near to where ossification is begun.
In this blood gritty particles are to be felt by
the point of a knife, which have been formed
by the attraction & cohesion of the particles
of the ossifying juice obstructed along with
the other grosser fluids in the beginning of
the vessels, prepared to receive the influent
juices. The membranes or cartilages some
as alied between wc. or within wc. the bony
particles are deposited or shoot; but without 
any any intermixture of the particles of the
bone & cartilage, or continuation of the fibres
of one substance to those of the other as is
evident in bones made perfectly clean, the
cartilage dropping from it as easy or easier
than an acorn from its cup, & there is a
smoothness of the parts of both cartilage
and




and Bone which show that there is no
conjunction or union of the fibres of the
two substances.
While bones are increasing within
Cartilages, the cartilages are extended
& spread out, by wc., with the pressure they
suffer & the great influx of various fluids,
& the nutritious matter being kindred to
flow freely into them, they decrease
continually & at last may truly be void
to be entirely destroyed.
Bones digested in Acids for sometime
grow flexible & gelatinous like a tendon,
by which it appears the great quantity
of Earth they contain makes them hard
rigid. Bones are furnished with Arteries
and Veins, as is evident from the drops of
blood





blood seen in sawing bones lengthwise, &
upon their appearing tinged of a red color
after the animal has eaten Madder.
Dr. Havers divides the blood vessels
into sanguiferous, & medullan the latter
enter the bones mostly near their
center in an oblique manner.
Bones have Nerves as is evident
from their exquisite sensibility where
amputated, or exfoliated, & granules of flesh
have sprouted out.
Diseases of bones are 1st: a softness & 
rickety disposition. appearing generally from [illegible] to the 3d.
year after birth, though the habit may continue thro' life.
It seems to be owing to an Idiosyncrasy or a want of bony
matter in the constitution. Sometimes it is said to arise 
from the pox & scurvy, but probably less frequent than from
the other cause. We have the history of a species of Scurvy
in France that affected the Bones & separated the Epiphysis.
In Anson’s voyage we are told the Callus of bones wch. 
had been fractured & united again for may years were disposed
by this Scurvy ~




Softness from a venereal Taint can be nothing more
than a Caries of the bone. the disease first affecting the
Periosteum & then communicating itself to ye. subject bone.
As to softness from Idiosyncracy as its called; or from
a particular state of the solids & fluids. Mr. Goodye furnishes
us with a history of a woman whose bones without any apparent
cause grew soft; her body shortened, & at last she died, & he
found that he could easily cut through the limp bone & all.
The academy of Paris give a more remarkable history of
a woman whose bones were so soft that at length they had
not solidity enough to gird  the muscles action—no kind of a
scorbutic or pocky taint could be observed. see Vanss 4h:423.
Mr. Gooch had a case of this kind under his care, when
the patient died he found the bones so soft that he split the
thigh bone, the Tibia & bones of the foot the whole length
very easily with his knife. Dr. Tilton of Dover relates the like
Bones may likewise loose of their bulk like other
parts from a loss of juices as in alveolar & vessels of old people.
2dly: Fractures. All bones have a tendency to
unite again after being disjoined w:ch is effected by means of
a Callus this was formerly supposed to be unorganized, but is 
now known to be vascular by injections & being tinged with 
madder. When a Callus is broke it will unite again only
to the opinion of some authors. A pupil of Dr. Haller’s
in a Thesis he wrote on the subject say that the Callus is
first a bloody matter, then slimy, next gelatinous & then
vessels from the bone & meditullium shoot out thro' it & ossifications
begin directing themselves quaquavenum & thus the
Callus


Lecture 9th
Of the Cartilages & Ligaments.
Cartilages are compact, opaque, & a little
elastic: of wc. there are 3 kinds, 1st: such as
supply the place of bones as the Nose,
Trachea Artena &c: these preserve the
structure of the part & admit of motion.
2d. such as supply the place of bones before
they are formed as in a Foetus. 3d.
such as serve for the Articulation of
bones. Cartilages differ from bones
in not having Fibres nor blood vessels
to be siphoned, tho’. they are imagined
to be vascular; they serve at the Articulation 
by their smoothness to prevent
abrasion; they won’t granulate nor
exfoliate but may be corroded.
Ligaments


is compleat. sometimes the bones won’t unite but with great
difficulty.
3dly: Caries. A caries in alone is similar to an ulcer
in the flesh it has circulation but it is unsound &
often shoots out irregularly as the fungus of an ulcer
See more so in med:[illegible] 2:h:k0 [illegible] [4?377].
4thly: Spina ventosa – this is a caries beginning
on the inside of the bone & affecting it clear thro', hence
Surgeons bow into the bone to let out the matter, but
in general the limb is to be taken off. See Van Swieten 4 p 377
A node by some is said to be an Exostosis of
the bone, but for the most part if not always it begins
in the Periosteum. should be open'd before it affects the bone
5ly: Anchylosis is a stiff joint having little
or no motion. from the bones running into each other &
the cartilages being eroded. Van swieten vol 4 p 457
gives several curious cases of Anchylosis of all
the joints in the Body. See also Le Bran’s
Surgery.
x where it covers the Cartilage. it is calld. Perichondrium 
the external lamina of the capsular ligament goes
from the substance of one bone to the other over the articulation
& is inserted beyond the Epiphysis &: Friction
6th. Exostosis is a tumefaction of a Bone
or an excrescence growing out of the bone. It
may proceed from a redundancy of ossifying particles
in the system or in the part only from a morbid
cause see Van swieten 4 p 424. See the case of 9: Scott 
of the Pennsylvania Hospital in my Adversar: med:
See Cheselden p 5.


Ligaments are firm, compact, unelastic,
membranes; serving to connect the joints,
prevent luxation &c:
The Ligament, Bones, Cartilages,
Tendons & Dura Mater are now reckoned
none of them to have much sensibility
in a natural state. v: Whytt & Haller
The capsular ligaments are very
strong & compact, & made up of hard
Lamella, the inner lamella being a 
reflected membrane going over the
head of the joint. cover the Cartilage x
& so coming to join the external lamella,
which is firmly inserted near the joint.
These capsular ligaments forming
a sac in wc. is contained, a mucilaginous
liquor serving to lubricate the joint:
for




for in all Joints; for motion there are synovial
glands which discharge the above
synovia, this is subject to be disordered:
1st. to become thin & Icorous, 2d thick and
inspissated &c:
It is generally received of late, that the
capsular ligament is lacerated in a 
Luxation of a joint unless from internal
cause, or a relaxation; & violent extension
is unnecessary in reduction of the same;
no more being necessary than to bring
the ends even, and then coax them
into their proper places, & there keep
them by proper dressings & bandage.
For as particular description of the Bones
vide Monro’s Osteology, and of the muscles
Douglas’s Myographia




Lect. 40th:
In the Osteology we divided the body
into three parts, viz: Head, Trunk, and
Extremities; the Trunk of the Skeleton
we subdivided into, the spine, Thorax,
and Pelvis, but in a fresh subject we
divide the Trunk differently, viz: into
The Thorax, and Abdomen, or upper, &
lower belly. The Viscera of the Thorax
are only the Heart, and Lungs, & therefore
not necessary to be subdivided.
The Abdomen is separated from the
Thorax by the Diaphragm.
The Abdomen by reason of its largeness
and the many Viscera contained
therein, has been divided into several
parts, by imaginary lines, for the readier
knowing the particular situation of each
Viscus. The divisions are as follows,
1st
G 


 


1st. That which lies under the Cartilage
Xyphoides, is called Scrobiculus Cordis,
2d. From the Scrobiculus Cordis down to
within 2 or 3 inches of the Umbilicus
is called Regio Epigastrium, circumscribed,
and on each side there of it is called
Regio Hypochondrium. 3d. From the
Regio Epigastrium to 2 or 3 fingers
below the Umbilicus is called Regio
Umbilicus, circumscribed, and each
side Regio Lumborum, 4th. From the
Umbilical Region to the Os Pubis is
called Regio Hypogastrium, and
on each side the Regio Hiaea 5th. The
lowest part is called the Regio Pubis.
As we are sometimes called to open
the body of a deceased person before
their friends, particularly if they died
of a violent death; we should endeavor
to




to do it with regularity & decency.
The antients opened the Abdomen by
beginning at the Sternum & directing
the knife along the False Ribs to the
Loins, then along the spine of the Ilium
to the Os Pubis; and laying the loose
part over on the contrary side.
Others begin at the Xephoid
Cartilage & make a straight incision down
to the Umbilicus, then dividing the incision
directing one to the spine of the right, &
the other to the spine of the left Ilium,
and turning each part back.
But the best method is to begin
the incision at the Xephoid Cartilage
and going straight down to the Olsa Pubis
and then another transverse from the
Navel to the Loins each way.
The Thorax is opened by pushing off the
Teguments & Cutting the Cartilages by the Sternum.
Lect.



All the internal superficies of the cavity of the
Thorax, the ribs, cartilages of the ribs & convex side of the
Diaphragm except where the pericardium lies in contact wth.
it are lined with one continued, thin, nervous, very strong
membrane, internally very smooth called Pleura.
On the external superficies of this every where is the
cellular membrane wc. in very fat animals is often so enlarged
with fat as to lessen the capacity of the Thorax & these cause
a shortness of breath.
The Pleura when it gets round to the vertebra elevates itself
perpendicularly lowd. frenum wc. with the one on the other side
from a doable pleura called Mediastinum dorsale.
The same duplication is made of the Sternum when it is
called mediastinum pectorale.
The pleura likewise covers all the muscular circumference of
the diaphragm above the cellular membrane wc. arising up together
with the orb of the septum from the back sternum, from
the external membrane of the pericardium wc. is the third
cavity of the Thorax in the middle between the 2 cavities of
the pleura containing the Lungs & formed a conjunction of them
This membrane of the pericardium is lined internally with
a thin membrane wc. is a branch of the external membrane of
the Heart. The great vessels from the Heart as they pass
thro' the pericardium & go on beyond it or move also at above
the cellular one from the external membrane of the pericardium.
this membrane forming about to the pulmonary arteries & using wc. 
when they arise at the Lungs is expanded out & forms the extenal coat
of the Lungs. Kaan de Perspi Hippocrat. 


Lect. 41st:
Of the Pleura.
The Pleura is a fine membrane, which
lines all the cavity of the Thorax and
is reflected back over the Lungs.
There are two Pleura one on each
side, like two bladders beginning as we may
suppose at the sternum and going round
within the Ribs to the Vertebra of the
Back, then reflected back upon the
outside of the Lung (making the coat
of the Lungs) to the sternum; there
running in or uniting with the first
Fibres of the same and so on the other
side; where the two Pleura meet at
the sternum; they are not quite in
contact with each other, but there is
a small space left between which is
filled up with cellular Membrane.
Of


Constat pulmo duplici vasorum genere,
aerifero scilict & sanguifero.
Aerifera omnia vasa ortum ducunt ex una
trachea, quo mox a faucibus intitium capiens,
ante oesophagum, descendit, thoracem post
thymum intiat; post cavem descendentem & pericardii
apicem, as quartam thoracis vertebram, qua
est a superiore una tertia pars ipsius pulmonum
longitusinis divaricatur.
Hujus dein crura tendunt ad utrumque pulmonem,
& statim dividuntur, in homine dextrum in tres,
sinistrum in binos ramos, qui tune bronchia dicuntur,
as totidem pulmonum lobos, quos ubi ingressa funt,
disperguntur statim in ramos minores, & minores;
qui omnes ad obtusum angulum, respectutrancorum,
oviuntur.
Remi autum majors ingressi pulmones, pro
maxime parte, descendunt, pauci recti procedunt,
ubi ingrediuntur; aliivero adscendunt aeriferorum
truncorum, & horum ingressum est. quod
prater Eustachium meminen observasse video.
Ultimi


Of the Lungs.
The Lungs are Vascular Substances
composed chiefly of Air Vessels, and
Blood Vessels; the Air Vessels are
Ramifications of the Trachea Arteria,
and are called Bronchia; the blood
Vessels are ramifications of the Vena
and Arteria Pulmonalis; beside-which
they have an Artery wc. serves
to nourish them, called the Bronchial
Artery coming from the Ascending
Aorta together with Nerves and
Lymphatics, and some say also
Parenchyma which is perhaps no
more than cellular Membrane.
Some Anatomists suppose there are
little follicles or cells at the extremity
of the small Bronchial Vessels, which
if there is are not discernable.


Ultimi autem ramuli ommitunt cartilagineam
indolem, & expanduntur in vesiculas oblongas,
membranaceas, cavas, qua Malpighiana dicuntur,
ox quibus fiunt area, & lobuli, qui tandem pulmonum
lobos efficiunt.
Comitantur aerifera hac vasa, in omni decurser,
ad vesiculas usque, vasa Sanguifera, qua omnia
oriuntur ex arteria pulmonali, qua cordis dextro
ventriculs egressa, qua parte superiore ventriculs
sinistro jungitur, adscendit, mox se incurrat, arcum
facit, & sub aorta decumit. Descendit
The inside of the Trachea arteria is lined with a
membrane in which are small glands that secrete mucus 
for lubricating the its internal surfaces; in cold, this means
is sucked into great quantity—sometimes inspissated 
is spit up very thick especially in the morning.
Dissection has taught us that this membrane is the
seat of that disease in children called the Hives & is
found separated from the cartilages – nothing proves so useful
in this disease as large doses of 8. I have known 10 g of calom: given to 
a child 2 years old produced 2 copious stools & disease immediately vanished


The Lungs are divided into two Lobes,
by means of the Mediastinum and
Heart. The right Lobe is divided into
three Lobuli by fissures; and the
left Lobe is divided into two Lobuli.
In a natural state, the Lungs are
every were in contact with the Ribs,
so that there is no vacuity left.
The Trachea Arteria is composed of
cartilaginous Rings, which behind are not
quite shut but a small membrane between;
each of the cartilages are connected likewise
by membranes.
The Lungs are liable to inflammation,
and Ulceration. In inflammation of the
Lungs we should use plentiful bleeding,
oiluants, fomentations externally and
the steams of warm liquors particularly 
Vinegar, into the Lungs thro' the mouth.


x The ventricles are divided by a middle partition
called Septum Cordis.


Lect. 42d:
Of the Hearts.
The Heart is a strong muscular substance,
situated obliquely to the left
side, more than the right; part of the
inferior and or Apex in contact with
the Diaphragm, and pointing between
the sixth and seventh Ribs on the left
side; the Apex being likewise nigher
the sternum than the Basis.
The Heart is the Origin of the Veins
and Arteries.
There are four cavities in the Heart,
two Auricles, and two Ventricles; x one right
and one left, at the right Auricle the
Vena Cava enters, and at the left: the
Vena Pulmonalis; at the right Ventricle
the Arteria Pulmonalis egresses, and
the Aorta from the left.
M


x these cordae Tendineae arise from the Carnae 
Columnae.

At the entrance of the Vena Cava into
the right Auricle of the Heart are three
Valves called Valvula nobilis, and about
the middle of the Auricle there is a little
knob called Carna Sesamoidea: At the
entrance out of the right Auricle into the
right Ventricle and two valves called Valvulae 
bicuspides, connected by sou:e small tendinous
cords called Cordae Tendineae x; the internal
part of this Ventricle is rough & muscular
having many muscular Pillars, called
Carnae Columnae which serves for to
strengthen the motion of the Heart
and to work the blood so as to prevent
its concretion & forming Polypuses,-
which however sometimes happens.
After the blood has passed out of
the right Ventricle into the pulmonary Artery
it is prevented from returning by three
valves




Valves named Valvulae Semilunares.
There are likewise Valves at the
entrance between the left Auricle and
Ventricle named Valvulae Mitrales
fastened by the final Cordae Tendineaes
on the left side of the Heart.
The left Ventricle is larger and a
stronger & much thicker muscular bag
than the right Ventricle, its internal
part tougher and the Carnae Columnae
bigger. As the entrance out of the
left Ventricle into the Aorta are likewise
three Semilunar Valves.
The Heart is contained in a strong
Membranous bag called Pericardium
the internal part of which bag is very
smooth and lubricated with a juice
that continually transudes through the
same
H.




Same
Dr. Plott in  his History of Staffordshire
attests of his own knowledge the case of one
Mary Eagle who drew two quarts of
milk from her breasts every day besides
what her child sucked and that she
could make two pounds of butter
every week ever since she was
brought to bed which was above
five months when the Dr. saw her.
Borellus in his Hist: & Absence:
physioc-med: related an instance of
the like native in one Mary Caron
a Taylor’s wife of Bologna who afforded
milk enough for two children & made
Butter besides
Biog Dictionary Led: Esq:






Lect. 43d:
Of the Diaphragm
The Diaphragm is a large Muscle
between the Thorax and Abdomen, the
muscular fibres of which arise from the
internal part of all the ribs below the
sternum, and from the lower end of
the sternum, these fibres terminate in
a tendinous expansion which is nearly
in the middle of the Diaphragm, and
which is of an oblong figure coming
very nigh the sternum upon which
part the Apex of the Heart lies, and
from thence turning down towards
the Angle of the Ribs and is called
the oval tendon of the Diaphragm
the lower part of the Diaphragm is
likewise muscular and on each side
of the Vertebra are muscular Fibres
sent





Sent down some distance called the Crura
of the Diaphragm, these terminate
near the Origin of the Psoas muscles
which arise at the internal part of
the Vertebra of the Loins and pass out
of the Abdomen at the Inguen to be
inserted into the Os Femoris. it is
by making way through these muscles
that Abscesses of the Loins sometimes
fall down to the Thigh and are opened
and discharge their contents there.
There a three Apertures thro'
the Diaphragm, one of the right side
of the Vertebra through which the
Vena Cava goes, a second contiguous
to the Vertebra inclining a little to the
left thro' wc. goes the Aorta, a third
over the Aorta & exactly over the Vertebrae
through wc. the Oesophagus goes.
Of





Lecture 44th:
Of Respiration
Respiration is an alternate dilatation and
contraction of the Thorax the former performed
by Inspiration and the latter by Expiration.
The parts subservient to Respiration
are divided into Active and Passive
The active parts are the Ribs, Sternum,
Heart &c: acting upon the the passive
which are the Lungs themselves.
The dilatation of the Thorax happens
both in length and diameter; in length
by means of the Lungs pressing upon
the Diaphragm and thereby rendering
its convexity more plane, the diameter
is increased by the motion of the
intercostal muscles &c: Thus the
capacity




Capacity of the Thorax is increased
and as there is no vacuum between
the Lungs and ribs allowed of in a
natural state, the capacity of the Lungs
will also be increased and there will
be a vacuity in the Lungs wc. nature
not admitting of and by the pressure
of the Atmosphere rushing through
the Aspera Arteria they are soon
filled with Air making Inspiration.
The fresh Air that is drawn in
by Inspiration stretching the Bronchiae
and stimulating the same cause
them to contract and expel the Air
making Expiration, some Authors
imagine these are small Muscles
between




Between the cartilaginous Rings of
the Bronchiae which they call Musculi
Mesenchrondroeci serving to contract the
the same in Expiration.
The uses of Respiration are four,
1st For the circulation of the Blood, thus
in Inspiration the Lungs are distended
and the fine contorsions of the Arteries are
are elongated so as to allow, blood to pass
through them whereas in a collapsed state
the blood cannot pass through them.
in Expiration the Lungs collapsing push
the Blood through the Veins into the left
Auricle of the Heart.
2d. For sanguification by communicating
the Blood making it more florid & denser
3. For cooling the blood
4th. For Vocification, exclusion of [illegible] &c:




Of the Peritoneum
This membrane is similar to the pleura, being smooth
on one side & connected by cellular membrane on the other; it is
reflected from the contained path to the containing. It makes
a compleat bag 1st: covering the viscera by intimate connection,
& then covering the abdominal muscles loosely on the
inside. The peritoneum has been considered
as a double membrane true or false, the last is no
more than cellular membrane wch. connects the peritoneum
to the external parts. We may conceive that all
the viscera are behind or without the peritoneum, wch. 
running up on one side of a viscus is reflected back
on another so as to form an almost compleat 
cover to each viscus separately, so that by a very
nice dissection the peritoneum may be taken out
in a compleat bladder having no perforation at
all, leaving all the viscera undisturbed.




Lecture 45th:
Of the Stomach
The stomach is a large muscular bag
situate Obliquely from the Left Hypochondrium
to the Epigastrium and serves for
the reception of our food & digestion of
the same, it has an upper & lower curvature
called the lesser and greater curvatures
of the stomach.
There are two Orifices to the stomach;
the superior one called the Cardia which
enters it from the Oesophagus don't open
at the fundus of the same but obliquely,
at the side an inch or more from the
end. Towards the inferior end the
stomach grows smaller & turns up
opening into the Duodenum by an
Orifice called the Pylorus where there
is
J


The Nerves of the stomach come from the
par vagum.



Is a partial kind of a valve which does not
prevent the regurgitation of fluids into
the stomach being only a thickness of
the internal coat of the stomach.
The stomach is furnished with
Nerves and blood vessels. x
Some Anatomists say there are
small glands in the stomach, but if
so they are not easily discovered, there
is however a fluid discharged into the
stomach from the extremities of the
Arteries called the Gastric lymph
from the gastros the Greek name for the
stomach, there is likewise Lymphatics
which absorb the redundant fluids
& carrys it into the blood.
The coats of the Stomach are three
1st. coming from the peritoneum and is
called




called the Peritoneal Coat. 2d. Muscular
being composed of thin muscular fibres
running longitudinal and transversely
by which the capacity of the stomach
is decreased the readier, to expel its
contents. & 3d: Villous or internal Coat
which is thin.
Of the Intestines
The first Intestine next the stomach
is the Duodenum beginning at the
Pylorus and ascending two or three
Inches, has then two or three inflections
pulsing down & across the Vertebrae —
being all the way tied fast by a
duplicature of the Peritoneum to the
back, having no mesentery.
The Ductus Choledocus & ductus
Pancreaticus both enter the Duodenum
several




Several inches from the Pylorus, not
both by one Orifice but by two very
near together, next the Duodenum is
the Jejunum, & then the Ilium which
is the last of the small instestines.
The coats of the Intestines are
three the same as the Stomach, and
in the small intestines are anular
duplicatures of the internal Villous coat
forming what is called Valvulae Coniventes
which serve for two purposes, first to
make the passage rough & prevent
the Faeces, from passing on too fast
and secondly to give more capacious origin.
to the Lacteals
The Ilium enters the Caecum 
not at the end but about an Inch
there from obliquely the blind end only
being




Being called Caecum, where there is
an appendage called Apendicula Vermiformis.
At the entrance of the Ilium
into the great Intestines, there is a
Valve formed by the inner coat of the
Colon & called Valvula Colli which
in a sound state entirely prevents the
regurgitation of the Faeces or any fluids
passing, injected per Anum.
The Colon runs up the right
side then along under the stomach
and down the left side, surrounding
all the Abdomen, hence Clysters
beside discharging the Faeces serve
the purpose of a fomentation to the
contents of the Abdomen.
The Intestines are furnished with
blood vessels from the two mesenteries 
except


 


except the Rectum which receives
its from the Hemorrhoidals.
The Mesentery is a double membrane
formed by a duplicature of the Peritoneum
serving to connect the Intestines. & through
which which the blood vessels go to be distributed
to the Intestines, through it
likewise goes the Lacteals which are fine
Lymphatic or absorbent vessels arising
from the villous coat of the Intestines
and passing through the mesentery, they
terminate in the Receptaculum
Chyli, to be described hereafter, there
is also a great number of Glands in
the Mesentery through which the
Chyle passes, and by which it is
supposed to receive some alteration.
These glands are very small.




Lect. 46th
Of the Lacteals & Thoracic Duct
The Lacteals are an innumerable number
of small vessels arising as before said
from the villous coat of the Intestines &
running through the mesentery in the
duplicature of the same and through
many fine glands and terminate in the
Thoracic Duct serving to convey the Chyle
The Thoracic Duct is a small
canal running up the Vertebra of the
Spine between the Aorta & Vena Azygos
and under the Vena Cava until it gets
above the Heart then it turns a little to
the left and ascending empties itself in
to the subclavian Vein.
The lowest end of this Duct has been
called Receptaculum Chyli but improperly
as its no larger than the rest of the Duct
neither do all the Lacteals enter there, but some higher






Of Digestion
Digestion is that change of the Aliments
whereby they are filled for the nourishments
of the body, this is different from the
different juices mixed therewith and in
the different parts of the body.
The first change that happens to the
Aliments is in the mouth by means of
Mastication and mixing with the Saliva
by which it is somewhat dissolved and
fitted for more easy Deglutition
Saliva is a clear mucous transparent
fluid secreted by the Glands of the
Mouth in the great plenty, and is of great
use in digestion.
After the Aliments is sufficiently
masticated & mixed with the Saliva they
are by the Tongue pressing against
the roof of the Mouth forced into the
Pharynx




Pharynx and from thence through the
Oesophagus into the Stomach. The
Muscles employed in this act of deglutition
are very many, serving chiefly to
pull up the Oesophagus and to press the
food down through the same, and we
may very well conceive of the act of
Deglutition by that of drawing a stocking
on the Leg, part of the muscles drawing
up the Oesophagus as we draw up
a stocking upon the leg, and the rest
pushing down its contents as we push
down our leg into a stocking.
The manner in which our food is
digested in the stomach was by some
of the Antients reckoned to proceed from
heat
K




Heat, others reckoned it was performed
by means of trituration, and others again
from the different juices there mixed
imagined it was performed by Fermentation,
but modern Physiologists from
many observations, think it is performed
by all three jointly viz: Heat, friction
and Fermentation.
After the Aliments are sufficiently
digested in the stomach, by the contraction
thereof which is the beginning of the
peristaltic motion of the Intestines, they
are forced through the Pylorus into the
Duodenum, where it continues some
time and receives another change by
having the Bile and pancreatic juices
mixed therewith.
The







The Bile is an oily bitter, and attenuating
substance endued also with
a saponaceous virtue it will incorporate
with Oils and when so mixed they are
both soluble in water, it unites with
salt forming a green color. by which
it appears that the Bile is of great—
use in attenuating the viscid part of
the Aliments, and stimulating the—
Intestines, the latter we are assured—
of by this that Bile secreted and—
discharged into the Intestines in too great
a quantity causes a Diarrehea, and in
a Jaundice where the Bile returns into
the Blood and is not sent into the
Intestines a Costiveness happens
with while stools, and Boerhaave
says






Says the Gall of Animals is of use
in this case to supply the want of Gall
DeGraaf collected great quantities
of the Pancreatic juice from Animals
which he says is subacid it is reckoned
to be somewhat of the nature of the
Saliva, some reckoned it serves to
sheath the Acrimony of the Bile but
this in a natural state is not too Aerid
These two fluids being mixed with
the Aliments in the Duodenum the
fluid and nutritious particles of the
same are absorbed by the Lacteal vessels
and by them carried into the Thoracic
Duct to be conveyed into the Blood.
These Lacteals are in all the intestines,
but in the small ones in the 
Greatest 




Greatest plenty, That there are also
Lacteals in the Colon seems evident
1st. From the rout the colon makes round
the Abdomen, for if that is not for
absorbing the particles that may chance
to be not taken up by the vessels in
the small Intestines why did it not
go out strait like the Rectum and
immediately terminate in Ans?
2. From persons being known to have
lived a long time by Glysters, not being
able to get any thing thro' the Oesophasgus,
& it is known that they cannot
pass by the Valve of the Colon.
The contents of the Intestines are 
carried along by the Peristaltic motion
thereof




thereof. Vomiting is an inversion of
the peristaltic motion and is performed by
means of a deep inspiration which presses
the Diaphragm against the stomach &
a convulsive contraction of the stomach
by which its contents are thrown up
hence we learn that Emetics are good
in Fluxes by inverting the peristaltic
motion they stop the same.




Of the Bile
Bile is secreted in the Liver. It is
8 times as viscid as water. More
subject to concrete than any other
humour in the body. Its specific
gravity to water is as 010 to 795.
In a such quadrupeds & in the human
species the bile is very bitter, but
most so in carnivorous animals.
Recent bile easily mixess with water.
It mixes with oil by triture. Mixed
with water it partakes of the property
of Soap, dissolves oil so that it will
mix with water & takes out grease
spots. It dissolves resins & mixes
with balsams. It dissolves Myrrh
Bdellium & Wax like the yolk of
an Egg, & is supposed to dissolve
the Blood when mixed with it as
in a Jaundice.




The Ductus Choledochus may
may be compressed & stopped by
the Duodenum being distended with
flatus. Eating Mushrooms has
been known to distend the duodenum
greatly & trangulate the ductus
choledocus as it were with a
ligature. It may also be obstructed
by the contractions of the fibres of the 
intestine from stimuli as happens
in the Colica pictonum, biliosa,
inflammation of the duodenum, acrid
purges, glass of Antimony & poisons.
Hither we may refer the Jaundice
in Infants which is removed by
Rhubarb. Storck has seen the ductus
choledochus obstructed with a cheesy
coagulum. Hillary says this is
frequent in the warm Islands.
See Monro Ed: Ess: v. p 247 Baglivi
prax: med: Haller tom: 6. p 590


x about 4 fingers breadth below the pylorus.


Lect. 47th Of the Liver
The Liver is a large Viscus situated
immediately under the diaphragm mostly in
the right Hypochondrium extending over the Stomach
into the Epigastrium it is convex
above and concave below suspended by three
Ligaments one above to the Diaphragm one
broad on the upper part of the round ligament
from the Umbilicus which was the Umbilical
Vessel in a foetus state. There are several
fissures in the Liver 1st. Divide the great lobe
from the lesser one. 2d. divides the Lobulee
spigeli & the third where the Hepatic
Vessels enter;
The Vesica Fellis lies in a depness in
between the two lobes of the Liver from
where goes a duct remarkably contorted to
appearance about two inches when it joins
the hepatic duct, both of them united
form the Ductus comunis Cholidochus
which terminates in the Duodenum. x
The Coat of the Liver comes from
the
L

x sometimes called Tunica Glissoniana
*The hepatic Artery divides a little before it enters the
Liver one branch going to one lobe & the other to the other
Lobe; it serves to nourish the liver & is said to secrete a
small part of the Bile, some few of its evanescent frame has
terminating in the pori biliarii as is proved by injections.


The Peritoneum x beside which some Authors
describe another coat wc. is scarce to be
seen, The Gall Bladder has three coats
1st. from the Peritoneum, 2d: Muscular
& The 3d. Villous, appearing like a honey
comb inside. The Liver is furnished with
Veins Arteries & Nerves.
The Blood Vessels are the Hepatic *
Artery & Veins & the Vena Porta.
The Vena Porta is like an Artery first
in its Office & 2dly. in the thickness of its
coats; it arises from all the Viscera of the
Abdomen terminating in the Liver and
is supposed to carry the blood for the
secretion of the bile, 1st. From the longness
thereof & the smallness of the hepatic Artery.
2dly: By injections passing from it
into the biliary Duets &c:
It is certain however that the blood
being carried into the Liver, part of it is
converted


x The general opinion of the ancient
Anatomists was that the bile was conveyed
into the Gall Bladder by little ducts
running from the liver immediately
into the bladder which they called
ducti hepaticistics. Pechlin was the 
first who denied the existence of these ducts
in the human body, then Ruysch,
Cowper, Bidlow, Berger, Morgagni,
Heister, Ludwig, Carsons, Lieutaud, Ceyer,
& Cheselden. who says if a ligature be
applied round the cystic duct, or if it
be obstructed the gall bladder does not
become turgid. Bohnius emptied the
gall bladder of bile then tied a ligature
round the cystic duct & upon examining
the same several days afterwards found
no bile in the cyst itself but the part of
the duct between the ligature & liver was
greatly distended. Bianchus & Haller
have done the same. This clearly proves
that there is no communication between the
Liver & Gall bladder but by the cystic duct.
What was supposed to be Hepatocystic ducts
is demonstrated to be only blood vessels
by Ruysch, Guntz, Haller Morgagni & others.


converted into Bile & carried by the pori
Biliarii which all meeting together form
the hepatic duct though the hepatic duct
to the cystic then regurgitates into the Gall
Bladder; that the Bile regurgitates thus x
into the reservoir is proved 1st. by there being
no other passage though some supposed there
was by little ducts wc. they called cysto hepatic
ducts, but there is no such is evident from
the injections not passing through that way
 into the Cyst, & in a Viper the Gall Bladder
is vitiate some distance from the Liver.
Horses & Deer have no Gall Bladder.
That the Bile goes through the hepatic Cystic
Ducts into the Gall Bladder is proved 2dly:
by blowing into the hepatic duct the wind
passes free into the cystic than through
the ductus cholodochus.
The remainder of the Blood is received
by the Veins & carried back to the Heart
Diseases


x more frequently if not always the Jaundice
arises from an obstruction of the
Ductus communis Cholidocus
An obstruction of the cystic duct
alone will not occasion a Jaundice.


Diseases of the Liver are:
1st. Hydatides these are of two sorts
the first tumors composed of several lesser
cysts filled with a gelatinous matter, the
other a kind of vascular Cysts, the fluid
circulating through it.
2d. Inflammation this is best relieved
by plentiful bleeding warm relaxing and
stimulating applications &c: It sometimes
suppurates & even grows cancerous.
3d Scirrhi like other Glandular parts
4th. It gives origin to the Jaundice wc.
proceeds from an obstruction in the Cystic x
duct by wc. means the Bile is prevented
from going into the Gall bladder and
therefore returns into the Liver where it
is absorbed by the Veins or lymphatic
Vessels & carried into the blood & by that
means tinges the shin, the cystic duct
may be stopped by concretions tumors compressing
the




The same or more commonly by means of a
stone lodged therein: a stone or concretion
is best removed by Vomits which agitating
the parts serves to remove it or by friction
stimulating the same.
Some have imagined that a Jaundice
proceeds from a scirrhus Liver, but this
is proved to not be the cause as no Jaundice
can be unless the bile is absorbed after
it is perfectly made
Transient Jaundices sometimes
happens to Children from a spasm of the
Duodenum from acidities or otherwise
hinders the Bile from passing therein &
which is relieved as soon as the spasm
is removed.
Durable Jaundices happen when
the Obstruction of the Cistic duct cannot
be removed
Lect. 40th:
Pancreas is a long slender conglomerate
Gland situate obliquely under the stomach
between the spleen & Duodenum. each
little


x Haller supposes the pancreas secretes three times
as much fluid as the salival Glands.
* a costiveness and a pain in the region where this
gland is seated is the common symptoms of its being
obstructed.


little acini or knot supposed to be the extremity
of an Artery wound up in a knot and
the whole vascular like the liver and all
the other Glands of the body. from each
acini goes a small excretion Duct which
terminates in a larger duct in the middle
of the Pancreas & called the pancreatic
Duct & through which the pancreatic
juice flows into the duodenum, the
glands of the pancreas being the same
with those that discharge the Saliva
are supposed to secrete the same juice
and for the same Use. x
Diseases of the Pancreas are
Inflammation, Cancer, & Schirri, which *
are very difficult to be known until past
cure they are however removed much
in the same same manner as the same
Diseases on other parts, Soap is a very
good thing in this case which not only seen


x This appears very reasonable though it was
never taken notice of by any author before Mr. Monro.


Is a good resolvent but supplies the place
of this juice in digestion.
Sometimes a Diarrhea happens in a
Salivation and proceeds from a too great a
secretion of the pancreatic juice which being
the same with that of the saliva is supposed
to be effected in the same manner with
Mercury & is only to be removed by removing the cause. x
Omentum is a fatty double membrane
composed or formed by a duplicature of
of the Peritoneum it has an appendage
between the Liver & stomach called the
Omentum minor & may be inflated.
Uses of the Omentum are to lubricate
& keep the Intestines warm, and it is
supposed to supply oily particles to the
Bile and also the blood.
It is sometimes much distended with
Fat and in very lean subjects quite
reticular. Spleen




Of the Spleen
The Spleen is a roundish lobulated
Gland situated in the left Hypochondrium
it is furnished with blood Vessels and
but very few Nerves.
The Antients supposed its use
was to counterbalance the Liver, others
thought it contained a fluid called the
Atrabilis, but the moderns mostly
think that it is subservient to the
Liver, it has been taken out of several
animals without any apparent damage
and is not therefore a vital viscera.
It is subject to very few diseases,
scarce ever being inflamed schirrius or
cancerated, by reason of the fewness
of the nerves, its only subject to a
viscidity of its fluid and an enlargement
therefrom.
Lect.


x The arteries generally divide into three branches
and the vein into two before they enter the Kidneys.


Lect. 49th
Of the Kidneys
The Kidneys are two Glandular bodies
situate between the false ribs & Ilium.
the situation of the right Kidney is somewhat
lower than that of the left oweing
to the Liver being on that side. The
blood vessels of the Kidneys are an Artery
and a Vein called Renales or Emulgents
the right emulgent Artery is longer than
the left & the left Vein than the right.
These vessels enter at the Pelvis and
are distributed through the same. x
The external part of the Kidney is called
Cortical the thickness of which is irregular
and in this the Urine is secreted and
emptied into little ducts in the inner
part  
M


x the pelvis is an enlargement or expansion of the
of the upper part of the ureter where it enters the
Kidney or rather where the united urinary Tubes regress
out of it.


part of the same, which is called the
Mamillary part of the Kidneys.
The little ducts into which the Urine
is secreted are called Tubuli Urinarii
and are in number about a dozen,
these all unite in the Pelvis x forming the
Ureter which is a membranous canal
conveying the Urine from the Kidneys
to the Vesica Urinaria. The Ureter
as it enters the Pelvis of the Kidney
divides into three parts one going towards
each end and the other through
the middle. The coats of the Kidneys
are two, the first called Adipose and the
second Membranaceous.
There is an appendage to the 
Kidney called Glandula Renales or
Gland




Glandula Succentriari situate at the
top of the Kidneys its particular use
not known but supposed to be subservient
to the Kidneys.
Diseases of the Kidneys are,
Inflammation, Diabetes from a too
great laxness of the Vessels allowing
the red particles of the blood to pass
through them, gravel, Scirrhi &c:
Lect. 50th:
Of the Bladder
The Bladder is a membraneous Bag
situate in the Pelvis the upper part of
which is covered with the Peritoneum
but when it is very much distended it
protrudes about an Inch above the
Pelvis & being there covered with the
Peritoneum




Peritoneum & in this place is the upper
Operation for the Stone performed by
making an Incision into the Bladder
without cutting the peritoneum the doing
which would be of dangerous consequence.
The coats of the Bladder are three,
1st: the common coat 2d: muscular and
3d: Villous, the muscular coat at the
neck of the Bladder is thick & circular
and is called Sphincter.
The Ureters enter the Bladder one
on each side about an Inch from the
neck thereof by a small Orifice obliquely.
The situation of the Bladder is between
the Rectum & Olsa Pubis in men and 
between the Uterus & Pubis in women 
its use is a Reservoir to the Urine




Parts of Generation
Lect 51st
1st In a Male.
These are the spermatic Cord, Testes
Scrotum, Vesica Seminales, Prostate
Gland, and Penis.
The spermatic cord is composed of
the spermatic Artery and Vein, Nerves,
Lymphatics, & Vas deferens all included
in acellular coat and some have
supposed a muscular wc. they called
Cremaster wc. is not visible except where
it passes out of the Abdomen wc. it does
in an oblique manner through the rings
of the Abdomen, by which the Intestines
and Omentum sometimes falls thro' 
forming an Herniae Inguinalis or Jerotalis
along the side of the spermatic Cord
The


x Caput Gallinaginis


The vas deferens empty themselves somewhat
like the biliary ducts there being a passage
from them immediately into the Urethra, but
it commonly regurgitates into the Vesicula
Seminales & there kept till used.
Vesicula Seminales are two Glands situate
under the neck of the Bladder, composed of
little cells which communicate with each
each other, being reservoirs for the semen,
from each of these there goes a small duct
which opens into the Urethra at the 
Caput Galaginis, x where is a large Gland called
the Prostate Gland which secretes a fine
mucus to defend the Urethra from the acrimony
of the Urine.
The Scrotum is composed of skin Cellular
Membrane &c: next to which has been reckoned
a muscle called the Dartos which is not to be
discerned




discerned, and the first obvious Coat
is that wc. surrounds the Testicle much
as the Pleura or Peritoneum does the
contents within them this is called the
Tunica Vaginalis propria Testes, and
within that is a coat which adheres to
the substance of the Testicle called the 
Tunica Albuginea,
The substance of the Testicle is
wholly Glandular, the spermatic Artery
entering in at the side of the same and
distributed through the same terminating
in fine secretory ducts and these again
in excretory ducts which uniting into one
form the Vas deferens, The Epididymus
is an Appendage to the Testicle formed by
numerous convolutions of the excretory duct,
reckoned 6 times as long as the Spermatic Cord.




Lect. 52d:
Parts of Generation in Females.
These are either external or internal, the
external are the Mons Veneris on which
hair grows at a certain age
Labia or External Lips of the Orifice
at the upper part of wc. is a small body
called the Clitoris under which in a
small groove is the Iter ad Urinam
thro' which the urine passes & into which
the Catheter must be introduced in a
suppression of Urine, & we should be well
acquainted with this Orifice as the modesty
of women often denies us a sight of the
part, so that we must introduce the Catheter
by feeling, at the lower part where the
Labia unite is formed a Fraenum or
Fushet or Foushette.



x Iter externum ad Uterum



Nymphae are two spongy bodies
within the Labia within these in Virgins
is a circular membrane called Hymen
within these is the Iter externum ad Uterum x
Vagina is a membranous substance
furnished with rugae by wc. the Penis is
more titillated in Coitus, there is likewise
many small glands in the Vagina wc.
secrete a liquor to lubricate the same and
during the Venereal orgasm whether real
or imaginary there is sometimes so much
mucus secreted by these glands that
it has been discharged, in great quantities
so as to wet all the external parts, this
by some is reckoned the Female semen.
At the bottom of the Vagina is the
Iter internum ad Uterum, the Os Uteri or
Os Tincae. N Between


x or young Puppy



Between the Fushet and Anus, there is
a seam called Perinaeum, this in
difficult deliveries is sometimes lacerated
by the largeness of the Foetus & it is
necessary to prevent this accident for to
support the Perinaeum with the hand
while the Foetus advances
Uterus is a small body situate
obliquely between the Bladder & Rectum
its coats size near half an Inch thick
& its internal cavity very small; the
Neck of the Uterus is full of rugae wc. 
serve to allow the same to dilate for the
expulsion of the Foetus. The Os Tincae
resembles the mouth of a Tench x situate
at the bottom of the Vagina tho' not a
continuation thereof the Vagina being
inserted



x An demande si le corps de la matrice
etant renverse, & ayant tente inutiliment
va induction, elle montroit quilque
disposition a ve gangrener, e il conviendroit
pour lors de l’eactirper, apris
avoir porte une ligature le plus haut
qu’il veroit possible. En parsil cas
on ne devroit point balancer de faire
cette operation pour empecker que la
gangrene faisant du progres du cote
des parties interieures, elle ne causat
la mort a la malade. L'extirpation
de la matrice, quoique rare, never sit
point en cette occasion une operation
temeraire, son succes etant prour a
par plusieurs observations
Verdeer's Anal: v: 22 p 66
Rousset, dans son Traite de
Partes Caesares, dit qu'une femme
a la suite de pluesieurs accouchemens
laborieux, eut une precipitation de
matrice qui ne pouvant etre


inserted round the Os Tincae. From the
Fundus of the Uterus there goes off nearly
transversely on each side, a tube called the
Fallopian Tubes lying loose & growing
larger toward the further end wc. is fimbricated.
The Uterus is suspended by the
ligament lata & rotunda x
Ovaria are two glandular bodies
situate on each side of the Uterus inclosed
in cellular membrane in each of these
Ovaria are near 20 small Ova
Of Generation
This is perfomed per Coitus by the
Male’s introducing his Penis into the
Vagina, & perhaps into the Os Uteri tho'
this is denied by some at which time the
parts grow turgid by the venereal Orgasm
the Os Tincae opens & receives the male Semen
in which are Anamalcules, immediately
attended.


reduite, se gangrena, & tomba
d’elle-meme. La femme ne daigna
pas garder le lit, & elle Jouit d’une
parfaite vante’ pendant trois ans,
au bout desquels, etant morte d'uno
fievre continue, louverture de fon
corps fid voir que c’ etoit veritablement
le corps de la matrice, qui
par pourriture s’etoit s’epare
de lui-meme
Ibidem p168.


afterwards the Os Tinca closes
During the Orgasm the fallopian Tubes
grow erect & the Timbria seize the Ovaria
at wc. time some one or more of the Animalcule
ascend through the Fallopian Tubes & enter
the first ripe Ovum wc. has now burst
the cellular membrane by its turgidity, then
the Ovum is disengaged & carried by the
Fallopian Tube into the Uterus, and the
place where the Ovum was in the Ovarium
is soon after filled up by a yellowish substance
called Corpus Luteum, this I proved by
opening a Bitch in the Hornes of the Uterus
were 7 whelps in one three & the other four
& in the Ovaria were the same number of
Corpora Lutea, by alike experiment upon a
Bitch opened while the Dog was fastened
thereto, for dogs have no Vesicula Feminalis
are obliged to remain fastened to the Bitch
a




a long time while the Semen is excreted and
carried from the Testes by the Vas deferens
into the Uterus I found that the semen
was ejected immediately into the Uterus.
Though the preceeding Hypothesis seems
incredible and almost impossible, yet it
answers all the Phenomena of Generation
the best of any system yet advanced:
however the subject is extremely intricate
& no doubt is one of the Arcana natura
which the omniscient Jehovah of his
infinite goodness sees fit to hide from us.




Lect: 53d.
Of the Foetus its Nutrition &c.
The Ovum of the female wc. is foecundated in
the preceeding manner by the semen Masculinum is supposed
to contact also the membranes that envelop the foetus
with the Placenta, Umbilical Chord &c:
The Ovum lies in the Uterus 9 months, but for
the first two or three months the Placenta does not
adhere to the Uterus
The Chorionis the external coat of the Foetus it
is a thick spongy membrane.
The Amnios is within the Chorion it is very
thin and smooth, between these two membranes
some have described another called Alantois wch.
includes the Urine of the foetus carried there from ye. bladder by the
Urachus, this is found in some brutes but cannot
be discerned in the human species
The Placenta is made up of a congress of vessels.
How does the Placenta adhere to the Uterus? How is
the Foetus nourished? is it by the Mouth; the
Umbilical Vein, or by both together? Does red 
blood go immediately from the uterine Vessels of 
the


As first this want of Navel String, 2d: a diminution 
of the the Liquor Amnii, 3d. Mucus being found in the mouth
& stomach & meconium &c:
# 1st. A want of mouth or any passage into the
chylopoetic organs, 2d a corruption of the Liquor Amnii
3d. That the liquor Amnii is an exudation from the
foetus & consequently not fit for its nourishment &c:


the mother through the Placenta to the Foetus &
vice versa? from whence comes the Liqour of
the Amnios? these are question, that have been
differently solved by physiologists.
Some have imagined that the placenta adheres
to the Uterus by its vessels inosculating with those of
the Uterus, others imagine there is no continuation of
vessels by inosculation from the placenta to the
Uterus, but that the placenta adheres thereto by
a kind of cement; for (say they) if  it adhered otherwise
there must be a laceration (& consequently an inflammation & suppuration)
wc. does not happen when it is bro.' away.
As to the Nourishment of the foetus many have
imagined that it rec'd. nourishment by the mouth
& bring many arguments to prove it*, on the contrary
others deny that the Foetus receives any nourishment
by the mouth but wholly by the umbilical Chord -
this is the most viewed Opinion, but for a particular
acc't. of the Nutrition of the Foetus in Utero side
Med: Essays of Edinburgh and Dr. Shippen’s
Thesis for the connection of the Placenta to the Uterus
A




It was the rec'd. Opinion till of late by all who
allowed the foetus to be nourished by the umbilical
Chord that red blood was immediately conveyed from
the mother to the foetus; Their arguments for it are 1st.
that if the mother bleeds to death the Foetus will
be deprived of blood also. 2d. Injections pass from
the mother to the Foetus. 3d. that hemorrhages happen
upon a separation of the placenta from the
uterus. 4th that the umbilical Chord will bleed a
great quantity when cut &c: but the most modern
doctrine that now prevails & wc. answers all the
phenomena best is that red blood does not pass
immediately from the mother to the Foetus, for
before the placenta adheres to the Uterus it certainly
cannot, & then it must be nourished by absorption
of the Placentine vessels as well before as after
its adhersion to the Uterus; we have said
before that the placenta does not adhere to the
Uterus by inosculation of the Vessels, but by a
slight cementation, thence we suppose that
the


   


the small ends of the placentine Vessels open into
the mouths of the uterine ones, and as the mouths
of the uterine Vessels are so large near the
time of delivery as to admit a goose quill
whereas the mouths of the placentine Vessels
are so small as not to admit red blood
its very probable there are many of the
placentine vessels open into one of those of
the uterus.
These small placentine vasculae are part
of them supposed to absorb the chylous & ferrous
nutritious part of the blood in the uterine
vessels which the placenta forms into red
blood before it is conveyed to the Foetus;
The manner how the placenta acts in forming
this nutritious fluid into blood is
unknown, but it is supposed to perform
the office of Lungs in that particular.
The placentine vessels having absorbed
the nutritious particles of the mother’s blood
and


   


and the placenta formed it into red blood
it is conveyed by the umbilical Vein into
the Foetus, for its increase & nourishment,
while the superfluous & unnutritious part is reconveyed
by the umbilical Arteries into the
placenta & is absorbed by the uterine Vessels
and mixed with the blood of the mother;
thus instead of a reciprocal circulation between
the Foetus & Mother which was formerly Supposed,
and is still by some, there is only a
secretion of the fluids which pass from one
to the other. The Arguments brought to Support
this new doctrine are, 1st: That upon the mother’s
bleeding to death, the Foetus will not be deprived
of any of its blood this Dr. Shippen proved by
an experiment he made in Edinburgh before
Alexander Monro jun'r he bled a Bitch to
death then opened her and took out her whelps
which appeared to have lost not one drop of
blood




blood. 2d. That the umbilical Cord when cut
will not bleed but very little, no more than
the blood contained in the Placenta, this most
Midwives know & it is mentioned by Smellie:
but 3d. Lastly the greatest argument of all
is that Injections cannot be made to pass
from the placenta into the Vessels of the
uterus nor vice versa tho' it has been
repeatedly tried by the greatest Anatomists
notwithstanding what has been said by some
to the contrary.


   


   


   


   


   


   


   


   


   


   


   


A Course of Bandages
Bandages are very necessary to confine dressings
upon any external part of the body, injured either
by accident or by a necessary Operation.
Lect: 54th:
Bandages of the Head.
1st: Handkerchief doubled & made 3 square
put round the head & tied behind
2d: Grand Covre Chef a large square
handkerchief doubled to ab.t 2/3 the way &
laid on the head the single part so as to
reach the Nose, the double part the forehead,
wc. double part being uppermost must be
fastened under the Chin, the other then
turned up & tied behind in the nape of Neck
3d: Poormans Bandage of Galen
a piece of linen cut into 6 tails & laid
on the top of the head, the middle tails
fastened


   


fastened under the Chin the hind ones before
& the fore ones at last behind.
4th: Capaline a long doubleheaded bandage
4 or 5 fingers breadth wide to put round
the head
5th: Uniting Bandage double headed &
like the former with a slit near the middle
to be applied to a wound of the forehead.
6th: Scapha for bleeding in the frontal
vein going several times round the head
at last the first end turned over & tied behind
7th: Kiaster double headed for bleeding in
the Temporal Artery going several times
round the head then twisted round to a hard
knot over the Orifice & then part one end
over the crown the other under the Chin
and fastened.
8&9 Monos- & Bi-Ocular double headed
the first covering one Eye the last both Eyes
Lect.


   


Lecture 55th:
10 Accipiter a T Bandage for the Nose
going round & tail tied over the head.
11 A four tailed sling bandage for the
upper Lip.
12 A four tailed sling bandage for the
Chin the under half being the broadest.
13 Capistrum double headed bandage passing
from under the Chin to top of the head
then to neck & round to the Chin &c:
14. Divisive along double headed
rowler to keep up the head.
Bandages of the Trunk
15 Spica double headed for the shoulder
16 Star Bandage for a fracture of
the Clavicle a single headed rowler & if
necessary the Capaline may be applied
with it for greater safety.
17






17 For the Thorax the Jenriette or Napkin
& Scapulier the first going round the
body the latter slit going over the head &
fastened thereto.
18 Suspensor of Heliodorus for a diseased
Breast a X bandage
19 For Paracentesis a broad flannel roller
to go round & compress the Abdomen.
Lecture 56th:
20 Spica Inguinis double headed
for any disorder in the inguen.
21 T Bandage or Suspensor Scroti
beside wc. there are several others of less
note to these parts particularly the Truss
Bandages of the Extremities
22 Deloer for the Wrist
23 Spica Pollicis for the thumb.
24 Gauntlet ~ } for the fingers
25 Denigantlet 26




26 Eight tailed bandage for a broken
Patella &c:
27 For a simple Fracture Thypodesmus 
going round under the splints a single
headed roler & Epidesmus going over
the splints one roler very long may
serve for both.
28 For a compound Fracture where there
is a Wound &c: the 18 tailed bandage
together with splints Tape &c: and
lastly Junchs, Box, or Cradle &c:
if it is one of the Legs.




A Course of Operations
Lecture 57th:~
Of Sutures
There has been many sutures invented
most of which are out of use.
We ought to observe that a wound made
longitudinally in the direction of the ~
Fibres requires no sutures be it ever so
great, for by means of a bandage the
sides of the Wound is easily brought
together without suture.
But a wound made obliquely or
transversely requires a suture as no
Bandage can be made to keep the wound
together.
The intention of Sutures is to bring
the likes of a fresh wound in apposition, that the
vessels may inosculate & heal by the
first intention, the chief sutures are 
The




Glovers stitch, The interrupted suture,
The quilled suture, & the Gastroraphy,
The Glovers stitch is performed with
a strait needle & waxed thread single,
turned over and over.
The interrupted Suture is
made with a crooked needle & single waxed
thread the lips of the wound being brought
together first make a stitch in the middle the
Rule for which is to begin as far from the
edge of the wound as the wound is deep
making the needle come out at the bottom
of the wound & continued thro' on the contrary
side then tied not over the wound but on
one side, then make two other stitches near
each end wc. is mostly sufficient.
Quilled Suture is made with
a crooked needle as before with a double cord &
tied at the end with a quill on each side the Wound.
The




The Gastroraphy is performed when
the parietes of the Abdomen & Intestines
are cut. The intestine is to be saved up
with the Glovers stitch leaving a piece of
the thread at each end to lie out of the
wound of the Abdomen, then the Parietes
is to be stitched with the interrupted
Suture in a particular manner viz: on each
end of a waxed cord must be put a crooked
Needle, then take one needle & from within
the wound push it out then take the
other needle & do the same on the other side
of the wound, bringing them together
& tying the same, do so until you have
as many stitches as you think is
necessary




Of Trepaning
When it is necessary to perform this Operation
we should consider first the places where the Trepan
may be applied; there are 3 places where it is
improper to apply it viz: to the Sagital Suture,
the frontal Sinuses, & the Os Accipitis.
In Operating, an Incision must be made
of a good length through the scalp, the same opened
& the Cranium scraped, than having fixed upon
the place apply first the perforator & after that
the Trepan secundum Artem.
Of Fistula Lacrymalis
This operation is performed when the ductus
as Nasum is stopped & has formed in the
Lacrymal Sac &c: Sometimes compression
alone will cure this disease but when the Operation
is necessary its performed by making an incision
over the Sac at the bottom of the Orbit & half
the length of the same, into the Sac & cleaning
out





out the matter & if necessary making an Aperture
through the Os Unguis with a strong Probe or a
Trocar into the Nose.
Of the Polypus of the Nose
This is an excrescence growing in the Nose
in the Schneiderian Membrane, has different
degrees of firmness, in a recent state it is very
tender but by degrees grows harder until it gets
to a great firmness; the best time for extracting
it is when its so hard as not to break easily
with the Forceps but not so hard as to adhere
to the Schneiderian membrane too strongly.
Its extracted by taking hold of it with the
polypus Forceps & working it to one side and
the other backwards & forwards &c: until it is
loosened.




Extirpating the Tonsils.
This is best done by Ligature for fear of an
Hamorrhage if the Tonsils are largest at the
apex its an easy matter with proper Instruments
to pass the Ligature round its basis & make it
tight, but, it often happens that the Basis
is largest in this case a ligature put round woud
slip off therefore with a proper needle it must
be run through the middle of the Tonsils & tied on
each side cum node Chirurgica &c:
Of Amputation
Amputation is sometimes necessary but not near
so often as has been thought; all agree that it is
necessary in a Mortification, but then it must
not be performed until the mortification is stopped
& even new flesh begins to granulate.
In Amputating the Leg we must stand
between the legs that the saw may take the
Fibula before the Tibia is quite cut off.
we




We first apply the Tourniquet to the thigh
to stop the blood, then with a strait knife wc. 
is the best we make a circular incision with
two cuts round the leg or thigh through the
skin cellular membrane & fat about an Inch
below where we intend to cut off the Bone,
then an Assistant must pull up the skin
as high as possible, after wc. the Operator
must make a second Incision through the
muscles to the bone then if it’s the leg or
forearm the double edged scalpel must be
run between the bones to cut the interosseous
Ligament & Muscles, lastly the bone itself
must be cut off with the saw. & then the Arteries
taken up &c:
The Fingers are Amputated contrary to all
other parts at the Joins by cutting the flesh
as before then stretching it up & with the
scalpel beginning on the side take off the Joint.




Of Empiema
This is an operation for letting Pus Water or
Blood out of the cavity of the Thorax, oftenest
Pus, wc. comes from an inflammation & Suppuration,
when this is in but small quantities, the Lungs
by then great power of Absorption often carries
it off by Expectoration as we see in Pleurisies;
but when in great quantities the operation
must be performed very carefully for fear of
hurting the Lungs between the 6 & 7 or 7 & 8
Ribs with a common scalpel.
Of Bubonocele
This is the dangerousest operation in Surgery,
& not to be performed but when absolutely necessary;
when so it is done by making a long incision
from above the rings of the abdominal Muscles
almost to the bottom of the scrotum carefully
in to the Intestine thro' the Peritoneum or
Herniary Sac then dilate the passage by incision
& carefully reduce the Intestine.




Of Couching
This Operation is performed for the removal of a
Cataract or opacity of the crystaline Lens; there are
two ways of doing it, the old way of depressing the Lens
with a needle to the bottom of the Eye into the
vitreous humor wc. is done by running the needle abt.
1/10 of an Inch below the Cornea into the posterior
Chamber behind the Iris & depressing the Lens.
The other method, wc. is the new way, much in
vogue at present, & I think the best is to cut the
Cornea & extract the the crystalline Lens. In the
Old way the Lens is very apt to use after it has been
depressed wc. makes this new way preferable; it is
performed by a small knife with but one Edge wc.
is to enter near the place where the Needle enters & 
pushed thro' into the anterior chamber above the
Iris (taking care not to cut it) and out on the
other side cutting half or better of the Cornea, then
with the point of the knife cut the capsulae of the
Lens & its easily pressed out.




Of Lithotomy
This Operation is performed for extracting a 
stone out of the Vesica Urinariae; there has been
several methods invented to perform this operation
but the Lateral Operation or that invented by
Irene Jaques is the best & universally in use.
We are not to operate until we are certain
there is a stone in the Bladder & we can feel it
by sounding & all the other Surgeons present.
In Operating we first tye the patient on a
Table of a sufficient height lying on his back
by making a noose with a garter round the Wrist
then making him take hold of the bottom of
his foot with his hand putting the Garter round
his Instep & hand in form of 8 a sufficient number
of times, with an assistant to hold each knee
then introduce the Staff into the bladder, letting
a careful assistant hold the same bending the
top a little towards the right Groin is as that the
bend of the same may turn a little to the left
then




then the Operator setting down right before the
Patient must with a sharp scalpel make an incision
immediately upon the staff from the Base of the
scrotum to beyond the anus abt. an Inch to the
left of Cerines through the skin & fat, (this should
be made thus large that we may get at any Artery
if necessary) then make the incision shorter down
to the staff when we feel the staff bare we must
take the Gorget put the point of it into the Groove
of the staff then take hold of the staff from
your assistant & turn it over while you slip the
Gorget along the groove into the bladder, then
take out the staff, & introduce the Forceps upon
the groove of the Gorget, when they are in the
Bladder pull out the Gorget & gently feel for
the stone, when you find it take care to get good
hold of, it not being in too big a hurry; when you
have it fast extract it.
If the stone breaks take out what you can
with the Forceps & the rest with a scoop.
The wound must be drest gently wth. dry Lint.


Med. Hist.
MS.
B
158


Of Tapping












Of Injections
The ancients used to employ only
Ink for Injections (which answered the end
but very poorly) until the time of Ruysch 
who made his injections of wax, some of wc.
have since been improved; his method of
Injection was as follows viz. He first
laid open the hypogastrium & made two
incisions about an Inch long into the Aorta
& Vena Cava, then put the Subject in cold
water several days pressing out the blood
frequently. Next he put them in warm
water several days more & put two tubes
in the Artery one upwards & one downwards
& fastened them tightly.
His injection was only simple Suet
calomel with Cinnabar in cold weather &
in the Summer time he added a little white
wax & injected it gently when warm into
the vessels, then put the Subject into cold
water till the injection was cold, then dried
the preparation carefully or preserved it in
spirits of wine
Injections used by the modern are the follg:


Corroding Injection of Dr. Nicholls
Rx Wax 4 ounces Resin 3 ounces when
melted add Turpentine Varnish 3 ounces 
Dr. Hunter's Corroding Injections
Rx Wax 3 ounces Resin 3 ounces when melted
add Venice Turpentine 11 ounces 
Another
Rx Wax 4 ounces Resin 3 ounces when
melted add Oil of Turpentine 2 ounces 
Another
Rx Wax 4 ounces Resin 8 ounces or 10 ounces 
Tallow 3 ounces melt them together
The Injection is known to be of a
proper consistence by dropping some of
it when melted in water & when thoroughly
cold forming it into the shape of the Vessels
if upon Landing it breaks it is too hard
if it bends easily it is too soft & must
be mended. Those Injections which have
Turpentine Varnish, Venice Turpentine
or Oil of Turpentine in them must be
tried as above every time they are heated because
in heating they loose of their volatile oil


Of the Colours
To the foregoing Injections such a
quantity of colouring matter must be
added as will give them a bright colour
which must be determind by the Eye
Colours generally used are Vermillion
Kings Yellow, Blue Verditer & Flake
White. Other colours may be used.
They are generally to be mixed with the
Injections when they are melted; but
there are some objections to this rule
in some of the colours particularly the
blue Verditer & in some measure the Flake
White for Navy both ferment when mixed
with the foregoing Injections; to prevent
which it is necessary to melt some of the
Ingredients alone & add the colour to it before
the other Ingredients are added. The
following Experiments will particularize
these Exceptions
1 Blue Verditer with Tallow alone
causes no Fermentation
2 Blue Verditer with wax alone don’t
Ferment


3d. Blue Verditer with Resin alone
does ferment, therefore mix the blue
Verditer with the Tallow or Wax alone or
together & afterwards add the Resin
which causes a small froathing
If Turpentine Varnish, Venice
Turpentine or Oil of Turpentine be 
used mix your colour first with the
melted wax & then add either of these 
Ingredients with the Resin
These observations are equally true
of the Flake White
When we make a white Injection
instead of yellow Wax we use white.
It would seem that we have
not yet any Green Colour, but as blue
& yellow make a Green the blue Verditer
added to the yellow wax or Resin gives
us a fine green


Dr: Nicholls fine Injection
Rx Hard Brown Varnish & hard White
Varnish a 5 ounces Turpentine Varnish 2 ounces 
add the Colour & shake the Vial first
putting some shot therein to make them
mix. Either of the hard Varnishes will
do as well as both adding the same
proportion of Turpentine Varnish viz
1 to 5
Another
Rx Hard Brown Varnish & hard
White do. a 8 ounces Venice Turpentine 2 1/2 ounces 
mix these as the former
If we neglect being nice in our
proportions or from often heating these
Injections become too hard or Brittle.
We know when they are of a
proper consistence by the following
Experiment; Drop one drop of it upon
cold water which will immediately diffuse
itself over the whole surface when the
spirit will be immediately attracted by
the water & the gums with the Turpentine


will be left swimming on it, if this
will bear raising up without breaking
it is of a proper consistence, but if it
breaks its too hard & much be softened
till it is properly tenacious
Of Watery Injections
Glue dissolved in water alone makes
a good minute Injection; before it
is dissolved by heating its necessary
to steep it in water for 12 hours then
boil it upon the fire till the whole is
dissolved, afterwards strain it & drop
some of it upon a cold stone or any
cold substance to cool that you may
know its consistence; when it is somewhat
thicker than a common gelly
it is of a proper consistence
Isinglass & water prepared in
the same manner as the preceding ~
makes an Injection similar to it


Gum Arabic, Tragacanth, or
any of mucilaginous Gum dissolved
in Water to the consistence of Cream
& strained as the preceeding make a very
minute Injection
As the Colours mix difficultly with
with these watery Injections, they
ought first to be mixed well with
a little of the Injection & then the
remainder added to it.
Of Oily Injections
We often make Injections of almost
all Oils as Oil of Turpentine Hogs lard
Tallow &c: The oil of Turpentine is
rather too thin of itself but when added
to two parts Tallow is a good Injection
Butter or Hogs Lard make
of themselves a pretty good Injection


All fine Injections require more
Colours than coarse ones, for as it is to
run into much smaller vessels it of course
becomes more & more transparent and
therefore requires such a quantity of
colour as to render it opaque even
when it is most minutely separated on
diffused within in very small vessels or
on any surface
Of Common Injections
The corroding Injections are too hard
for several purposes & the fine ones
too soft therefore we need something
between them, some of which must
be softer than others
The hardest is Rx Resin 3 ounces Tallow 2 ounces 
Wax 1/2 ounce Colour sufficient for an Injectn.
is Rx Resin 2 ounces Tallow 2 ounces 
Colour sufficient for an Injection
These are generally used when
the part is intended to be dissected


Varnishes
Turpentine Varnish
Yellow Resin 14 lbs Oil of Turpentine
16 lbs, boil the water out of the Resin 
& then add the Oil of Turpentine from
the fire.
White Hard Varnish
Mastich & Gum Juniper a 1 grain 
Alcohol 8 grains ~
Brown Hard Varnish
Shell Lac & Seed Lac a 1 1/2 grains 
Gum Juniper 1 1/2 grains Alcohol Galls. 2 
clean the Gums from dirt & bruise
them pretty small then put them in
the spirits & dissolve them in a Sand heat
The Spirit of Sea Salt is the
corrosion commonly used by Anatomists


The part to be Injected must be
macerated in water blood warm 2 or 3
days so as to relax the vessels & soak
out all the blood in them, then having
a proper sized Syringe with pipes of
different sizes, fit one of the pipes
into the vessel & fasten it well with
a ligature bringing the ligature round
the cross piece to secure it the latter.
The part to be injected lying in the
warm water & the Syringe and
Injection being warm, the Syringe
is to filled with the Injection, the
end of it put into the pipe & kept fast
& the Embolus of the Syringe pressed
gently down with the breast till the
part is sufficiently injected or the
syringe when it is to be filled and
emptied as before if necessary ~
Med. Hist.
MS
B
158


















Med. Hist.
MS.
B
158








Ex Libris Jonathani Elmer
Ipromet manu Jeripris




Jonathn. Elmer’s




A Course
of
Anatomical Lectures
Delivered
By Dr. William Shippen junr.
Professor of Anatomy & Surgery
in the College of Philadelphia
Anno 1766
Quanta autem existerent consilii
solertissimi indicia, su tota hominis
fabrica perspecta foret? si corporis totius
species et dignitas? Sensuum organa
subtillissime fabricata, et aptissime locata.
Synop: Meta:
Anatomia fundamentum est Medicinae
Anomal

















Anatomical Lectures
Lecture 1st:
Anatomy avatouia in Greek signifies
cutting & by it antiently was meant only
the dissecting of bodies, but at present it
is implied in a more general sense.
Anatomy in respect of its object is divided 
into human and comparative.
Human Anatomy is that which is
employed on the human body; and comparative
Anatomy is that which is employed upon
the bodies of other animals, these serving
for the more accurate descriptions of several
parts, and supplying the defects of human
bodies.
Anatomy from its various ends may
be said to be of four kinds viz: Theological,
Medical, Juridical, and Judicial.
The




The first consists in an acquaintance with
the works of the creator in the human frame;
according to Fontanel the study of Anatomy
& Autonomy afford the strongest arguments
against Atheism.
Medical Anatomy is ultimately health,
for the presentation of which, restoring it when
impaired, by diseases, or even preventing
their access, nothing surely is more necessary
than a true knowledge of the structure of that
frame so liable to be injured.
Juridical Anatomy is the determining
the causes of suspicious deaths, impotency,
barrenness, the true times of pregnancy and
delivery, the mortality of Wounds and a
multitude of other causes of great importance
to be adjusted in account of Judicature.
Judicial Anatomy is the determining
the cause and manner of the death of diseased
persons from a subsequent dissection of the
body




body; this is of the utmost use in the practice
of Physic.
Upon the whole then the use of Anatomy
in very great, nor is it confined to the bounds
of Medicine alone; the Philosopher and
Theologist, the Magistrate, Painter and
Sculptor are in their respective employments
more or less qualified in proportion to the progress
they have made in this science; but the
physician and Surgeon are the people to 
whom it is most immediately necessary
and who without a perfect knowledge of it
cannot do justice to the world in their
professions. What the needle is to the
mariner, Anatomy is to both these, and
we may venture to say that without its
assistance, they would be rather detrimental 
than beneficial to mankind.




The Anatomy of the solid parts is by Heister
called Osteology and that of the soft parts
Sarcology, each of these are subdivided.
Osteology or the anatomy of the Solid
parts is divided into the anatomy of the 
Bones called Osteology; Chondrology or the
anatomy of the Cartilages; and Syndesmology
or the anatomy of the Ligaments.
Sarcology or the anatomy of the soft parts
is divided into Dermatology or the anatomy of
the Teguments; Splanchnology or the anatomy
of the Viscera; Myology or the anatomy of
the Muscles; Neurology or the anatomy of
the Nerves; Angiology or the anatomy of the 
Veins and Arteries and Adenology or the
Doctrine of the Glands.
In the human body as a complex hydraulic machine
a double inquiry must be made 1st. Into the structure of
the parts, this is called Anatomy, 2d. Their functions & the
laws of their motion which is termed Physiology





Lecture 2d.
As the solids are formed out of one
principal fluid chiefly, called the Blood
it is proper to begin therewith.
Of the Blood
Blood in Scripture is called the life of
the Animal; according to some it is the
primum vivens ultemum moriens, its
a heterogeneous mass, as is evident from the
variety of ingredients of which it is made up,
and the various forms it assumes in the
animal machine.
The blood is composed of three substances
viz: Serum, Gravamentum & a coagulable
Lymph: We shall consider these in three
different manners; first when ocularly
examined, 2d. Viewed with a Microscope,
and
B





3dly: The chemical Analysis thereof.
Blood fresh drawn from a sound
living animal, upon landing, part of
it congeals into a hard coagulum suspended 
in a yellowish Serum, the
upper surface being of a florid color
while the bottom is black; the reason
of the blood appearing bright and
florid at the top is from its being in
contact with the Air; this is confirmed
by an experiment of Dr. Hunter’s who put
a quantity of blood fresh drawn into a
vial, & stopt it close; upon standing it
all turned of an uniform black color,
except a little spot upon the top with which
a globule of Air had got in contact.
Blood stirred round with a probe
whilst




Whilst warm, a fibrous elastic substance
is obtained, which, put in water turns of
a whitish color; this is the coagulable
Lymph, is strongly elastic, & is the cause
of cohesion in the particles of the Blood,
as is evident from the extravasation of
the blood after death by dissolution
of the cohering particles. The coagulable
Lymph is sometimes discharged from
the Uterus and by Nurses taken for
an Abortion; this error they are sometimes
led into from a desire that it should be
so. If spirits of Wine be added to
Serum, or the same made boiling hot,
it rises up, emits fumes, and turns into
a coagulum similar to the White of an egg:
the fibrous part of the blood is what forms
Polypuses




Polypuses concretions &c:
Blood viewed by a microscope appears 
to consist of a number of globules,
the larger ones being those that tinge
it of a red color, &c: therefore chiefly
make the crassamentum, are of a certain
determinate magnitude being of the
same bigness in all animals, in a Sheep
as in an Ox, in an eel as in a man.
These globules are composed of six
smaller or ceruminous ones; and these
ceruminous ones are composed of smaller
or lymphatic ones; and it is probable there
are still lower orders of globules of blood.
These globules of blood are of a
lenticular form and elastic the largest
kind being less than the 1/3000 part of an
inch




Inch. the crassamentum is supposed
to contain 1/3 of the mass and the
Serum to make up the other 2/3.
Blood chemically analyzed; upon
distillation with a slow fire a quantity
of Phlegm arises, with the fire increased
next arises an Oil and a volatile Salt,
the caput mortuum being a fixed
alkali and a cretaceous Earth.
The chemical proportions of the
blood are by Dr. Martin & Boyle recvd.
as follows viz: of Phlegm 5/6 of
Oil 1/15, of Salt 1/25, of Air 1/20, &
of Earth 1/75, part of the whole mass.
The specific gravity of the blood
to that of rain water is by Dr. Jurin
and




and Martin reckoned as follows,
by Jurin as 1000 to 1054 by Martin
as 1000 to 1056 or 1057 or as 10 to 19.
The density of blood in living animals 
is to its density when reduced to
the coldness of temperate Air as 134
to 135 or 992 1/2 to 1000.
The color of blood is for the most
part red, but redness is not a constituent
quality in blood, for some Animals
have white blood. In the human
body the blood is redder & more florid
in the Arteries than in the Veins,
oweing to the action of the Lungs upon
it, for by shaking fresh blood in a vial
taken from a vein, it appears of the
color of arterial blood. That the blood
is




is reder in the Arteries than in the
Veins. Dr. Hunter proved by the following
experiement: he opened the Thorax of a
live Dog and kept his Lungs working
with a pair of Bellows; and drew a
spoonful of blood from each side of the
Heart is, from the Vena Cava & Aorta 
the latter of which appeared the reddest.
From the accurate experiements it is
found that a cubic inch of rain Water
weighs 253 1/3 grains, a cubic inch
of warm blood 264 3/4 grains.
An Ounce of Blood contains 1,813
Inches, an avoirdupois ounce weights
437 1/2 grains equal to 1,727 inches
of water and 1,6526 of warm blood.
Lect.


*Among these we may reckon Boerhaave instit. vol. 2
the colour of the Arteries are of aligamentous substance
and not muscular as is evident from their white appearance 
and their of elasticity both of which is contrary to the general
characteristic of a muscle however we are informed that
Dr. Cullen has lately discovered that there are muscular
fiber in the coats of the arteries the action of which he
thinks assists in propelling the blood onward.
J. Cullen likewise says that there is a muscular coat
to the arteries as well as Boerhaave & many others.
&c physiology [illegible].


Lecture 3d.
Of the Arteries & Veins
An Artery is a strong, membranous,
ramifying, elastic Tube, endowed with
pulsation; arising from the left side 
of the Heart, and terminating in every
part of the body. The Arteries are composed 
of three coats, tho’ some have
reckoned four and some five.* The
first external coat is very thin the fibres of x
which going longitudinal & circular;
the second coat is thickest and the fibres
of it go in a circular direction; the 3d.
coat is very compact and its inside
very smooth and even, this smoothness 
and compactness of the inner coat
serves two purposes. 1st. to allow the blood
to




to pass without hindrance & 2d. to
prevent its exudation.
The pulsatory motion of the Arteries
is a dilatation and contraction of them;
the former called Diastole, and the latter
Systole, which precedes proceeds from
the Heart, besides which they have a
sort of aperistaltic motion, as is evident
from an experiement of Dr. Hunter’s,
who opened alive Dog and cutting off
the mesenteric Artery, injected it wth. 
a warm milk, which he could plainly
perceive the Artery to carry along wth. a
vernicular motion; to confirm is the
more he injected the mesenteric Vein
but the milk went no farther than
the
&




the force of the injecting propelled it.
There are but two Arteries in the
body viz: the pulmonic, which carries
the blood through the small circulation,
and the Aorta, which carries it to all
the parts of the body.
The coats of the Arteries are very
elastic, and are furnished with blood
vessels for their nourishment; the
Arteries mostly and all except the
Epigastric ramify at acute angles.
The commonest diseases the
Arteries are subject to, are, Aneurisms
and Ossification.
Aneurisms proceed from a preternatural 
dilatation of the coats of the Artery’s
and are of two kinds 1st. When the blood
is


x it is sometimes found in young subjects and is
oweing perhaps to a disposition of the constitution
to form bony matter.


is contained within the coats of the
Artery. 2d. when the Artery is burst &
the blood extravasated into a membranous 
bag.
Ossification happens mostly to
Old people from a weak & slow circulation 
of the Blood. x
Veins are elastic, ramifying Tubes,
like the Arteries; except smaller. their
coats thinner, and without motion.
Phisiologically speaking the Veins
begin at the extremities of the Arteries,
or more properly speaking they are a
continuation of the Arteries reflected
back toward their Origin the Heart;
but anatomically speaking the Veins
arise from the Heart.
There




There are 7 Veins in the body from
which all the rest arise viz: The 2 Venae
Cava ascendans and decendans; 4
pulmonary Veins (two from each lobe
of the Lungs) and Vena Portarum.
The veins are mostly ramified in
the same manner as the Arteries, exct.
the Vena Portae, and the cutaneous
Veins of the extremities, & other parts.
The veins of the extremities have
valves, but not those of the Viscera;
the reason of which is because there
is no Muscles in the viscera; hence
the use of those valves in the Veins
of the extremities is to prevent the
blood from going backward as well
as


x Bellini especially is of this opinion


as well as for, to push it forward when
the muscle is contracted and the Vein
compressed.
Of Venesection & Hemorrhages.
In bleeding, the blood is supposed to 
x
flow out faster at the orifice than it
circulates in common, and to increase
the circulation to the part, hence the
doctrine of revulsion & derivation is
easily understood; thus we find in
a Cephalalgia bleeding in the foot
causes a derivation to the feet and
a revulsion from the Head &c:
In Hemorrhages the antients
used Ligatures round the joints,
wc. stopping the return of of the blood
to the Heart checked its impetus,
but









but by Venesection his ends are answered:
e,g, supposing an Hemorrhage at the
Nose, Lungs, Uterus &c: bleeding
takes off the impetus of the blood &
causes a revulsion, at the same time.
Dr. Haller thinks this latter method much the [illegible]
the Veins are some of them subject 
to Varices, which are an obstruction,
or destruction of the valves thereof.
The muscular coat of both the
Arteries and Veins are somewhat
subject to inflammation & suppuration,
but not near so much as the other
muscles of the body; this is very wisely
adapted to their function, for suppuration 
of their coats would be attended
with fatal consequences often.
Lecture




Lecture 4th.
Of the Lymphatics.
Lymphatic or absorbent vessels are
those fine ramifying vessels which contain 
a clear diaphanous Liquor; they
take their rise internally from the cavities, 
as the stomach, intestines, and
externally from the surfaces of the
skin. The antients supposed the
Lymphatics were a continuation of
the Arteries dividing them into three
classes, sanguineous, venous, and
Lymphatic, but, it has very lately
been discovered that the Lymphatics
are an entire system of vessels by
themselves, having no affinity or communication with
either the arteries or veins.
this




This is proved 1: by injections not passing into them from the arties 2: by
the motion of the fluid in them and the valves they
have; they are called absorbents from
their office, which is to absorb the Lymph
and other matters and carry it into the
thoracic duct or Receptaculum Chyli;
where they are all supposed to terminate.
Those vessels called lacteals
belong to this system; and called Lacteals
only, from their carrying a milky chyle:
their origin termination and course of
their fluids being the same. That the
lymphatics are absorbents is evident from
their absorbing moist substances rubbed
on the skin, as Mercury, Turpentine,
Garlic &c: but in a more obvious manner
in the venereal Disease, where absorbing
D the




virus they carry it to the adjacent
Lymphatic Glands and cause them to
tumify, hence Buboes &c: sometimes the
virus causing the glands to tumify and
inflame, constricts the vessels beyond
the same and prevents the infection
from going any farther; hence the cure
of the venereal disease sometimes by
the suppuration and discharge of a Bubo.
Of the Glands.
A Gland is a secretory Vessel — the
antients called only those Glands which
we feel hard movable kernels under the
chin and other were until Malpighius
by his microscope found the Liver and
other substances to be of the same texture,
and therefore termed them all Glandular.
A




A Gland he thought to be made up of
little fine round bodies consisting of
Follicles which contained the secreted
fluid and between which was a parynchemical 
substance; but Ruysch by
his injections found that the Glands
were vascular or made up of fine vessels
which has been further confirmed by
later anatomists. The vessels of the
Glands are Arteries, Veins, secretory
and to some excretory Vessels Nerves & lymphatics
Of Secretion
Some have imagined that the secretions
were performed by the diameters of the
secretory vessels, supposing them to be
of the size of the particles secreted;
but this theory is subject to these two
objections, viz: that the smaller particles
will




will go off with the larger ones and to the
secretion be confounded and in a Jaundice, 
when once the Bile had got into the
Blood it would continually remain [illegible] &
the Jaundice could not be cured; others supposed 
a particular fermentation happened
in the veneral glands, & from thence 
arose the difference in the veneral secreted 
fluids, and likewise was the cause of
the secretion; this theory is liable to the
same objections with the former, and
therefore the most received opinion is, that
the secretions depend upon the particular
disposition of the vessels, to the particular 
fluid it is to secrete; hence arises
these Axioms. 1st. That the secretions are
carried on uniformly in a living sound Animal.
2d. One secretion increased another is diminished &c:
Lect.




Lecture 5th.
Of the Muscles & Tendons.
A Muscle is a fleshy, fibrous, [crossed out]
substance, consisting of Veins, Arteries, &
Nerves; besides fleshy fibers &c; having
more nerves in proportion than another
part of the body serving to give notice to the
brain of any external stimulus or irritation.
The redness of the muscles is not
inherent in the fibres thereof, but only
oweing to the blood contained in them, of
which there is a great quantity, more
than is sufficient for their nourishment
and may possibly be subservient to their
motion.
A Tendon is a white compact fibrous
unelastic substance. most muscles terminate 
in Tendons, and the Tendons are by
some reckoned a continuation of the fibres
of




of the muscles to which they belong,
only more compacted together so as not
to admit the red globules of blood between 
their interstices: but Dr. Hunter
thinks the fibres of the Tendons are
not a continuation of those of the muscles,
but distinct fibres someway cemented
thereto.
The muscular fibres are cemented
together by the cellular membranes and
an intervening glue, & serve for the
moving of the solid parts of the body.
The Tendons are for the better
insertion of the muscles, and of great
use in motion; eg: in the Perforans and
Perforations of the hand, the muscle arises
from the inferior part of the Humerus, and
if that was continued down to its insertion
muscular, it would render the hand troublesome




some and unwieldy, whereas now, the
Tendons, being compact & taking up but
little space, remedy that inconvenience.
Round many of the Joints as the Wrist 
Ancle &c: there is a capsular Ligament or
Frenum which serves to keep these tendons
in their right places, and facilitate their
regular motion; likewise over some of the
Muscles there is a tendinous expansion
called Aponeurosis, of much the same use
as the preceding Ligament.
The muscles may be reckoned of
three kinds first Oblong as those of the
Arm, 2d. Convex as those of the Heart,
Stomach, Bladder &c. 3d. mixt as those of
the Abdomen the Pectoral muscles &c:
Muscles have their names from
their Origin, Insertion, Use Appearance &c:
Lect




Lecture 6th.
Of the Nerves.
The Nerves are now by every body
allowed to be a system of the vessels, and
they are a fasciculi of white fine fibres,
arising from the Medulla Oblongata &
Spinalis, egressing in pain.
Over the Brain are the Meninges, or,
1st. The Dura Mater which is externally, &
a thick vascular substance within this &
adhesive to the Brain is, 2d. The Pia Mater,
which is a thinner membrane; between
these two, some anatomists reckon another
membrane, extremely fine & reticular which
they call Tunica Arachnoides.
The Brain is divided into three
portions called, Cerebrum, Cerebellum,
and Medulla Oblongata, the latter 
being





being continued thro’ the spine of the back 
is called Medulla Spinalis.
The Brain is supposed to be vascular,
& its substance of two cortex; external of an
Ash color is called Corticalis; internal of a 
white color called Medullaris. The Nerves
are of the same substance with the Brain,
and are properly aportion thereof continued
to all the parts of the body. The Nerves
as they arise in pairs soon after decussate,
or change sides as in the Optic Nerves,
the left going to the right Eye, & the right
to the left; hence a wound, on one side of
the head affects the contrary of the body.
The Nerves are distributed thro' the
body in much the same manner as the
Arteries; the one proceeding from the Brain
the other from the Heart, but with this
difference
&





difference, that the trunks of the Arteries grow
less the more they are ramified together with
the ramifications ad infinitum; but the
capacity of a constituent Nerve never decreases
they being imperceptible, but the number of the
likes of the Fascicule decreases in proportion as the bundle
ramifies, thus the cords of the Nerves wc. as they
egress from the Brain contain an innumerable
number of constituent Nerves, decrease in No.
but not in capacity ad infinitum in proportion
as they are ramified.
The Nerves anastomose, but not in the
same manner as the blood vessels do, by
uniting their tubes but only by their coming
in contact with each other; these anastomoses
are called Plexuses. sometimes little knots
appear in Nerves called Ganglions, some
imagine these knots proceed from pressure &
inflammation, but this cannot be as they are
found




found in the Viscera, & in a Foetus where no
pressure could happen.
Lancesi, reckons the use of these Ganglions
is for an an additament to the Brain; because
he says more nerves go from them than go to
them, but from the substance of these knots
not being the same wth. the brain, that cannot
be. others think they serve to stop the nervous
fluid from flying out at the end of the Tube
without the impulse of the will by means
of muscular fibres, they being only in
those nerves destined for voluntary motion;
this also appears to be false.
The termination of the nerves is but
little known, but supposed to be in every
part of the body.
The use of the Nerves is for sensation,
motion, nutrition, &c: the Brain being called
the sensorium Comune to wc. the Nerves
carry all the sense communicated to them
Voluntary





Voluntary motion is acquired by experience,
as is evident from a child whose will is
frequently contrary to the Act performed.
Of the cellular Membrane.
The cellular membrane is of two kinds,
the one adipose containing fat, the other
reticular without fat; it is a net like
substance, vascular, very thin and tender,
consisting of many cells & its fibres very
fine: the cellular membrane is continued
throughout all the body, except some of
the viscera & is called by some the membrana
Musculorum Comunis. The cells of the
reticular part of the cellular membrane
communicate with each other, as is evident
from an Anasarca which is a transudation
of Phlegm into the cells, & so from the one to
the other, as is evident from the Legs swelling
by walking & subsiding when lying
down


x See the Londn: med: observations vol: 2


down; hence Eccymosis from a false
Aneurism, Diaeresis, Contusion &c: by
which the blood insinuates itself into the
cellular membrane; hence also the great
quantity of water evacuated from a
scarification in an Anasarca.
An Emphysema is a remarkable
proof of the communication of these cells;
this is caused by the air distending these
cells & often happens from a fractured
rib puncturing the Lungs by w.c the
Air gets into this membrane; a remarkable
instance of this happened in London,
by w.c the patient swelled to that degree that
his eyes could not be seen; Dr. Hunter x made
a puncture at the Eye by w.c the air gushed
out, & by puncturing & rubbing he was cured.
Putrefaction will cause an Emphysema,
from the fermentation generating air;
hence





hence a drowned person will after a while
rise to the surface of the water.
The fat contained in the adipose cells
differs in different bodies; in a Foetus
the fat is soft, and gelatinous; in children
of a year or two old, the fat is chiefly next
to skin; hence the fatness observed in
children; & in adults the fat is solid and
mostly internal.
The cellular membrane serves for
easy smooth motion, for a defence to the
body, to keep the parts warm & preserve
the figure of the body, & blunt acrimony.
some animals we reckoned to be
nourished in the Winter by their fat.




Lecture 7th
Of the Bones.
Here we shall, 1st. describe the external
conformation of the Bones, 2d. examine
their internal structure, 3d. their connection,
& 4th. Explain their use.
A Bone is a hard fibrous compact
substance. various Bones have various
shapes & conformations, some are cylindrical
& long, others flat, & broad, irregular &c:
bones are said to be made up of Fibres
forming Lamellae, fastened together by means
of oblique or transverse fibres.
Bones have processes and Cavities.
Processes have different names from their
different forms, & appearance: thus, a
Condyle is an oblong process arising from
the extremity of a bone; a Corone is an oblong
process





process terminating in a point; Spine is
the sharp ridge of a Bone; Supercilia is
a brim round a cavity; a protuberance is a
rough process of a bone. Processes are of
two kinds viz Apophysis, & Epiphysis;
Apophysis is a process growing out from
the body of a bone. Epiphysis is a process
growing to the body of the bone, being originally
separate therefrom  by a different Ossification.
The cavities in bones are of two kinds,
one for Articulation, & the other for the lodgment
of soft parts; cavities for Articulation are
of three kinds, 1st. Round & deep called Catyloid,
2d. round but superficial called Glenoid, and
3d, deep & narrow called Alveoli, the Articulation
of Bones is by Galen called [illegible] Joint
& by him is reckoned of 2 kinds, 1st. With motion
called





called Diarthrosis. 2d, without motion called
Synarthrosis; each of these are of 3 kinds.
Diarthrosis, are. 1st: Enarthrosis, 2d:
Arthrodia, 3d: Ginglymus.
Synarthrosis are, 1st: Suture or Raphe,
2d: Harmonia, 3d: Gomphosis.
The connection of bones is termed their
Symphysis, & is of two kinds: the one wth.
and the other without an intervening substance:
the first is that of the Cranium by mutual
Indentation. the second are of 3 kinds viz:
Synchondrosis, Syneurosis & Sysarcosis. 
Periosteum is an elastic fine membrane,
that covers the bones except at the joints teeth &c:
its case is for the insertion of vessels, to strengthen
the Epiphysis &c: the cylindric bones
are all hollow, & so are most others & contain
Marrow, the ends of the bones are cellular.
F Lect.





x see Edinburgh med: Essays.



Lecture 8th
Osteogonea.
In a Foetus, the first months, there are
no bones, nothing but a gelatinous fluid;
then it gradually grows cartilaginous, &
in time becomes boney; some imagine
Bones are formed of Cartilages only by
an expulsion of the redundant fluids;
but Dr. Nisbet x says, & it is now general recd.,
that in Ossification, there is in the blood, or
a fluid secreted therefrom, an ossifying
juice; consisting of particles wc. are not apparent;
that wherever nature designs an ossification
between membranes, or a cartilage she occasions
a more than ordinary afflux of fluid which
distends so much the vessels wc. were before
invisible as to make them capable of
receiving the red globules of blood wc. is always
to






to be seen near to where ossification is begun.
In this blood gritty particles are to be felt by
the point of a knife, which have been formed
by the attraction & cohesion of the particles
of the ossifying juice obstructed along with
the other grosser fluids in the beginning of
the vessels, prepared to receive the influent
juices. The membranes or cartilages some
as alied between wc. or within wc. the bony
particles are deposited or shoot; but without 
any any intermixture of the particles of the
bone & cartilage, or continuation of the fibres
of one substance to those of the other as is
evident in bones made perfectly clean, the
cartilage dropping from it as easy or easier
than an acorn from its cup, & there is a
smoothness of the parts of both cartilage
and




and Bone which show that there is no
conjunction or union of the fibres of the
two substances.
While bones are increasing within
Cartilages, the cartilages are extended
& spread out, by wc., with the pressure they
suffer & the great influx of various fluids,
& the nutritious matter being kindred to
flow freely into them, they decrease
continually & at last may truly be void
to be entirely destroyed.
Bones digested in Acids for sometime
grow flexible & gelatinous like a tendon,
by which it appears the great quantity
of Earth they contain makes them hard
rigid. Bones are furnished with Arteries
and Veins, as is evident from the drops of
blood





blood seen in sawing bones lengthwise, &
upon their appearing tinged of a red color
after the animal has eaten Madder.
Dr. Havers divides the blood vessels
into sanguiferous, & medullan the latter
enter the bones mostly near their
center in an oblique manner.
Bones have Nerves as is evident
from their exquisite sensibility where
amputated, or exfoliated, & granules of flesh
have sprouted out.
Diseases of bones are 1st: a softness & 
rickety disposition. appearing generally from [illegible] to the 3d.
year after birth, though the habit may continue thro' life.
It seems to be owing to an Idiosyncrasy or a want of bony
matter in the constitution. Sometimes it is said to arise 
from the pox & scurvy, but probably less frequent than from
the other cause. We have the history of a species of Scurvy
in France that affected the Bones & separated the Epiphysis.
In Anson’s voyage we are told the Callus of bones wch. 
had been fractured & united again for may years were disposed
by this Scurvy ~




Softness from a venereal Taint can be nothing more
than a Caries of the bone. the disease first affecting the
Periosteum & then communicating itself to ye. subject bone.
As to softness from Idiosyncracy as its called; or from
a particular state of the solids & fluids. Mr. Goodye furnishes
us with a history of a woman whose bones without any apparent
cause grew soft; her body shortened, & at last she died, & he
found that he could easily cut through the limp bone & all.
The academy of Paris give a more remarkable history of
a woman whose bones were so soft that at length they had
not solidity enough to gird  the muscles action—no kind of a
scorbutic or pocky taint could be observed. see Vanss 4h:423.
Mr. Gooch had a case of this kind under his care, when
the patient died he found the bones so soft that he split the
thigh bone, the Tibia & bones of the foot the whole length
very easily with his knife. Dr. Tilton of Dover relates the like
Bones may likewise loose of their bulk like other
parts from a loss of juices as in alveolar & vessels of old people.
2dly: Fractures. All bones have a tendency to
unite again after being disjoined w:ch is effected by means of
a Callus this was formerly supposed to be unorganized, but is 
now known to be vascular by injections & being tinged with 
madder. When a Callus is broke it will unite again only
to the opinion of some authors. A pupil of Dr. Haller’s
in a Thesis he wrote on the subject say that the Callus is
first a bloody matter, then slimy, next gelatinous & then
vessels from the bone & meditullium shoot out thro' it & ossifications
begin directing themselves quaquavenum & thus the
Callus


Lecture 9th
Of the Cartilages & Ligaments.
Cartilages are compact, opaque, & a little
elastic: of wc. there are 3 kinds, 1st: such as
supply the place of bones as the Nose,
Trachea Artena &c: these preserve the
structure of the part & admit of motion.
2d. such as supply the place of bones before
they are formed as in a Foetus. 3d.
such as serve for the Articulation of
bones. Cartilages differ from bones
in not having Fibres nor blood vessels
to be siphoned, tho’. they are imagined
to be vascular; they serve at the Articulation 
by their smoothness to prevent
abrasion; they won’t granulate nor
exfoliate but may be corroded.
Ligaments


is compleat. sometimes the bones won’t unite but with great
difficulty.
3dly: Caries. A caries in alone is similar to an ulcer
in the flesh it has circulation but it is unsound &
often shoots out irregularly as the fungus of an ulcer
See more so in med:[illegible] 2:h:k0 [illegible] [4?377].
4thly: Spina ventosa – this is a caries beginning
on the inside of the bone & affecting it clear thro', hence
Surgeons bow into the bone to let out the matter, but
in general the limb is to be taken off. See Van Swieten 4 p 377
A node by some is said to be an Exostosis of
the bone, but for the most part if not always it begins
in the Periosteum. should be open'd before it affects the bone
5ly: Anchylosis is a stiff joint having little
or no motion. from the bones running into each other &
the cartilages being eroded. Van swieten vol 4 p 457
gives several curious cases of Anchylosis of all
the joints in the Body. See also Le Bran’s
Surgery.
x where it covers the Cartilage. it is calld. Perichondrium 
the external lamina of the capsular ligament goes
from the substance of one bone to the other over the articulation
& is inserted beyond the Epiphysis &: Friction
6th. Exostosis is a tumefaction of a Bone
or an excrescence growing out of the bone. It
may proceed from a redundancy of ossifying particles
in the system or in the part only from a morbid
cause see Van swieten 4 p 424. See the case of 9: Scott 
of the Pennsylvania Hospital in my Adversar: med:
See Cheselden p 5.


Ligaments are firm, compact, unelastic,
membranes; serving to connect the joints,
prevent luxation &c:
The Ligament, Bones, Cartilages,
Tendons & Dura Mater are now reckoned
none of them to have much sensibility
in a natural state. v: Whytt & Haller
The capsular ligaments are very
strong & compact, & made up of hard
Lamella, the inner lamella being a 
reflected membrane going over the
head of the joint. cover the Cartilage x
& so coming to join the external lamella,
which is firmly inserted near the joint.
These capsular ligaments forming
a sac in wc. is contained, a mucilaginous
liquor serving to lubricate the joint:
for




for in all Joints; for motion there are synovial
glands which discharge the above
synovia, this is subject to be disordered:
1st. to become thin & Icorous, 2d thick and
inspissated &c:
It is generally received of late, that the
capsular ligament is lacerated in a 
Luxation of a joint unless from internal
cause, or a relaxation; & violent extension
is unnecessary in reduction of the same;
no more being necessary than to bring
the ends even, and then coax them
into their proper places, & there keep
them by proper dressings & bandage.
For as particular description of the Bones
vide Monro’s Osteology, and of the muscles
Douglas’s Myographia




Lect. 40th:
In the Osteology we divided the body
into three parts, viz: Head, Trunk, and
Extremities; the Trunk of the Skeleton
we subdivided into, the spine, Thorax,
and Pelvis, but in a fresh subject we
divide the Trunk differently, viz: into
The Thorax, and Abdomen, or upper, &
lower belly. The Viscera of the Thorax
are only the Heart, and Lungs, & therefore
not necessary to be subdivided.
The Abdomen is separated from the
Thorax by the Diaphragm.
The Abdomen by reason of its largeness
and the many Viscera contained
therein, has been divided into several
parts, by imaginary lines, for the readier
knowing the particular situation of each
Viscus. The divisions are as follows,
1st
G 


 


1st. That which lies under the Cartilage
Xyphoides, is called Scrobiculus Cordis,
2d. From the Scrobiculus Cordis down to
within 2 or 3 inches of the Umbilicus
is called Regio Epigastrium, circumscribed,
and on each side there of it is called
Regio Hypochondrium. 3d. From the
Regio Epigastrium to 2 or 3 fingers
below the Umbilicus is called Regio
Umbilicus, circumscribed, and each
side Regio Lumborum, 4th. From the
Umbilical Region to the Os Pubis is
called Regio Hypogastrium, and
on each side the Regio Hiaea 5th. The
lowest part is called the Regio Pubis.
As we are sometimes called to open
the body of a deceased person before
their friends, particularly if they died
of a violent death; we should endeavor
to




to do it with regularity & decency.
The antients opened the Abdomen by
beginning at the Sternum & directing
the knife along the False Ribs to the
Loins, then along the spine of the Ilium
to the Os Pubis; and laying the loose
part over on the contrary side.
Others begin at the Xephoid
Cartilage & make a straight incision down
to the Umbilicus, then dividing the incision
directing one to the spine of the right, &
the other to the spine of the left Ilium,
and turning each part back.
But the best method is to begin
the incision at the Xephoid Cartilage
and going straight down to the Olsa Pubis
and then another transverse from the
Navel to the Loins each way.
The Thorax is opened by pushing off the
Teguments & Cutting the Cartilages by the Sternum.
Lect.



All the internal superficies of the cavity of the
Thorax, the ribs, cartilages of the ribs & convex side of the
Diaphragm except where the pericardium lies in contact wth.
it are lined with one continued, thin, nervous, very strong
membrane, internally very smooth called Pleura.
On the external superficies of this every where is the
cellular membrane wc. in very fat animals is often so enlarged
with fat as to lessen the capacity of the Thorax & these cause
a shortness of breath.
The Pleura when it gets round to the vertebra elevates itself
perpendicularly lowd. frenum wc. with the one on the other side
from a doable pleura called Mediastinum dorsale.
The same duplication is made of the Sternum when it is
called mediastinum pectorale.
The pleura likewise covers all the muscular circumference of
the diaphragm above the cellular membrane wc. arising up together
with the orb of the septum from the back sternum, from
the external membrane of the pericardium wc. is the third
cavity of the Thorax in the middle between the 2 cavities of
the pleura containing the Lungs & formed a conjunction of them
This membrane of the pericardium is lined internally with
a thin membrane wc. is a branch of the external membrane of
the Heart. The great vessels from the Heart as they pass
thro' the pericardium & go on beyond it or move also at above
the cellular one from the external membrane of the pericardium.
this membrane forming about to the pulmonary arteries & using wc. 
when they arise at the Lungs is expanded out & forms the extenal coat
of the Lungs. Kaan de Perspi Hippocrat. 


Lect. 41st:
Of the Pleura.
The Pleura is a fine membrane, which
lines all the cavity of the Thorax and
is reflected back over the Lungs.
There are two Pleura one on each
side, like two bladders beginning as we may
suppose at the sternum and going round
within the Ribs to the Vertebra of the
Back, then reflected back upon the
outside of the Lung (making the coat
of the Lungs) to the sternum; there
running in or uniting with the first
Fibres of the same and so on the other
side; where the two Pleura meet at
the sternum; they are not quite in
contact with each other, but there is
a small space left between which is
filled up with cellular Membrane.
Of


Constat pulmo duplici vasorum genere,
aerifero scilict & sanguifero.
Aerifera omnia vasa ortum ducunt ex una
trachea, quo mox a faucibus intitium capiens,
ante oesophagum, descendit, thoracem post
thymum intiat; post cavem descendentem & pericardii
apicem, as quartam thoracis vertebram, qua
est a superiore una tertia pars ipsius pulmonum
longitusinis divaricatur.
Hujus dein crura tendunt ad utrumque pulmonem,
& statim dividuntur, in homine dextrum in tres,
sinistrum in binos ramos, qui tune bronchia dicuntur,
as totidem pulmonum lobos, quos ubi ingressa funt,
disperguntur statim in ramos minores, & minores;
qui omnes ad obtusum angulum, respectutrancorum,
oviuntur.
Remi autum majors ingressi pulmones, pro
maxime parte, descendunt, pauci recti procedunt,
ubi ingrediuntur; aliivero adscendunt aeriferorum
truncorum, & horum ingressum est. quod
prater Eustachium meminen observasse video.
Ultimi


Of the Lungs.
The Lungs are Vascular Substances
composed chiefly of Air Vessels, and
Blood Vessels; the Air Vessels are
Ramifications of the Trachea Arteria,
and are called Bronchia; the blood
Vessels are ramifications of the Vena
and Arteria Pulmonalis; beside-which
they have an Artery wc. serves
to nourish them, called the Bronchial
Artery coming from the Ascending
Aorta together with Nerves and
Lymphatics, and some say also
Parenchyma which is perhaps no
more than cellular Membrane.
Some Anatomists suppose there are
little follicles or cells at the extremity
of the small Bronchial Vessels, which
if there is are not discernable.


Ultimi autem ramuli ommitunt cartilagineam
indolem, & expanduntur in vesiculas oblongas,
membranaceas, cavas, qua Malpighiana dicuntur,
ox quibus fiunt area, & lobuli, qui tandem pulmonum
lobos efficiunt.
Comitantur aerifera hac vasa, in omni decurser,
ad vesiculas usque, vasa Sanguifera, qua omnia
oriuntur ex arteria pulmonali, qua cordis dextro
ventriculs egressa, qua parte superiore ventriculs
sinistro jungitur, adscendit, mox se incurrat, arcum
facit, & sub aorta decumit. Descendit
The inside of the Trachea arteria is lined with a
membrane in which are small glands that secrete mucus 
for lubricating the its internal surfaces; in cold, this means
is sucked into great quantity—sometimes inspissated 
is spit up very thick especially in the morning.
Dissection has taught us that this membrane is the
seat of that disease in children called the Hives & is
found separated from the cartilages – nothing proves so useful
in this disease as large doses of 8. I have known 10 g of calom: given to 
a child 2 years old produced 2 copious stools & disease immediately vanished


The Lungs are divided into two Lobes,
by means of the Mediastinum and
Heart. The right Lobe is divided into
three Lobuli by fissures; and the
left Lobe is divided into two Lobuli.
In a natural state, the Lungs are
every were in contact with the Ribs,
so that there is no vacuity left.
The Trachea Arteria is composed of
cartilaginous Rings, which behind are not
quite shut but a small membrane between;
each of the cartilages are connected likewise
by membranes.
The Lungs are liable to inflammation,
and Ulceration. In inflammation of the
Lungs we should use plentiful bleeding,
oiluants, fomentations externally and
the steams of warm liquors particularly 
Vinegar, into the Lungs thro' the mouth.


x The ventricles are divided by a middle partition
called Septum Cordis.


Lect. 42d:
Of the Hearts.
The Heart is a strong muscular substance,
situated obliquely to the left
side, more than the right; part of the
inferior and or Apex in contact with
the Diaphragm, and pointing between
the sixth and seventh Ribs on the left
side; the Apex being likewise nigher
the sternum than the Basis.
The Heart is the Origin of the Veins
and Arteries.
There are four cavities in the Heart,
two Auricles, and two Ventricles; x one right
and one left, at the right Auricle the
Vena Cava enters, and at the left: the
Vena Pulmonalis; at the right Ventricle
the Arteria Pulmonalis egresses, and
the Aorta from the left.
M


x these cordae Tendineae arise from the Carnae 
Columnae.

At the entrance of the Vena Cava into
the right Auricle of the Heart are three
Valves called Valvula nobilis, and about
the middle of the Auricle there is a little
knob called Carna Sesamoidea: At the
entrance out of the right Auricle into the
right Ventricle and two valves called Valvulae 
bicuspides, connected by sou:e small tendinous
cords called Cordae Tendineae x; the internal
part of this Ventricle is rough & muscular
having many muscular Pillars, called
Carnae Columnae which serves for to
strengthen the motion of the Heart
and to work the blood so as to prevent
its concretion & forming Polypuses,-
which however sometimes happens.
After the blood has passed out of
the right Ventricle into the pulmonary Artery
it is prevented from returning by three
valves




Valves named Valvulae Semilunares.
There are likewise Valves at the
entrance between the left Auricle and
Ventricle named Valvulae Mitrales
fastened by the final Cordae Tendineaes
on the left side of the Heart.
The left Ventricle is larger and a
stronger & much thicker muscular bag
than the right Ventricle, its internal
part tougher and the Carnae Columnae
bigger. As the entrance out of the
left Ventricle into the Aorta are likewise
three Semilunar Valves.
The Heart is contained in a strong
Membranous bag called Pericardium
the internal part of which bag is very
smooth and lubricated with a juice
that continually transudes through the
same
H.




Same
Dr. Plott in  his History of Staffordshire
attests of his own knowledge the case of one
Mary Eagle who drew two quarts of
milk from her breasts every day besides
what her child sucked and that she
could make two pounds of butter
every week ever since she was
brought to bed which was above
five months when the Dr. saw her.
Borellus in his Hist: & Absence:
physioc-med: related an instance of
the like native in one Mary Caron
a Taylor’s wife of Bologna who afforded
milk enough for two children & made
Butter besides
Biog Dictionary Led: Esq:






Lect. 43d:
Of the Diaphragm
The Diaphragm is a large Muscle
between the Thorax and Abdomen, the
muscular fibres of which arise from the
internal part of all the ribs below the
sternum, and from the lower end of
the sternum, these fibres terminate in
a tendinous expansion which is nearly
in the middle of the Diaphragm, and
which is of an oblong figure coming
very nigh the sternum upon which
part the Apex of the Heart lies, and
from thence turning down towards
the Angle of the Ribs and is called
the oval tendon of the Diaphragm
the lower part of the Diaphragm is
likewise muscular and on each side
of the Vertebra are muscular Fibres
sent





Sent down some distance called the Crura
of the Diaphragm, these terminate
near the Origin of the Psoas muscles
which arise at the internal part of
the Vertebra of the Loins and pass out
of the Abdomen at the Inguen to be
inserted into the Os Femoris. it is
by making way through these muscles
that Abscesses of the Loins sometimes
fall down to the Thigh and are opened
and discharge their contents there.
There a three Apertures thro'
the Diaphragm, one of the right side
of the Vertebra through which the
Vena Cava goes, a second contiguous
to the Vertebra inclining a little to the
left thro' wc. goes the Aorta, a third
over the Aorta & exactly over the Vertebrae
through wc. the Oesophagus goes.
Of





Lecture 44th:
Of Respiration
Respiration is an alternate dilatation and
contraction of the Thorax the former performed
by Inspiration and the latter by Expiration.
The parts subservient to Respiration
are divided into Active and Passive
The active parts are the Ribs, Sternum,
Heart &c: acting upon the the passive
which are the Lungs themselves.
The dilatation of the Thorax happens
both in length and diameter; in length
by means of the Lungs pressing upon
the Diaphragm and thereby rendering
its convexity more plane, the diameter
is increased by the motion of the
intercostal muscles &c: Thus the
capacity




Capacity of the Thorax is increased
and as there is no vacuum between
the Lungs and ribs allowed of in a
natural state, the capacity of the Lungs
will also be increased and there will
be a vacuity in the Lungs wc. nature
not admitting of and by the pressure
of the Atmosphere rushing through
the Aspera Arteria they are soon
filled with Air making Inspiration.
The fresh Air that is drawn in
by Inspiration stretching the Bronchiae
and stimulating the same cause
them to contract and expel the Air
making Expiration, some Authors
imagine these are small Muscles
between




Between the cartilaginous Rings of
the Bronchiae which they call Musculi
Mesenchrondroeci serving to contract the
the same in Expiration.
The uses of Respiration are four,
1st For the circulation of the Blood, thus
in Inspiration the Lungs are distended
and the fine contorsions of the Arteries are
are elongated so as to allow, blood to pass
through them whereas in a collapsed state
the blood cannot pass through them.
in Expiration the Lungs collapsing push
the Blood through the Veins into the left
Auricle of the Heart.
2d. For sanguification by communicating
the Blood making it more florid & denser
3. For cooling the blood
4th. For Vocification, exclusion of [illegible] &c:




Of the Peritoneum
This membrane is similar to the pleura, being smooth
on one side & connected by cellular membrane on the other; it is
reflected from the contained path to the containing. It makes
a compleat bag 1st: covering the viscera by intimate connection,
& then covering the abdominal muscles loosely on the
inside. The peritoneum has been considered
as a double membrane true or false, the last is no
more than cellular membrane wch. connects the peritoneum
to the external parts. We may conceive that all
the viscera are behind or without the peritoneum, wch. 
running up on one side of a viscus is reflected back
on another so as to form an almost compleat 
cover to each viscus separately, so that by a very
nice dissection the peritoneum may be taken out
in a compleat bladder having no perforation at
all, leaving all the viscera undisturbed.




Lecture 45th:
Of the Stomach
The stomach is a large muscular bag
situate Obliquely from the Left Hypochondrium
to the Epigastrium and serves for
the reception of our food & digestion of
the same, it has an upper & lower curvature
called the lesser and greater curvatures
of the stomach.
There are two Orifices to the stomach;
the superior one called the Cardia which
enters it from the Oesophagus don't open
at the fundus of the same but obliquely,
at the side an inch or more from the
end. Towards the inferior end the
stomach grows smaller & turns up
opening into the Duodenum by an
Orifice called the Pylorus where there
is
J


The Nerves of the stomach come from the
par vagum.



Is a partial kind of a valve which does not
prevent the regurgitation of fluids into
the stomach being only a thickness of
the internal coat of the stomach.
The stomach is furnished with
Nerves and blood vessels. x
Some Anatomists say there are
small glands in the stomach, but if
so they are not easily discovered, there
is however a fluid discharged into the
stomach from the extremities of the
Arteries called the Gastric lymph
from the gastros the Greek name for the
stomach, there is likewise Lymphatics
which absorb the redundant fluids
& carrys it into the blood.
The coats of the Stomach are three
1st. coming from the peritoneum and is
called




called the Peritoneal Coat. 2d. Muscular
being composed of thin muscular fibres
running longitudinal and transversely
by which the capacity of the stomach
is decreased the readier, to expel its
contents. & 3d: Villous or internal Coat
which is thin.
Of the Intestines
The first Intestine next the stomach
is the Duodenum beginning at the
Pylorus and ascending two or three
Inches, has then two or three inflections
pulsing down & across the Vertebrae —
being all the way tied fast by a
duplicature of the Peritoneum to the
back, having no mesentery.
The Ductus Choledocus & ductus
Pancreaticus both enter the Duodenum
several




Several inches from the Pylorus, not
both by one Orifice but by two very
near together, next the Duodenum is
the Jejunum, & then the Ilium which
is the last of the small instestines.
The coats of the Intestines are
three the same as the Stomach, and
in the small intestines are anular
duplicatures of the internal Villous coat
forming what is called Valvulae Coniventes
which serve for two purposes, first to
make the passage rough & prevent
the Faeces, from passing on too fast
and secondly to give more capacious origin.
to the Lacteals
The Ilium enters the Caecum 
not at the end but about an Inch
there from obliquely the blind end only
being




Being called Caecum, where there is
an appendage called Apendicula Vermiformis.
At the entrance of the Ilium
into the great Intestines, there is a
Valve formed by the inner coat of the
Colon & called Valvula Colli which
in a sound state entirely prevents the
regurgitation of the Faeces or any fluids
passing, injected per Anum.
The Colon runs up the right
side then along under the stomach
and down the left side, surrounding
all the Abdomen, hence Clysters
beside discharging the Faeces serve
the purpose of a fomentation to the
contents of the Abdomen.
The Intestines are furnished with
blood vessels from the two mesenteries 
except


 


except the Rectum which receives
its from the Hemorrhoidals.
The Mesentery is a double membrane
formed by a duplicature of the Peritoneum
serving to connect the Intestines. & through
which which the blood vessels go to be distributed
to the Intestines, through it
likewise goes the Lacteals which are fine
Lymphatic or absorbent vessels arising
from the villous coat of the Intestines
and passing through the mesentery, they
terminate in the Receptaculum
Chyli, to be described hereafter, there
is also a great number of Glands in
the Mesentery through which the
Chyle passes, and by which it is
supposed to receive some alteration.
These glands are very small.




Lect. 46th
Of the Lacteals & Thoracic Duct
The Lacteals are an innumerable number
of small vessels arising as before said
from the villous coat of the Intestines &
running through the mesentery in the
duplicature of the same and through
many fine glands and terminate in the
Thoracic Duct serving to convey the Chyle
The Thoracic Duct is a small
canal running up the Vertebra of the
Spine between the Aorta & Vena Azygos
and under the Vena Cava until it gets
above the Heart then it turns a little to
the left and ascending empties itself in
to the subclavian Vein.
The lowest end of this Duct has been
called Receptaculum Chyli but improperly
as its no larger than the rest of the Duct
neither do all the Lacteals enter there, but some higher






Of Digestion
Digestion is that change of the Aliments
whereby they are filled for the nourishments
of the body, this is different from the
different juices mixed therewith and in
the different parts of the body.
The first change that happens to the
Aliments is in the mouth by means of
Mastication and mixing with the Saliva
by which it is somewhat dissolved and
fitted for more easy Deglutition
Saliva is a clear mucous transparent
fluid secreted by the Glands of the
Mouth in the great plenty, and is of great
use in digestion.
After the Aliments is sufficiently
masticated & mixed with the Saliva they
are by the Tongue pressing against
the roof of the Mouth forced into the
Pharynx




Pharynx and from thence through the
Oesophagus into the Stomach. The
Muscles employed in this act of deglutition
are very many, serving chiefly to
pull up the Oesophagus and to press the
food down through the same, and we
may very well conceive of the act of
Deglutition by that of drawing a stocking
on the Leg, part of the muscles drawing
up the Oesophagus as we draw up
a stocking upon the leg, and the rest
pushing down its contents as we push
down our leg into a stocking.
The manner in which our food is
digested in the stomach was by some
of the Antients reckoned to proceed from
heat
K




Heat, others reckoned it was performed
by means of trituration, and others again
from the different juices there mixed
imagined it was performed by Fermentation,
but modern Physiologists from
many observations, think it is performed
by all three jointly viz: Heat, friction
and Fermentation.
After the Aliments are sufficiently
digested in the stomach, by the contraction
thereof which is the beginning of the
peristaltic motion of the Intestines, they
are forced through the Pylorus into the
Duodenum, where it continues some
time and receives another change by
having the Bile and pancreatic juices
mixed therewith.
The







The Bile is an oily bitter, and attenuating
substance endued also with
a saponaceous virtue it will incorporate
with Oils and when so mixed they are
both soluble in water, it unites with
salt forming a green color. by which
it appears that the Bile is of great—
use in attenuating the viscid part of
the Aliments, and stimulating the—
Intestines, the latter we are assured—
of by this that Bile secreted and—
discharged into the Intestines in too great
a quantity causes a Diarrehea, and in
a Jaundice where the Bile returns into
the Blood and is not sent into the
Intestines a Costiveness happens
with while stools, and Boerhaave
says






Says the Gall of Animals is of use
in this case to supply the want of Gall
DeGraaf collected great quantities
of the Pancreatic juice from Animals
which he says is subacid it is reckoned
to be somewhat of the nature of the
Saliva, some reckoned it serves to
sheath the Acrimony of the Bile but
this in a natural state is not too Aerid
These two fluids being mixed with
the Aliments in the Duodenum the
fluid and nutritious particles of the
same are absorbed by the Lacteal vessels
and by them carried into the Thoracic
Duct to be conveyed into the Blood.
These Lacteals are in all the intestines,
but in the small ones in the 
Greatest 




Greatest plenty, That there are also
Lacteals in the Colon seems evident
1st. From the rout the colon makes round
the Abdomen, for if that is not for
absorbing the particles that may chance
to be not taken up by the vessels in
the small Intestines why did it not
go out strait like the Rectum and
immediately terminate in Ans?
2. From persons being known to have
lived a long time by Glysters, not being
able to get any thing thro' the Oesophasgus,
& it is known that they cannot
pass by the Valve of the Colon.
The contents of the Intestines are 
carried along by the Peristaltic motion
thereof




thereof. Vomiting is an inversion of
the peristaltic motion and is performed by
means of a deep inspiration which presses
the Diaphragm against the stomach &
a convulsive contraction of the stomach
by which its contents are thrown up
hence we learn that Emetics are good
in Fluxes by inverting the peristaltic
motion they stop the same.




Of the Bile
Bile is secreted in the Liver. It is
8 times as viscid as water. More
subject to concrete than any other
humour in the body. Its specific
gravity to water is as 010 to 795.
In a such quadrupeds & in the human
species the bile is very bitter, but
most so in carnivorous animals.
Recent bile easily mixess with water.
It mixes with oil by triture. Mixed
with water it partakes of the property
of Soap, dissolves oil so that it will
mix with water & takes out grease
spots. It dissolves resins & mixes
with balsams. It dissolves Myrrh
Bdellium & Wax like the yolk of
an Egg, & is supposed to dissolve
the Blood when mixed with it as
in a Jaundice.




The Ductus Choledochus may
may be compressed & stopped by
the Duodenum being distended with
flatus. Eating Mushrooms has
been known to distend the duodenum
greatly & trangulate the ductus
choledocus as it were with a
ligature. It may also be obstructed
by the contractions of the fibres of the 
intestine from stimuli as happens
in the Colica pictonum, biliosa,
inflammation of the duodenum, acrid
purges, glass of Antimony & poisons.
Hither we may refer the Jaundice
in Infants which is removed by
Rhubarb. Storck has seen the ductus
choledochus obstructed with a cheesy
coagulum. Hillary says this is
frequent in the warm Islands.
See Monro Ed: Ess: v. p 247 Baglivi
prax: med: Haller tom: 6. p 590


x about 4 fingers breadth below the pylorus.


Lect. 47th Of the Liver
The Liver is a large Viscus situated
immediately under the diaphragm mostly in
the right Hypochondrium extending over the Stomach
into the Epigastrium it is convex
above and concave below suspended by three
Ligaments one above to the Diaphragm one
broad on the upper part of the round ligament
from the Umbilicus which was the Umbilical
Vessel in a foetus state. There are several
fissures in the Liver 1st. Divide the great lobe
from the lesser one. 2d. divides the Lobulee
spigeli & the third where the Hepatic
Vessels enter;
The Vesica Fellis lies in a depness in
between the two lobes of the Liver from
where goes a duct remarkably contorted to
appearance about two inches when it joins
the hepatic duct, both of them united
form the Ductus comunis Cholidochus
which terminates in the Duodenum. x
The Coat of the Liver comes from
the
L

x sometimes called Tunica Glissoniana
*The hepatic Artery divides a little before it enters the
Liver one branch going to one lobe & the other to the other
Lobe; it serves to nourish the liver & is said to secrete a
small part of the Bile, some few of its evanescent frame has
terminating in the pori biliarii as is proved by injections.


The Peritoneum x beside which some Authors
describe another coat wc. is scarce to be
seen, The Gall Bladder has three coats
1st. from the Peritoneum, 2d: Muscular
& The 3d. Villous, appearing like a honey
comb inside. The Liver is furnished with
Veins Arteries & Nerves.
The Blood Vessels are the Hepatic *
Artery & Veins & the Vena Porta.
The Vena Porta is like an Artery first
in its Office & 2dly. in the thickness of its
coats; it arises from all the Viscera of the
Abdomen terminating in the Liver and
is supposed to carry the blood for the
secretion of the bile, 1st. From the longness
thereof & the smallness of the hepatic Artery.
2dly: By injections passing from it
into the biliary Duets &c:
It is certain however that the blood
being carried into the Liver, part of it is
converted


x The general opinion of the ancient
Anatomists was that the bile was conveyed
into the Gall Bladder by little ducts
running from the liver immediately
into the bladder which they called
ducti hepaticistics. Pechlin was the 
first who denied the existence of these ducts
in the human body, then Ruysch,
Cowper, Bidlow, Berger, Morgagni,
Heister, Ludwig, Carsons, Lieutaud, Ceyer,
& Cheselden. who says if a ligature be
applied round the cystic duct, or if it
be obstructed the gall bladder does not
become turgid. Bohnius emptied the
gall bladder of bile then tied a ligature
round the cystic duct & upon examining
the same several days afterwards found
no bile in the cyst itself but the part of
the duct between the ligature & liver was
greatly distended. Bianchus & Haller
have done the same. This clearly proves
that there is no communication between the
Liver & Gall bladder but by the cystic duct.
What was supposed to be Hepatocystic ducts
is demonstrated to be only blood vessels
by Ruysch, Guntz, Haller Morgagni & others.


converted into Bile & carried by the pori
Biliarii which all meeting together form
the hepatic duct though the hepatic duct
to the cystic then regurgitates into the Gall
Bladder; that the Bile regurgitates thus x
into the reservoir is proved 1st. by there being
no other passage though some supposed there
was by little ducts wc. they called cysto hepatic
ducts, but there is no such is evident from
the injections not passing through that way
 into the Cyst, & in a Viper the Gall Bladder
is vitiate some distance from the Liver.
Horses & Deer have no Gall Bladder.
That the Bile goes through the hepatic Cystic
Ducts into the Gall Bladder is proved 2dly:
by blowing into the hepatic duct the wind
passes free into the cystic than through
the ductus cholodochus.
The remainder of the Blood is received
by the Veins & carried back to the Heart
Diseases


x more frequently if not always the Jaundice
arises from an obstruction of the
Ductus communis Cholidocus
An obstruction of the cystic duct
alone will not occasion a Jaundice.


Diseases of the Liver are:
1st. Hydatides these are of two sorts
the first tumors composed of several lesser
cysts filled with a gelatinous matter, the
other a kind of vascular Cysts, the fluid
circulating through it.
2d. Inflammation this is best relieved
by plentiful bleeding warm relaxing and
stimulating applications &c: It sometimes
suppurates & even grows cancerous.
3d Scirrhi like other Glandular parts
4th. It gives origin to the Jaundice wc.
proceeds from an obstruction in the Cystic x
duct by wc. means the Bile is prevented
from going into the Gall bladder and
therefore returns into the Liver where it
is absorbed by the Veins or lymphatic
Vessels & carried into the blood & by that
means tinges the shin, the cystic duct
may be stopped by concretions tumors compressing
the




The same or more commonly by means of a
stone lodged therein: a stone or concretion
is best removed by Vomits which agitating
the parts serves to remove it or by friction
stimulating the same.
Some have imagined that a Jaundice
proceeds from a scirrhus Liver, but this
is proved to not be the cause as no Jaundice
can be unless the bile is absorbed after
it is perfectly made
Transient Jaundices sometimes
happens to Children from a spasm of the
Duodenum from acidities or otherwise
hinders the Bile from passing therein &
which is relieved as soon as the spasm
is removed.
Durable Jaundices happen when
the Obstruction of the Cistic duct cannot
be removed
Lect. 40th:
Pancreas is a long slender conglomerate
Gland situate obliquely under the stomach
between the spleen & Duodenum. each
little


x Haller supposes the pancreas secretes three times
as much fluid as the salival Glands.
* a costiveness and a pain in the region where this
gland is seated is the common symptoms of its being
obstructed.


little acini or knot supposed to be the extremity
of an Artery wound up in a knot and
the whole vascular like the liver and all
the other Glands of the body. from each
acini goes a small excretion Duct which
terminates in a larger duct in the middle
of the Pancreas & called the pancreatic
Duct & through which the pancreatic
juice flows into the duodenum, the
glands of the pancreas being the same
with those that discharge the Saliva
are supposed to secrete the same juice
and for the same Use. x
Diseases of the Pancreas are
Inflammation, Cancer, & Schirri, which *
are very difficult to be known until past
cure they are however removed much
in the same same manner as the same
Diseases on other parts, Soap is a very
good thing in this case which not only seen


x This appears very reasonable though it was
never taken notice of by any author before Mr. Monro.


Is a good resolvent but supplies the place
of this juice in digestion.
Sometimes a Diarrhea happens in a
Salivation and proceeds from a too great a
secretion of the pancreatic juice which being
the same with that of the saliva is supposed
to be effected in the same manner with
Mercury & is only to be removed by removing the cause. x
Omentum is a fatty double membrane
composed or formed by a duplicature of
of the Peritoneum it has an appendage
between the Liver & stomach called the
Omentum minor & may be inflated.
Uses of the Omentum are to lubricate
& keep the Intestines warm, and it is
supposed to supply oily particles to the
Bile and also the blood.
It is sometimes much distended with
Fat and in very lean subjects quite
reticular. Spleen




Of the Spleen
The Spleen is a roundish lobulated
Gland situated in the left Hypochondrium
it is furnished with blood Vessels and
but very few Nerves.
The Antients supposed its use
was to counterbalance the Liver, others
thought it contained a fluid called the
Atrabilis, but the moderns mostly
think that it is subservient to the
Liver, it has been taken out of several
animals without any apparent damage
and is not therefore a vital viscera.
It is subject to very few diseases,
scarce ever being inflamed schirrius or
cancerated, by reason of the fewness
of the nerves, its only subject to a
viscidity of its fluid and an enlargement
therefrom.
Lect.


x The arteries generally divide into three branches
and the vein into two before they enter the Kidneys.


Lect. 49th
Of the Kidneys
The Kidneys are two Glandular bodies
situate between the false ribs & Ilium.
the situation of the right Kidney is somewhat
lower than that of the left oweing
to the Liver being on that side. The
blood vessels of the Kidneys are an Artery
and a Vein called Renales or Emulgents
the right emulgent Artery is longer than
the left & the left Vein than the right.
These vessels enter at the Pelvis and
are distributed through the same. x
The external part of the Kidney is called
Cortical the thickness of which is irregular
and in this the Urine is secreted and
emptied into little ducts in the inner
part  
M


x the pelvis is an enlargement or expansion of the
of the upper part of the ureter where it enters the
Kidney or rather where the united urinary Tubes regress
out of it.


part of the same, which is called the
Mamillary part of the Kidneys.
The little ducts into which the Urine
is secreted are called Tubuli Urinarii
and are in number about a dozen,
these all unite in the Pelvis x forming the
Ureter which is a membranous canal
conveying the Urine from the Kidneys
to the Vesica Urinaria. The Ureter
as it enters the Pelvis of the Kidney
divides into three parts one going towards
each end and the other through
the middle. The coats of the Kidneys
are two, the first called Adipose and the
second Membranaceous.
There is an appendage to the 
Kidney called Glandula Renales or
Gland




Glandula Succentriari situate at the
top of the Kidneys its particular use
not known but supposed to be subservient
to the Kidneys.
Diseases of the Kidneys are,
Inflammation, Diabetes from a too
great laxness of the Vessels allowing
the red particles of the blood to pass
through them, gravel, Scirrhi &c:
Lect. 50th:
Of the Bladder
The Bladder is a membraneous Bag
situate in the Pelvis the upper part of
which is covered with the Peritoneum
but when it is very much distended it
protrudes about an Inch above the
Pelvis & being there covered with the
Peritoneum




Peritoneum & in this place is the upper
Operation for the Stone performed by
making an Incision into the Bladder
without cutting the peritoneum the doing
which would be of dangerous consequence.
The coats of the Bladder are three,
1st: the common coat 2d: muscular and
3d: Villous, the muscular coat at the
neck of the Bladder is thick & circular
and is called Sphincter.
The Ureters enter the Bladder one
on each side about an Inch from the
neck thereof by a small Orifice obliquely.
The situation of the Bladder is between
the Rectum & Olsa Pubis in men and 
between the Uterus & Pubis in women 
its use is a Reservoir to the Urine




Parts of Generation
Lect 51st
1st In a Male.
These are the spermatic Cord, Testes
Scrotum, Vesica Seminales, Prostate
Gland, and Penis.
The spermatic cord is composed of
the spermatic Artery and Vein, Nerves,
Lymphatics, & Vas deferens all included
in acellular coat and some have
supposed a muscular wc. they called
Cremaster wc. is not visible except where
it passes out of the Abdomen wc. it does
in an oblique manner through the rings
of the Abdomen, by which the Intestines
and Omentum sometimes falls thro' 
forming an Herniae Inguinalis or Jerotalis
along the side of the spermatic Cord
The


x Caput Gallinaginis


The vas deferens empty themselves somewhat
like the biliary ducts there being a passage
from them immediately into the Urethra, but
it commonly regurgitates into the Vesicula
Seminales & there kept till used.
Vesicula Seminales are two Glands situate
under the neck of the Bladder, composed of
little cells which communicate with each
each other, being reservoirs for the semen,
from each of these there goes a small duct
which opens into the Urethra at the 
Caput Galaginis, x where is a large Gland called
the Prostate Gland which secretes a fine
mucus to defend the Urethra from the acrimony
of the Urine.
The Scrotum is composed of skin Cellular
Membrane &c: next to which has been reckoned
a muscle called the Dartos which is not to be
discerned




discerned, and the first obvious Coat
is that wc. surrounds the Testicle much
as the Pleura or Peritoneum does the
contents within them this is called the
Tunica Vaginalis propria Testes, and
within that is a coat which adheres to
the substance of the Testicle called the 
Tunica Albuginea,
The substance of the Testicle is
wholly Glandular, the spermatic Artery
entering in at the side of the same and
distributed through the same terminating
in fine secretory ducts and these again
in excretory ducts which uniting into one
form the Vas deferens, The Epididymus
is an Appendage to the Testicle formed by
numerous convolutions of the excretory duct,
reckoned 6 times as long as the Spermatic Cord.




Lect. 52d:
Parts of Generation in Females.
These are either external or internal, the
external are the Mons Veneris on which
hair grows at a certain age
Labia or External Lips of the Orifice
at the upper part of wc. is a small body
called the Clitoris under which in a
small groove is the Iter ad Urinam
thro' which the urine passes & into which
the Catheter must be introduced in a
suppression of Urine, & we should be well
acquainted with this Orifice as the modesty
of women often denies us a sight of the
part, so that we must introduce the Catheter
by feeling, at the lower part where the
Labia unite is formed a Fraenum or
Fushet or Foushette.



x Iter externum ad Uterum



Nymphae are two spongy bodies
within the Labia within these in Virgins
is a circular membrane called Hymen
within these is the Iter externum ad Uterum x
Vagina is a membranous substance
furnished with rugae by wc. the Penis is
more titillated in Coitus, there is likewise
many small glands in the Vagina wc.
secrete a liquor to lubricate the same and
during the Venereal orgasm whether real
or imaginary there is sometimes so much
mucus secreted by these glands that
it has been discharged, in great quantities
so as to wet all the external parts, this
by some is reckoned the Female semen.
At the bottom of the Vagina is the
Iter internum ad Uterum, the Os Uteri or
Os Tincae. N Between


x or young Puppy



Between the Fushet and Anus, there is
a seam called Perinaeum, this in
difficult deliveries is sometimes lacerated
by the largeness of the Foetus & it is
necessary to prevent this accident for to
support the Perinaeum with the hand
while the Foetus advances
Uterus is a small body situate
obliquely between the Bladder & Rectum
its coats size near half an Inch thick
& its internal cavity very small; the
Neck of the Uterus is full of rugae wc. 
serve to allow the same to dilate for the
expulsion of the Foetus. The Os Tincae
resembles the mouth of a Tench x situate
at the bottom of the Vagina tho' not a
continuation thereof the Vagina being
inserted



x An demande si le corps de la matrice
etant renverse, & ayant tente inutiliment
va induction, elle montroit quilque
disposition a ve gangrener, e il conviendroit
pour lors de l’eactirper, apris
avoir porte une ligature le plus haut
qu’il veroit possible. En parsil cas
on ne devroit point balancer de faire
cette operation pour empecker que la
gangrene faisant du progres du cote
des parties interieures, elle ne causat
la mort a la malade. L'extirpation
de la matrice, quoique rare, never sit
point en cette occasion une operation
temeraire, son succes etant prour a
par plusieurs observations
Verdeer's Anal: v: 22 p 66
Rousset, dans son Traite de
Partes Caesares, dit qu'une femme
a la suite de pluesieurs accouchemens
laborieux, eut une precipitation de
matrice qui ne pouvant etre


inserted round the Os Tincae. From the
Fundus of the Uterus there goes off nearly
transversely on each side, a tube called the
Fallopian Tubes lying loose & growing
larger toward the further end wc. is fimbricated.
The Uterus is suspended by the
ligament lata & rotunda x
Ovaria are two glandular bodies
situate on each side of the Uterus inclosed
in cellular membrane in each of these
Ovaria are near 20 small Ova
Of Generation
This is perfomed per Coitus by the
Male’s introducing his Penis into the
Vagina, & perhaps into the Os Uteri tho'
this is denied by some at which time the
parts grow turgid by the venereal Orgasm
the Os Tincae opens & receives the male Semen
in which are Anamalcules, immediately
attended.


reduite, se gangrena, & tomba
d’elle-meme. La femme ne daigna
pas garder le lit, & elle Jouit d’une
parfaite vante’ pendant trois ans,
au bout desquels, etant morte d'uno
fievre continue, louverture de fon
corps fid voir que c’ etoit veritablement
le corps de la matrice, qui
par pourriture s’etoit s’epare
de lui-meme
Ibidem p168.


afterwards the Os Tinca closes
During the Orgasm the fallopian Tubes
grow erect & the Timbria seize the Ovaria
at wc. time some one or more of the Animalcule
ascend through the Fallopian Tubes & enter
the first ripe Ovum wc. has now burst
the cellular membrane by its turgidity, then
the Ovum is disengaged & carried by the
Fallopian Tube into the Uterus, and the
place where the Ovum was in the Ovarium
is soon after filled up by a yellowish substance
called Corpus Luteum, this I proved by
opening a Bitch in the Hornes of the Uterus
were 7 whelps in one three & the other four
& in the Ovaria were the same number of
Corpora Lutea, by alike experiment upon a
Bitch opened while the Dog was fastened
thereto, for dogs have no Vesicula Feminalis
are obliged to remain fastened to the Bitch
a




a long time while the Semen is excreted and
carried from the Testes by the Vas deferens
into the Uterus I found that the semen
was ejected immediately into the Uterus.
Though the preceeding Hypothesis seems
incredible and almost impossible, yet it
answers all the Phenomena of Generation
the best of any system yet advanced:
however the subject is extremely intricate
& no doubt is one of the Arcana natura
which the omniscient Jehovah of his
infinite goodness sees fit to hide from us.




Lect: 53d.
Of the Foetus its Nutrition &c.
The Ovum of the female wc. is foecundated in
the preceeding manner by the semen Masculinum is supposed
to contact also the membranes that envelop the foetus
with the Placenta, Umbilical Chord &c:
The Ovum lies in the Uterus 9 months, but for
the first two or three months the Placenta does not
adhere to the Uterus
The Chorionis the external coat of the Foetus it
is a thick spongy membrane.
The Amnios is within the Chorion it is very
thin and smooth, between these two membranes
some have described another called Alantois wch.
includes the Urine of the foetus carried there from ye. bladder by the
Urachus, this is found in some brutes but cannot
be discerned in the human species
The Placenta is made up of a congress of vessels.
How does the Placenta adhere to the Uterus? How is
the Foetus nourished? is it by the Mouth; the
Umbilical Vein, or by both together? Does red 
blood go immediately from the uterine Vessels of 
the


As first this want of Navel String, 2d: a diminution 
of the the Liquor Amnii, 3d. Mucus being found in the mouth
& stomach & meconium &c:
# 1st. A want of mouth or any passage into the
chylopoetic organs, 2d a corruption of the Liquor Amnii
3d. That the liquor Amnii is an exudation from the
foetus & consequently not fit for its nourishment &c:


the mother through the Placenta to the Foetus &
vice versa? from whence comes the Liqour of
the Amnios? these are question, that have been
differently solved by physiologists.
Some have imagined that the placenta adheres
to the Uterus by its vessels inosculating with those of
the Uterus, others imagine there is no continuation of
vessels by inosculation from the placenta to the
Uterus, but that the placenta adheres thereto by
a kind of cement; for (say they) if  it adhered otherwise
there must be a laceration (& consequently an inflammation & suppuration)
wc. does not happen when it is bro.' away.
As to the Nourishment of the foetus many have
imagined that it rec'd. nourishment by the mouth
& bring many arguments to prove it*, on the contrary
others deny that the Foetus receives any nourishment
by the mouth but wholly by the umbilical Chord -
this is the most viewed Opinion, but for a particular
acc't. of the Nutrition of the Foetus in Utero side
Med: Essays of Edinburgh and Dr. Shippen’s
Thesis for the connection of the Placenta to the Uterus
A




It was the rec'd. Opinion till of late by all who
allowed the foetus to be nourished by the umbilical
Chord that red blood was immediately conveyed from
the mother to the foetus; Their arguments for it are 1st.
that if the mother bleeds to death the Foetus will
be deprived of blood also. 2d. Injections pass from
the mother to the Foetus. 3d. that hemorrhages happen
upon a separation of the placenta from the
uterus. 4th that the umbilical Chord will bleed a
great quantity when cut &c: but the most modern
doctrine that now prevails & wc. answers all the
phenomena best is that red blood does not pass
immediately from the mother to the Foetus, for
before the placenta adheres to the Uterus it certainly
cannot, & then it must be nourished by absorption
of the Placentine vessels as well before as after
its adhersion to the Uterus; we have said
before that the placenta does not adhere to the
Uterus by inosculation of the Vessels, but by a
slight cementation, thence we suppose that
the


   


the small ends of the placentine Vessels open into
the mouths of the uterine ones, and as the mouths
of the uterine Vessels are so large near the
time of delivery as to admit a goose quill
whereas the mouths of the placentine Vessels
are so small as not to admit red blood
its very probable there are many of the
placentine vessels open into one of those of
the uterus.
These small placentine vasculae are part
of them supposed to absorb the chylous & ferrous
nutritious part of the blood in the uterine
vessels which the placenta forms into red
blood before it is conveyed to the Foetus;
The manner how the placenta acts in forming
this nutritious fluid into blood is
unknown, but it is supposed to perform
the office of Lungs in that particular.
The placentine vessels having absorbed
the nutritious particles of the mother’s blood
and


   


and the placenta formed it into red blood
it is conveyed by the umbilical Vein into
the Foetus, for its increase & nourishment,
while the superfluous & unnutritious part is reconveyed
by the umbilical Arteries into the
placenta & is absorbed by the uterine Vessels
and mixed with the blood of the mother;
thus instead of a reciprocal circulation between
the Foetus & Mother which was formerly Supposed,
and is still by some, there is only a
secretion of the fluids which pass from one
to the other. The Arguments brought to Support
this new doctrine are, 1st: That upon the mother’s
bleeding to death, the Foetus will not be deprived
of any of its blood this Dr. Shippen proved by
an experiment he made in Edinburgh before
Alexander Monro jun'r he bled a Bitch to
death then opened her and took out her whelps
which appeared to have lost not one drop of
blood




blood. 2d. That the umbilical Cord when cut
will not bleed but very little, no more than
the blood contained in the Placenta, this most
Midwives know & it is mentioned by Smellie:
but 3d. Lastly the greatest argument of all
is that Injections cannot be made to pass
from the placenta into the Vessels of the
uterus nor vice versa tho' it has been
repeatedly tried by the greatest Anatomists
notwithstanding what has been said by some
to the contrary.


   


   


   


   


   


   


   


   


   


   


   


A Course of Bandages
Bandages are very necessary to confine dressings
upon any external part of the body, injured either
by accident or by a necessary Operation.
Lect: 54th:
Bandages of the Head.
1st: Handkerchief doubled & made 3 square
put round the head & tied behind
2d: Grand Covre Chef a large square
handkerchief doubled to ab.t 2/3 the way &
laid on the head the single part so as to
reach the Nose, the double part the forehead,
wc. double part being uppermost must be
fastened under the Chin, the other then
turned up & tied behind in the nape of Neck
3d: Poormans Bandage of Galen
a piece of linen cut into 6 tails & laid
on the top of the head, the middle tails
fastened


   


fastened under the Chin the hind ones before
& the fore ones at last behind.
4th: Capaline a long doubleheaded bandage
4 or 5 fingers breadth wide to put round
the head
5th: Uniting Bandage double headed &
like the former with a slit near the middle
to be applied to a wound of the forehead.
6th: Scapha for bleeding in the frontal
vein going several times round the head
at last the first end turned over & tied behind
7th: Kiaster double headed for bleeding in
the Temporal Artery going several times
round the head then twisted round to a hard
knot over the Orifice & then part one end
over the crown the other under the Chin
and fastened.
8&9 Monos- & Bi-Ocular double headed
the first covering one Eye the last both Eyes
Lect.


   


Lecture 55th:
10 Accipiter a T Bandage for the Nose
going round & tail tied over the head.
11 A four tailed sling bandage for the
upper Lip.
12 A four tailed sling bandage for the
Chin the under half being the broadest.
13 Capistrum double headed bandage passing
from under the Chin to top of the head
then to neck & round to the Chin &c:
14. Divisive along double headed
rowler to keep up the head.
Bandages of the Trunk
15 Spica double headed for the shoulder
16 Star Bandage for a fracture of
the Clavicle a single headed rowler & if
necessary the Capaline may be applied
with it for greater safety.
17






17 For the Thorax the Jenriette or Napkin
& Scapulier the first going round the
body the latter slit going over the head &
fastened thereto.
18 Suspensor of Heliodorus for a diseased
Breast a X bandage
19 For Paracentesis a broad flannel roller
to go round & compress the Abdomen.
Lecture 56th:
20 Spica Inguinis double headed
for any disorder in the inguen.
21 T Bandage or Suspensor Scroti
beside wc. there are several others of less
note to these parts particularly the Truss
Bandages of the Extremities
22 Deloer for the Wrist
23 Spica Pollicis for the thumb.
24 Gauntlet ~ } for the fingers
25 Denigantlet 26




26 Eight tailed bandage for a broken
Patella &c:
27 For a simple Fracture Thypodesmus 
going round under the splints a single
headed roler & Epidesmus going over
the splints one roler very long may
serve for both.
28 For a compound Fracture where there
is a Wound &c: the 18 tailed bandage
together with splints Tape &c: and
lastly Junchs, Box, or Cradle &c:
if it is one of the Legs.




A Course of Operations
Lecture 57th:~
Of Sutures
There has been many sutures invented
most of which are out of use.
We ought to observe that a wound made
longitudinally in the direction of the ~
Fibres requires no sutures be it ever so
great, for by means of a bandage the
sides of the Wound is easily brought
together without suture.
But a wound made obliquely or
transversely requires a suture as no
Bandage can be made to keep the wound
together.
The intention of Sutures is to bring
the likes of a fresh wound in apposition, that the
vessels may inosculate & heal by the
first intention, the chief sutures are 
The




Glovers stitch, The interrupted suture,
The quilled suture, & the Gastroraphy,
The Glovers stitch is performed with
a strait needle & waxed thread single,
turned over and over.
The interrupted Suture is
made with a crooked needle & single waxed
thread the lips of the wound being brought
together first make a stitch in the middle the
Rule for which is to begin as far from the
edge of the wound as the wound is deep
making the needle come out at the bottom
of the wound & continued thro' on the contrary
side then tied not over the wound but on
one side, then make two other stitches near
each end wc. is mostly sufficient.
Quilled Suture is made with
a crooked needle as before with a double cord &
tied at the end with a quill on each side the Wound.
The




The Gastroraphy is performed when
the parietes of the Abdomen & Intestines
are cut. The intestine is to be saved up
with the Glovers stitch leaving a piece of
the thread at each end to lie out of the
wound of the Abdomen, then the Parietes
is to be stitched with the interrupted
Suture in a particular manner viz: on each
end of a waxed cord must be put a crooked
Needle, then take one needle & from within
the wound push it out then take the
other needle & do the same on the other side
of the wound, bringing them together
& tying the same, do so until you have
as many stitches as you think is
necessary




Of Trepaning
When it is necessary to perform this Operation
we should consider first the places where the Trepan
may be applied; there are 3 places where it is
improper to apply it viz: to the Sagital Suture,
the frontal Sinuses, & the Os Accipitis.
In Operating, an Incision must be made
of a good length through the scalp, the same opened
& the Cranium scraped, than having fixed upon
the place apply first the perforator & after that
the Trepan secundum Artem.
Of Fistula Lacrymalis
This operation is performed when the ductus
as Nasum is stopped & has formed in the
Lacrymal Sac &c: Sometimes compression
alone will cure this disease but when the Operation
is necessary its performed by making an incision
over the Sac at the bottom of the Orbit & half
the length of the same, into the Sac & cleaning
out





out the matter & if necessary making an Aperture
through the Os Unguis with a strong Probe or a
Trocar into the Nose.
Of the Polypus of the Nose
This is an excrescence growing in the Nose
in the Schneiderian Membrane, has different
degrees of firmness, in a recent state it is very
tender but by degrees grows harder until it gets
to a great firmness; the best time for extracting
it is when its so hard as not to break easily
with the Forceps but not so hard as to adhere
to the Schneiderian membrane too strongly.
Its extracted by taking hold of it with the
polypus Forceps & working it to one side and
the other backwards & forwards &c: until it is
loosened.




Extirpating the Tonsils.
This is best done by Ligature for fear of an
Hamorrhage if the Tonsils are largest at the
apex its an easy matter with proper Instruments
to pass the Ligature round its basis & make it
tight, but, it often happens that the Basis
is largest in this case a ligature put round woud
slip off therefore with a proper needle it must
be run through the middle of the Tonsils & tied on
each side cum node Chirurgica &c:
Of Amputation
Amputation is sometimes necessary but not near
so often as has been thought; all agree that it is
necessary in a Mortification, but then it must
not be performed until the mortification is stopped
& even new flesh begins to granulate.
In Amputating the Leg we must stand
between the legs that the saw may take the
Fibula before the Tibia is quite cut off.
we




We first apply the Tourniquet to the thigh
to stop the blood, then with a strait knife wc. 
is the best we make a circular incision with
two cuts round the leg or thigh through the
skin cellular membrane & fat about an Inch
below where we intend to cut off the Bone,
then an Assistant must pull up the skin
as high as possible, after wc. the Operator
must make a second Incision through the
muscles to the bone then if it’s the leg or
forearm the double edged scalpel must be
run between the bones to cut the interosseous
Ligament & Muscles, lastly the bone itself
must be cut off with the saw. & then the Arteries
taken up &c:
The Fingers are Amputated contrary to all
other parts at the Joins by cutting the flesh
as before then stretching it up & with the
scalpel beginning on the side take off the Joint.




Of Empiema
This is an operation for letting Pus Water or
Blood out of the cavity of the Thorax, oftenest
Pus, wc. comes from an inflammation & Suppuration,
when this is in but small quantities, the Lungs
by then great power of Absorption often carries
it off by Expectoration as we see in Pleurisies;
but when in great quantities the operation
must be performed very carefully for fear of
hurting the Lungs between the 6 & 7 or 7 & 8
Ribs with a common scalpel.
Of Bubonocele
This is the dangerousest operation in Surgery,
& not to be performed but when absolutely necessary;
when so it is done by making a long incision
from above the rings of the abdominal Muscles
almost to the bottom of the scrotum carefully
in to the Intestine thro' the Peritoneum or
Herniary Sac then dilate the passage by incision
& carefully reduce the Intestine.




Of Couching
This Operation is performed for the removal of a
Cataract or opacity of the crystaline Lens; there are
two ways of doing it, the old way of depressing the Lens
with a needle to the bottom of the Eye into the
vitreous humor wc. is done by running the needle abt.
1/10 of an Inch below the Cornea into the posterior
Chamber behind the Iris & depressing the Lens.
The other method, wc. is the new way, much in
vogue at present, & I think the best is to cut the
Cornea & extract the the crystalline Lens. In the
Old way the Lens is very apt to use after it has been
depressed wc. makes this new way preferable; it is
performed by a small knife with but one Edge wc.
is to enter near the place where the Needle enters & 
pushed thro' into the anterior chamber above the
Iris (taking care not to cut it) and out on the
other side cutting half or better of the Cornea, then
with the point of the knife cut the capsulae of the
Lens & its easily pressed out.




Of Lithotomy
This Operation is performed for extracting a 
stone out of the Vesica Urinariae; there has been
several methods invented to perform this operation
but the Lateral Operation or that invented by
Irene Jaques is the best & universally in use.
We are not to operate until we are certain
there is a stone in the Bladder & we can feel it
by sounding & all the other Surgeons present.
In Operating we first tye the patient on a
Table of a sufficient height lying on his back
by making a noose with a garter round the Wrist
then making him take hold of the bottom of
his foot with his hand putting the Garter round
his Instep & hand in form of 8 a sufficient number
of times, with an assistant to hold each knee
then introduce the Staff into the bladder, letting
a careful assistant hold the same bending the
top a little towards the right Groin is as that the
bend of the same may turn a little to the left
then




then the Operator setting down right before the
Patient must with a sharp scalpel make an incision
immediately upon the staff from the Base of the
scrotum to beyond the anus abt. an Inch to the
left of Cerines through the skin & fat, (this should
be made thus large that we may get at any Artery
if necessary) then make the incision shorter down
to the staff when we feel the staff bare we must
take the Gorget put the point of it into the Groove
of the staff then take hold of the staff from
your assistant & turn it over while you slip the
Gorget along the groove into the bladder, then
take out the staff, & introduce the Forceps upon
the groove of the Gorget, when they are in the
Bladder pull out the Gorget & gently feel for
the stone, when you find it take care to get good
hold of, it not being in too big a hurry; when you
have it fast extract it.
If the stone breaks take out what you can
with the Forceps & the rest with a scoop.
The wound must be drest gently wth. dry Lint.


Med. Hist.
MS.
B
158


Of Tapping












Of Injections
The ancients used to employ only
Ink for Injections (which answered the end
but very poorly) until the time of Ruysch 
who made his injections of wax, some of wc.
have since been improved; his method of
Injection was as follows viz. He first
laid open the hypogastrium & made two
incisions about an Inch long into the Aorta
& Vena Cava, then put the Subject in cold
water several days pressing out the blood
frequently. Next he put them in warm
water several days more & put two tubes
in the Artery one upwards & one downwards
& fastened them tightly.
His injection was only simple Suet
calomel with Cinnabar in cold weather &
in the Summer time he added a little white
wax & injected it gently when warm into
the vessels, then put the Subject into cold
water till the injection was cold, then dried
the preparation carefully or preserved it in
spirits of wine
Injections used by the modern are the follg:


Corroding Injection of Dr. Nicholls
Rx Wax 4 ounces Resin 3 ounces when
melted add Turpentine Varnish 3 ounces 
Dr. Hunter's Corroding Injections
Rx Wax 3 ounces Resin 3 ounces when melted
add Venice Turpentine 11 ounces 
Another
Rx Wax 4 ounces Resin 3 ounces when
melted add Oil of Turpentine 2 ounces 
Another
Rx Wax 4 ounces Resin 8 ounces or 10 ounces 
Tallow 3 ounces melt them together
The Injection is known to be of a
proper consistence by dropping some of
it when melted in water & when thoroughly
cold forming it into the shape of the Vessels
if upon Landing it breaks it is too hard
if it bends easily it is too soft & must
be mended. Those Injections which have
Turpentine Varnish, Venice Turpentine
or Oil of Turpentine in them must be
tried as above every time they are heated because
in heating they loose of their volatile oil


Of the Colours
To the foregoing Injections such a
quantity of colouring matter must be
added as will give them a bright colour
which must be determind by the Eye
Colours generally used are Vermillion
Kings Yellow, Blue Verditer & Flake
White. Other colours may be used.
They are generally to be mixed with the
Injections when they are melted; but
there are some objections to this rule
in some of the colours particularly the
blue Verditer & in some measure the Flake
White for Navy both ferment when mixed
with the foregoing Injections; to prevent
which it is necessary to melt some of the
Ingredients alone & add the colour to it before
the other Ingredients are added. The
following Experiments will particularize
these Exceptions
1 Blue Verditer with Tallow alone
causes no Fermentation
2 Blue Verditer with wax alone don’t
Ferment


3d. Blue Verditer with Resin alone
does ferment, therefore mix the blue
Verditer with the Tallow or Wax alone or
together & afterwards add the Resin
which causes a small froathing
If Turpentine Varnish, Venice
Turpentine or Oil of Turpentine be 
used mix your colour first with the
melted wax & then add either of these 
Ingredients with the Resin
These observations are equally true
of the Flake White
When we make a white Injection
instead of yellow Wax we use white.
It would seem that we have
not yet any Green Colour, but as blue
& yellow make a Green the blue Verditer
added to the yellow wax or Resin gives
us a fine green


Dr: Nicholls fine Injection
Rx Hard Brown Varnish & hard White
Varnish a 5 ounces Turpentine Varnish 2 ounces 
add the Colour & shake the Vial first
putting some shot therein to make them
mix. Either of the hard Varnishes will
do as well as both adding the same
proportion of Turpentine Varnish viz
1 to 5
Another
Rx Hard Brown Varnish & hard
White do. a 8 ounces Venice Turpentine 2 1/2 ounces 
mix these as the former
If we neglect being nice in our
proportions or from often heating these
Injections become too hard or Brittle.
We know when they are of a
proper consistence by the following
Experiment; Drop one drop of it upon
cold water which will immediately diffuse
itself over the whole surface when the
spirit will be immediately attracted by
the water & the gums with the Turpentine


will be left swimming on it, if this
will bear raising up without breaking
it is of a proper consistence, but if it
breaks its too hard & much be softened
till it is properly tenacious
Of Watery Injections
Glue dissolved in water alone makes
a good minute Injection; before it
is dissolved by heating its necessary
to steep it in water for 12 hours then
boil it upon the fire till the whole is
dissolved, afterwards strain it & drop
some of it upon a cold stone or any
cold substance to cool that you may
know its consistence; when it is somewhat
thicker than a common gelly
it is of a proper consistence
Isinglass & water prepared in
the same manner as the preceding ~
makes an Injection similar to it


Gum Arabic, Tragacanth, or
any of mucilaginous Gum dissolved
in Water to the consistence of Cream
& strained as the preceeding make a very
minute Injection
As the Colours mix difficultly with
with these watery Injections, they
ought first to be mixed well with
a little of the Injection & then the
remainder added to it.
Of Oily Injections
We often make Injections of almost
all Oils as Oil of Turpentine Hogs lard
Tallow &c: The oil of Turpentine is
rather too thin of itself but when added
to two parts Tallow is a good Injection
Butter or Hogs Lard make
of themselves a pretty good Injection


All fine Injections require more
Colours than coarse ones, for as it is to
run into much smaller vessels it of course
becomes more & more transparent and
therefore requires such a quantity of
colour as to render it opaque even
when it is most minutely separated on
diffused within in very small vessels or
on any surface
Of Common Injections
The corroding Injections are too hard
for several purposes & the fine ones
too soft therefore we need something
between them, some of which must
be softer than others
The hardest is Rx Resin 3 ounces Tallow 2 ounces 
Wax 1/2 ounce Colour sufficient for an Injectn.
is Rx Resin 2 ounces Tallow 2 ounces 
Colour sufficient for an Injection
These are generally used when
the part is intended to be dissected


Varnishes
Turpentine Varnish
Yellow Resin 14 lbs Oil of Turpentine
16 lbs, boil the water out of the Resin 
& then add the Oil of Turpentine from
the fire.
White Hard Varnish
Mastich & Gum Juniper a 1 grain 
Alcohol 8 grains ~
Brown Hard Varnish
Shell Lac & Seed Lac a 1 1/2 grains 
Gum Juniper 1 1/2 grains Alcohol Galls. 2 
clean the Gums from dirt & bruise
them pretty small then put them in
the spirits & dissolve them in a Sand heat
The Spirit of Sea Salt is the
corrosion commonly used by Anatomists


The part to be Injected must be
macerated in water blood warm 2 or 3
days so as to relax the vessels & soak
out all the blood in them, then having
a proper sized Syringe with pipes of
different sizes, fit one of the pipes
into the vessel & fasten it well with
a ligature bringing the ligature round
the cross piece to secure it the latter.
The part to be injected lying in the
warm water & the Syringe and
Injection being warm, the Syringe
is to filled with the Injection, the
end of it put into the pipe & kept fast
& the Embolus of the Syringe pressed
gently down with the breast till the
part is sufficiently injected or the
syringe when it is to be filled and
emptied as before if necessary ~
Med. Hist.
MS
B
158


















Med. Hist.
MS.
B
158








Ex Libris Jonathani Elmer
Ipromet manu Jeripris




Jonathn. Elmer’s




A Course
of
Anatomical Lectures
Delivered
By Dr. William Shippen junr.
Professor of Anatomy & Surgery
in the College of Philadelphia
Anno 1766
Quanta autem existerent consilii
solertissimi indicia, su tota hominis
fabrica perspecta foret? si corporis totius
species et dignitas? Sensuum organa
subtillissime fabricata, et aptissime locata.
Synop: Meta:
Anatomia fundamentum est Medicinae
Anomal

















Anatomical Lectures
Lecture 1st:
Anatomy avatouia in Greek signifies
cutting & by it antiently was meant only
the dissecting of bodies, but at present it
is implied in a more general sense.
Anatomy in respect of its object is divided 
into human and comparative.
Human Anatomy is that which is
employed on the human body; and comparative
Anatomy is that which is employed upon
the bodies of other animals, these serving
for the more accurate descriptions of several
parts, and supplying the defects of human
bodies.
Anatomy from its various ends may
be said to be of four kinds viz: Theological,
Medical, Juridical, and Judicial.
The




The first consists in an acquaintance with
the works of the creator in the human frame;
according to Fontanel the study of Anatomy
& Autonomy afford the strongest arguments
against Atheism.
Medical Anatomy is ultimately health,
for the presentation of which, restoring it when
impaired, by diseases, or even preventing
their access, nothing surely is more necessary
than a true knowledge of the structure of that
frame so liable to be injured.
Juridical Anatomy is the determining
the causes of suspicious deaths, impotency,
barrenness, the true times of pregnancy and
delivery, the mortality of Wounds and a
multitude of other causes of great importance
to be adjusted in account of Judicature.
Judicial Anatomy is the determining
the cause and manner of the death of diseased
persons from a subsequent dissection of the
body




body; this is of the utmost use in the practice
of Physic.
Upon the whole then the use of Anatomy
in very great, nor is it confined to the bounds
of Medicine alone; the Philosopher and
Theologist, the Magistrate, Painter and
Sculptor are in their respective employments
more or less qualified in proportion to the progress
they have made in this science; but the
physician and Surgeon are the people to 
whom it is most immediately necessary
and who without a perfect knowledge of it
cannot do justice to the world in their
professions. What the needle is to the
mariner, Anatomy is to both these, and
we may venture to say that without its
assistance, they would be rather detrimental 
than beneficial to mankind.




The Anatomy of the solid parts is by Heister
called Osteology and that of the soft parts
Sarcology, each of these are subdivided.
Osteology or the anatomy of the Solid
parts is divided into the anatomy of the 
Bones called Osteology; Chondrology or the
anatomy of the Cartilages; and Syndesmology
or the anatomy of the Ligaments.
Sarcology or the anatomy of the soft parts
is divided into Dermatology or the anatomy of
the Teguments; Splanchnology or the anatomy
of the Viscera; Myology or the anatomy of
the Muscles; Neurology or the anatomy of
the Nerves; Angiology or the anatomy of the 
Veins and Arteries and Adenology or the
Doctrine of the Glands.
In the human body as a complex hydraulic machine
a double inquiry must be made 1st. Into the structure of
the parts, this is called Anatomy, 2d. Their functions & the
laws of their motion which is termed Physiology





Lecture 2d.
As the solids are formed out of one
principal fluid chiefly, called the Blood
it is proper to begin therewith.
Of the Blood
Blood in Scripture is called the life of
the Animal; according to some it is the
primum vivens ultemum moriens, its
a heterogeneous mass, as is evident from the
variety of ingredients of which it is made up,
and the various forms it assumes in the
animal machine.
The blood is composed of three substances
viz: Serum, Gravamentum & a coagulable
Lymph: We shall consider these in three
different manners; first when ocularly
examined, 2d. Viewed with a Microscope,
and
B





3dly: The chemical Analysis thereof.
Blood fresh drawn from a sound
living animal, upon landing, part of
it congeals into a hard coagulum suspended 
in a yellowish Serum, the
upper surface being of a florid color
while the bottom is black; the reason
of the blood appearing bright and
florid at the top is from its being in
contact with the Air; this is confirmed
by an experiment of Dr. Hunter’s who put
a quantity of blood fresh drawn into a
vial, & stopt it close; upon standing it
all turned of an uniform black color,
except a little spot upon the top with which
a globule of Air had got in contact.
Blood stirred round with a probe
whilst




Whilst warm, a fibrous elastic substance
is obtained, which, put in water turns of
a whitish color; this is the coagulable
Lymph, is strongly elastic, & is the cause
of cohesion in the particles of the Blood,
as is evident from the extravasation of
the blood after death by dissolution
of the cohering particles. The coagulable
Lymph is sometimes discharged from
the Uterus and by Nurses taken for
an Abortion; this error they are sometimes
led into from a desire that it should be
so. If spirits of Wine be added to
Serum, or the same made boiling hot,
it rises up, emits fumes, and turns into
a coagulum similar to the White of an egg:
the fibrous part of the blood is what forms
Polypuses




Polypuses concretions &c:
Blood viewed by a microscope appears 
to consist of a number of globules,
the larger ones being those that tinge
it of a red color, &c: therefore chiefly
make the crassamentum, are of a certain
determinate magnitude being of the
same bigness in all animals, in a Sheep
as in an Ox, in an eel as in a man.
These globules are composed of six
smaller or ceruminous ones; and these
ceruminous ones are composed of smaller
or lymphatic ones; and it is probable there
are still lower orders of globules of blood.
These globules of blood are of a
lenticular form and elastic the largest
kind being less than the 1/3000 part of an
inch




Inch. the crassamentum is supposed
to contain 1/3 of the mass and the
Serum to make up the other 2/3.
Blood chemically analyzed; upon
distillation with a slow fire a quantity
of Phlegm arises, with the fire increased
next arises an Oil and a volatile Salt,
the caput mortuum being a fixed
alkali and a cretaceous Earth.
The chemical proportions of the
blood are by Dr. Martin & Boyle recvd.
as follows viz: of Phlegm 5/6 of
Oil 1/15, of Salt 1/25, of Air 1/20, &
of Earth 1/75, part of the whole mass.
The specific gravity of the blood
to that of rain water is by Dr. Jurin
and




and Martin reckoned as follows,
by Jurin as 1000 to 1054 by Martin
as 1000 to 1056 or 1057 or as 10 to 19.
The density of blood in living animals 
is to its density when reduced to
the coldness of temperate Air as 134
to 135 or 992 1/2 to 1000.
The color of blood is for the most
part red, but redness is not a constituent
quality in blood, for some Animals
have white blood. In the human
body the blood is redder & more florid
in the Arteries than in the Veins,
oweing to the action of the Lungs upon
it, for by shaking fresh blood in a vial
taken from a vein, it appears of the
color of arterial blood. That the blood
is




is reder in the Arteries than in the
Veins. Dr. Hunter proved by the following
experiement: he opened the Thorax of a
live Dog and kept his Lungs working
with a pair of Bellows; and drew a
spoonful of blood from each side of the
Heart is, from the Vena Cava & Aorta 
the latter of which appeared the reddest.
From the accurate experiements it is
found that a cubic inch of rain Water
weighs 253 1/3 grains, a cubic inch
of warm blood 264 3/4 grains.
An Ounce of Blood contains 1,813
Inches, an avoirdupois ounce weights
437 1/2 grains equal to 1,727 inches
of water and 1,6526 of warm blood.
Lect.


*Among these we may reckon Boerhaave instit. vol. 2
the colour of the Arteries are of aligamentous substance
and not muscular as is evident from their white appearance 
and their of elasticity both of which is contrary to the general
characteristic of a muscle however we are informed that
Dr. Cullen has lately discovered that there are muscular
fiber in the coats of the arteries the action of which he
thinks assists in propelling the blood onward.
J. Cullen likewise says that there is a muscular coat
to the arteries as well as Boerhaave & many others.
&c physiology [illegible].


Lecture 3d.
Of the Arteries & Veins
An Artery is a strong, membranous,
ramifying, elastic Tube, endowed with
pulsation; arising from the left side 
of the Heart, and terminating in every
part of the body. The Arteries are composed 
of three coats, tho’ some have
reckoned four and some five.* The
first external coat is very thin the fibres of x
which going longitudinal & circular;
the second coat is thickest and the fibres
of it go in a circular direction; the 3d.
coat is very compact and its inside
very smooth and even, this smoothness 
and compactness of the inner coat
serves two purposes. 1st. to allow the blood
to




to pass without hindrance & 2d. to
prevent its exudation.
The pulsatory motion of the Arteries
is a dilatation and contraction of them;
the former called Diastole, and the latter
Systole, which precedes proceeds from
the Heart, besides which they have a
sort of aperistaltic motion, as is evident
from an experiement of Dr. Hunter’s,
who opened alive Dog and cutting off
the mesenteric Artery, injected it wth. 
a warm milk, which he could plainly
perceive the Artery to carry along wth. a
vernicular motion; to confirm is the
more he injected the mesenteric Vein
but the milk went no farther than
the
&




the force of the injecting propelled it.
There are but two Arteries in the
body viz: the pulmonic, which carries
the blood through the small circulation,
and the Aorta, which carries it to all
the parts of the body.
The coats of the Arteries are very
elastic, and are furnished with blood
vessels for their nourishment; the
Arteries mostly and all except the
Epigastric ramify at acute angles.
The commonest diseases the
Arteries are subject to, are, Aneurisms
and Ossification.
Aneurisms proceed from a preternatural 
dilatation of the coats of the Artery’s
and are of two kinds 1st. When the blood
is


x it is sometimes found in young subjects and is
oweing perhaps to a disposition of the constitution
to form bony matter.


is contained within the coats of the
Artery. 2d. when the Artery is burst &
the blood extravasated into a membranous 
bag.
Ossification happens mostly to
Old people from a weak & slow circulation 
of the Blood. x
Veins are elastic, ramifying Tubes,
like the Arteries; except smaller. their
coats thinner, and without motion.
Phisiologically speaking the Veins
begin at the extremities of the Arteries,
or more properly speaking they are a
continuation of the Arteries reflected
back toward their Origin the Heart;
but anatomically speaking the Veins
arise from the Heart.
There




There are 7 Veins in the body from
which all the rest arise viz: The 2 Venae
Cava ascendans and decendans; 4
pulmonary Veins (two from each lobe
of the Lungs) and Vena Portarum.
The veins are mostly ramified in
the same manner as the Arteries, exct.
the Vena Portae, and the cutaneous
Veins of the extremities, & other parts.
The veins of the extremities have
valves, but not those of the Viscera;
the reason of which is because there
is no Muscles in the viscera; hence
the use of those valves in the Veins
of the extremities is to prevent the
blood from going backward as well
as


x Bellini especially is of this opinion


as well as for, to push it forward when
the muscle is contracted and the Vein
compressed.
Of Venesection & Hemorrhages.
In bleeding, the blood is supposed to 
x
flow out faster at the orifice than it
circulates in common, and to increase
the circulation to the part, hence the
doctrine of revulsion & derivation is
easily understood; thus we find in
a Cephalalgia bleeding in the foot
causes a derivation to the feet and
a revulsion from the Head &c:
In Hemorrhages the antients
used Ligatures round the joints,
wc. stopping the return of of the blood
to the Heart checked its impetus,
but









but by Venesection his ends are answered:
e,g, supposing an Hemorrhage at the
Nose, Lungs, Uterus &c: bleeding
takes off the impetus of the blood &
causes a revulsion, at the same time.
Dr. Haller thinks this latter method much the [illegible]
the Veins are some of them subject 
to Varices, which are an obstruction,
or destruction of the valves thereof.
The muscular coat of both the
Arteries and Veins are somewhat
subject to inflammation & suppuration,
but not near so much as the other
muscles of the body; this is very wisely
adapted to their function, for suppuration 
of their coats would be attended
with fatal consequences often.
Lecture




Lecture 4th.
Of the Lymphatics.
Lymphatic or absorbent vessels are
those fine ramifying vessels which contain 
a clear diaphanous Liquor; they
take their rise internally from the cavities, 
as the stomach, intestines, and
externally from the surfaces of the
skin. The antients supposed the
Lymphatics were a continuation of
the Arteries dividing them into three
classes, sanguineous, venous, and
Lymphatic, but, it has very lately
been discovered that the Lymphatics
are an entire system of vessels by
themselves, having no affinity or communication with
either the arteries or veins.
this




This is proved 1: by injections not passing into them from the arties 2: by
the motion of the fluid in them and the valves they
have; they are called absorbents from
their office, which is to absorb the Lymph
and other matters and carry it into the
thoracic duct or Receptaculum Chyli;
where they are all supposed to terminate.
Those vessels called lacteals
belong to this system; and called Lacteals
only, from their carrying a milky chyle:
their origin termination and course of
their fluids being the same. That the
lymphatics are absorbents is evident from
their absorbing moist substances rubbed
on the skin, as Mercury, Turpentine,
Garlic &c: but in a more obvious manner
in the venereal Disease, where absorbing
D the




virus they carry it to the adjacent
Lymphatic Glands and cause them to
tumify, hence Buboes &c: sometimes the
virus causing the glands to tumify and
inflame, constricts the vessels beyond
the same and prevents the infection
from going any farther; hence the cure
of the venereal disease sometimes by
the suppuration and discharge of a Bubo.
Of the Glands.
A Gland is a secretory Vessel — the
antients called only those Glands which
we feel hard movable kernels under the
chin and other were until Malpighius
by his microscope found the Liver and
other substances to be of the same texture,
and therefore termed them all Glandular.
A




A Gland he thought to be made up of
little fine round bodies consisting of
Follicles which contained the secreted
fluid and between which was a parynchemical 
substance; but Ruysch by
his injections found that the Glands
were vascular or made up of fine vessels
which has been further confirmed by
later anatomists. The vessels of the
Glands are Arteries, Veins, secretory
and to some excretory Vessels Nerves & lymphatics
Of Secretion
Some have imagined that the secretions
were performed by the diameters of the
secretory vessels, supposing them to be
of the size of the particles secreted;
but this theory is subject to these two
objections, viz: that the smaller particles
will




will go off with the larger ones and to the
secretion be confounded and in a Jaundice, 
when once the Bile had got into the
Blood it would continually remain [illegible] &
the Jaundice could not be cured; others supposed 
a particular fermentation happened
in the veneral glands, & from thence 
arose the difference in the veneral secreted 
fluids, and likewise was the cause of
the secretion; this theory is liable to the
same objections with the former, and
therefore the most received opinion is, that
the secretions depend upon the particular
disposition of the vessels, to the particular 
fluid it is to secrete; hence arises
these Axioms. 1st. That the secretions are
carried on uniformly in a living sound Animal.
2d. One secretion increased another is diminished &c:
Lect.




Lecture 5th.
Of the Muscles & Tendons.
A Muscle is a fleshy, fibrous, [crossed out]
substance, consisting of Veins, Arteries, &
Nerves; besides fleshy fibers &c; having
more nerves in proportion than another
part of the body serving to give notice to the
brain of any external stimulus or irritation.
The redness of the muscles is not
inherent in the fibres thereof, but only
oweing to the blood contained in them, of
which there is a great quantity, more
than is sufficient for their nourishment
and may possibly be subservient to their
motion.
A Tendon is a white compact fibrous
unelastic substance. most muscles terminate 
in Tendons, and the Tendons are by
some reckoned a continuation of the fibres
of




of the muscles to which they belong,
only more compacted together so as not
to admit the red globules of blood between 
their interstices: but Dr. Hunter
thinks the fibres of the Tendons are
not a continuation of those of the muscles,
but distinct fibres someway cemented
thereto.
The muscular fibres are cemented
together by the cellular membranes and
an intervening glue, & serve for the
moving of the solid parts of the body.
The Tendons are for the better
insertion of the muscles, and of great
use in motion; eg: in the Perforans and
Perforations of the hand, the muscle arises
from the inferior part of the Humerus, and
if that was continued down to its insertion
muscular, it would render the hand troublesome




some and unwieldy, whereas now, the
Tendons, being compact & taking up but
little space, remedy that inconvenience.
Round many of the Joints as the Wrist 
Ancle &c: there is a capsular Ligament or
Frenum which serves to keep these tendons
in their right places, and facilitate their
regular motion; likewise over some of the
Muscles there is a tendinous expansion
called Aponeurosis, of much the same use
as the preceding Ligament.
The muscles may be reckoned of
three kinds first Oblong as those of the
Arm, 2d. Convex as those of the Heart,
Stomach, Bladder &c. 3d. mixt as those of
the Abdomen the Pectoral muscles &c:
Muscles have their names from
their Origin, Insertion, Use Appearance &c:
Lect




Lecture 6th.
Of the Nerves.
The Nerves are now by every body
allowed to be a system of the vessels, and
they are a fasciculi of white fine fibres,
arising from the Medulla Oblongata &
Spinalis, egressing in pain.
Over the Brain are the Meninges, or,
1st. The Dura Mater which is externally, &
a thick vascular substance within this &
adhesive to the Brain is, 2d. The Pia Mater,
which is a thinner membrane; between
these two, some anatomists reckon another
membrane, extremely fine & reticular which
they call Tunica Arachnoides.
The Brain is divided into three
portions called, Cerebrum, Cerebellum,
and Medulla Oblongata, the latter 
being





being continued thro’ the spine of the back 
is called Medulla Spinalis.
The Brain is supposed to be vascular,
& its substance of two cortex; external of an
Ash color is called Corticalis; internal of a 
white color called Medullaris. The Nerves
are of the same substance with the Brain,
and are properly aportion thereof continued
to all the parts of the body. The Nerves
as they arise in pairs soon after decussate,
or change sides as in the Optic Nerves,
the left going to the right Eye, & the right
to the left; hence a wound, on one side of
the head affects the contrary of the body.
The Nerves are distributed thro' the
body in much the same manner as the
Arteries; the one proceeding from the Brain
the other from the Heart, but with this
difference
&





difference, that the trunks of the Arteries grow
less the more they are ramified together with
the ramifications ad infinitum; but the
capacity of a constituent Nerve never decreases
they being imperceptible, but the number of the
likes of the Fascicule decreases in proportion as the bundle
ramifies, thus the cords of the Nerves wc. as they
egress from the Brain contain an innumerable
number of constituent Nerves, decrease in No.
but not in capacity ad infinitum in proportion
as they are ramified.
The Nerves anastomose, but not in the
same manner as the blood vessels do, by
uniting their tubes but only by their coming
in contact with each other; these anastomoses
are called Plexuses. sometimes little knots
appear in Nerves called Ganglions, some
imagine these knots proceed from pressure &
inflammation, but this cannot be as they are
found




found in the Viscera, & in a Foetus where no
pressure could happen.
Lancesi, reckons the use of these Ganglions
is for an an additament to the Brain; because
he says more nerves go from them than go to
them, but from the substance of these knots
not being the same wth. the brain, that cannot
be. others think they serve to stop the nervous
fluid from flying out at the end of the Tube
without the impulse of the will by means
of muscular fibres, they being only in
those nerves destined for voluntary motion;
this also appears to be false.
The termination of the nerves is but
little known, but supposed to be in every
part of the body.
The use of the Nerves is for sensation,
motion, nutrition, &c: the Brain being called
the sensorium Comune to wc. the Nerves
carry all the sense communicated to them
Voluntary





Voluntary motion is acquired by experience,
as is evident from a child whose will is
frequently contrary to the Act performed.
Of the cellular Membrane.
The cellular membrane is of two kinds,
the one adipose containing fat, the other
reticular without fat; it is a net like
substance, vascular, very thin and tender,
consisting of many cells & its fibres very
fine: the cellular membrane is continued
throughout all the body, except some of
the viscera & is called by some the membrana
Musculorum Comunis. The cells of the
reticular part of the cellular membrane
communicate with each other, as is evident
from an Anasarca which is a transudation
of Phlegm into the cells, & so from the one to
the other, as is evident from the Legs swelling
by walking & subsiding when lying
down


x See the Londn: med: observations vol: 2


down; hence Eccymosis from a false
Aneurism, Diaeresis, Contusion &c: by
which the blood insinuates itself into the
cellular membrane; hence also the great
quantity of water evacuated from a
scarification in an Anasarca.
An Emphysema is a remarkable
proof of the communication of these cells;
this is caused by the air distending these
cells & often happens from a fractured
rib puncturing the Lungs by w.c the
Air gets into this membrane; a remarkable
instance of this happened in London,
by w.c the patient swelled to that degree that
his eyes could not be seen; Dr. Hunter x made
a puncture at the Eye by w.c the air gushed
out, & by puncturing & rubbing he was cured.
Putrefaction will cause an Emphysema,
from the fermentation generating air;
hence





hence a drowned person will after a while
rise to the surface of the water.
The fat contained in the adipose cells
differs in different bodies; in a Foetus
the fat is soft, and gelatinous; in children
of a year or two old, the fat is chiefly next
to skin; hence the fatness observed in
children; & in adults the fat is solid and
mostly internal.
The cellular membrane serves for
easy smooth motion, for a defence to the
body, to keep the parts warm & preserve
the figure of the body, & blunt acrimony.
some animals we reckoned to be
nourished in the Winter by their fat.




Lecture 7th
Of the Bones.
Here we shall, 1st. describe the external
conformation of the Bones, 2d. examine
their internal structure, 3d. their connection,
& 4th. Explain their use.
A Bone is a hard fibrous compact
substance. various Bones have various
shapes & conformations, some are cylindrical
& long, others flat, & broad, irregular &c:
bones are said to be made up of Fibres
forming Lamellae, fastened together by means
of oblique or transverse fibres.
Bones have processes and Cavities.
Processes have different names from their
different forms, & appearance: thus, a
Condyle is an oblong process arising from
the extremity of a bone; a Corone is an oblong
process





process terminating in a point; Spine is
the sharp ridge of a Bone; Supercilia is
a brim round a cavity; a protuberance is a
rough process of a bone. Processes are of
two kinds viz Apophysis, & Epiphysis;
Apophysis is a process growing out from
the body of a bone. Epiphysis is a process
growing to the body of the bone, being originally
separate therefrom  by a different Ossification.
The cavities in bones are of two kinds,
one for Articulation, & the other for the lodgment
of soft parts; cavities for Articulation are
of three kinds, 1st. Round & deep called Catyloid,
2d. round but superficial called Glenoid, and
3d, deep & narrow called Alveoli, the Articulation
of Bones is by Galen called [illegible] Joint
& by him is reckoned of 2 kinds, 1st. With motion
called





called Diarthrosis. 2d, without motion called
Synarthrosis; each of these are of 3 kinds.
Diarthrosis, are. 1st: Enarthrosis, 2d:
Arthrodia, 3d: Ginglymus.
Synarthrosis are, 1st: Suture or Raphe,
2d: Harmonia, 3d: Gomphosis.
The connection of bones is termed their
Symphysis, & is of two kinds: the one wth.
and the other without an intervening substance:
the first is that of the Cranium by mutual
Indentation. the second are of 3 kinds viz:
Synchondrosis, Syneurosis & Sysarcosis. 
Periosteum is an elastic fine membrane,
that covers the bones except at the joints teeth &c:
its case is for the insertion of vessels, to strengthen
the Epiphysis &c: the cylindric bones
are all hollow, & so are most others & contain
Marrow, the ends of the bones are cellular.
F Lect.





x see Edinburgh med: Essays.



Lecture 8th
Osteogonea.
In a Foetus, the first months, there are
no bones, nothing but a gelatinous fluid;
then it gradually grows cartilaginous, &
in time becomes boney; some imagine
Bones are formed of Cartilages only by
an expulsion of the redundant fluids;
but Dr. Nisbet x says, & it is now general recd.,
that in Ossification, there is in the blood, or
a fluid secreted therefrom, an ossifying
juice; consisting of particles wc. are not apparent;
that wherever nature designs an ossification
between membranes, or a cartilage she occasions
a more than ordinary afflux of fluid which
distends so much the vessels wc. were before
invisible as to make them capable of
receiving the red globules of blood wc. is always
to






to be seen near to where ossification is begun.
In this blood gritty particles are to be felt by
the point of a knife, which have been formed
by the attraction & cohesion of the particles
of the ossifying juice obstructed along with
the other grosser fluids in the beginning of
the vessels, prepared to receive the influent
juices. The membranes or cartilages some
as alied between wc. or within wc. the bony
particles are deposited or shoot; but without 
any any intermixture of the particles of the
bone & cartilage, or continuation of the fibres
of one substance to those of the other as is
evident in bones made perfectly clean, the
cartilage dropping from it as easy or easier
than an acorn from its cup, & there is a
smoothness of the parts of both cartilage
and




and Bone which show that there is no
conjunction or union of the fibres of the
two substances.
While bones are increasing within
Cartilages, the cartilages are extended
& spread out, by wc., with the pressure they
suffer & the great influx of various fluids,
& the nutritious matter being kindred to
flow freely into them, they decrease
continually & at last may truly be void
to be entirely destroyed.
Bones digested in Acids for sometime
grow flexible & gelatinous like a tendon,
by which it appears the great quantity
of Earth they contain makes them hard
rigid. Bones are furnished with Arteries
and Veins, as is evident from the drops of
blood





blood seen in sawing bones lengthwise, &
upon their appearing tinged of a red color
after the animal has eaten Madder.
Dr. Havers divides the blood vessels
into sanguiferous, & medullan the latter
enter the bones mostly near their
center in an oblique manner.
Bones have Nerves as is evident
from their exquisite sensibility where
amputated, or exfoliated, & granules of flesh
have sprouted out.
Diseases of bones are 1st: a softness & 
rickety disposition. appearing generally from [illegible] to the 3d.
year after birth, though the habit may continue thro' life.
It seems to be owing to an Idiosyncrasy or a want of bony
matter in the constitution. Sometimes it is said to arise 
from the pox & scurvy, but probably less frequent than from
the other cause. We have the history of a species of Scurvy
in France that affected the Bones & separated the Epiphysis.
In Anson’s voyage we are told the Callus of bones wch. 
had been fractured & united again for may years were disposed
by this Scurvy ~




Softness from a venereal Taint can be nothing more
than a Caries of the bone. the disease first affecting the
Periosteum & then communicating itself to ye. subject bone.
As to softness from Idiosyncracy as its called; or from
a particular state of the solids & fluids. Mr. Goodye furnishes
us with a history of a woman whose bones without any apparent
cause grew soft; her body shortened, & at last she died, & he
found that he could easily cut through the limp bone & all.
The academy of Paris give a more remarkable history of
a woman whose bones were so soft that at length they had
not solidity enough to gird  the muscles action—no kind of a
scorbutic or pocky taint could be observed. see Vanss 4h:423.
Mr. Gooch had a case of this kind under his care, when
the patient died he found the bones so soft that he split the
thigh bone, the Tibia & bones of the foot the whole length
very easily with his knife. Dr. Tilton of Dover relates the like
Bones may likewise loose of their bulk like other
parts from a loss of juices as in alveolar & vessels of old people.
2dly: Fractures. All bones have a tendency to
unite again after being disjoined w:ch is effected by means of
a Callus this was formerly supposed to be unorganized, but is 
now known to be vascular by injections & being tinged with 
madder. When a Callus is broke it will unite again only
to the opinion of some authors. A pupil of Dr. Haller’s
in a Thesis he wrote on the subject say that the Callus is
first a bloody matter, then slimy, next gelatinous & then
vessels from the bone & meditullium shoot out thro' it & ossifications
begin directing themselves quaquavenum & thus the
Callus


Lecture 9th
Of the Cartilages & Ligaments.
Cartilages are compact, opaque, & a little
elastic: of wc. there are 3 kinds, 1st: such as
supply the place of bones as the Nose,
Trachea Artena &c: these preserve the
structure of the part & admit of motion.
2d. such as supply the place of bones before
they are formed as in a Foetus. 3d.
such as serve for the Articulation of
bones. Cartilages differ from bones
in not having Fibres nor blood vessels
to be siphoned, tho’. they are imagined
to be vascular; they serve at the Articulation 
by their smoothness to prevent
abrasion; they won’t granulate nor
exfoliate but may be corroded.
Ligaments


is compleat. sometimes the bones won’t unite but with great
difficulty.
3dly: Caries. A caries in alone is similar to an ulcer
in the flesh it has circulation but it is unsound &
often shoots out irregularly as the fungus of an ulcer
See more so in med:[illegible] 2:h:k0 [illegible] [4?377].
4thly: Spina ventosa – this is a caries beginning
on the inside of the bone & affecting it clear thro', hence
Surgeons bow into the bone to let out the matter, but
in general the limb is to be taken off. See Van Swieten 4 p 377
A node by some is said to be an Exostosis of
the bone, but for the most part if not always it begins
in the Periosteum. should be open'd before it affects the bone
5ly: Anchylosis is a stiff joint having little
or no motion. from the bones running into each other &
the cartilages being eroded. Van swieten vol 4 p 457
gives several curious cases of Anchylosis of all
the joints in the Body. See also Le Bran’s
Surgery.
x where it covers the Cartilage. it is calld. Perichondrium 
the external lamina of the capsular ligament goes
from the substance of one bone to the other over the articulation
& is inserted beyond the Epiphysis &: Friction
6th. Exostosis is a tumefaction of a Bone
or an excrescence growing out of the bone. It
may proceed from a redundancy of ossifying particles
in the system or in the part only from a morbid
cause see Van swieten 4 p 424. See the case of 9: Scott 
of the Pennsylvania Hospital in my Adversar: med:
See Cheselden p 5.


Ligaments are firm, compact, unelastic,
membranes; serving to connect the joints,
prevent luxation &c:
The Ligament, Bones, Cartilages,
Tendons & Dura Mater are now reckoned
none of them to have much sensibility
in a natural state. v: Whytt & Haller
The capsular ligaments are very
strong & compact, & made up of hard
Lamella, the inner lamella being a 
reflected membrane going over the
head of the joint. cover the Cartilage x
& so coming to join the external lamella,
which is firmly inserted near the joint.
These capsular ligaments forming
a sac in wc. is contained, a mucilaginous
liquor serving to lubricate the joint:
for




for in all Joints; for motion there are synovial
glands which discharge the above
synovia, this is subject to be disordered:
1st. to become thin & Icorous, 2d thick and
inspissated &c:
It is generally received of late, that the
capsular ligament is lacerated in a 
Luxation of a joint unless from internal
cause, or a relaxation; & violent extension
is unnecessary in reduction of the same;
no more being necessary than to bring
the ends even, and then coax them
into their proper places, & there keep
them by proper dressings & bandage.
For as particular description of the Bones
vide Monro’s Osteology, and of the muscles
Douglas’s Myographia




Lect. 40th:
In the Osteology we divided the body
into three parts, viz: Head, Trunk, and
Extremities; the Trunk of the Skeleton
we subdivided into, the spine, Thorax,
and Pelvis, but in a fresh subject we
divide the Trunk differently, viz: into
The Thorax, and Abdomen, or upper, &
lower belly. The Viscera of the Thorax
are only the Heart, and Lungs, & therefore
not necessary to be subdivided.
The Abdomen is separated from the
Thorax by the Diaphragm.
The Abdomen by reason of its largeness
and the many Viscera contained
therein, has been divided into several
parts, by imaginary lines, for the readier
knowing the particular situation of each
Viscus. The divisions are as follows,
1st
G 


 


1st. That which lies under the Cartilage
Xyphoides, is called Scrobiculus Cordis,
2d. From the Scrobiculus Cordis down to
within 2 or 3 inches of the Umbilicus
is called Regio Epigastrium, circumscribed,
and on each side there of it is called
Regio Hypochondrium. 3d. From the
Regio Epigastrium to 2 or 3 fingers
below the Umbilicus is called Regio
Umbilicus, circumscribed, and each
side Regio Lumborum, 4th. From the
Umbilical Region to the Os Pubis is
called Regio Hypogastrium, and
on each side the Regio Hiaea 5th. The
lowest part is called the Regio Pubis.
As we are sometimes called to open
the body of a deceased person before
their friends, particularly if they died
of a violent death; we should endeavor
to




to do it with regularity & decency.
The antients opened the Abdomen by
beginning at the Sternum & directing
the knife along the False Ribs to the
Loins, then along the spine of the Ilium
to the Os Pubis; and laying the loose
part over on the contrary side.
Others begin at the Xephoid
Cartilage & make a straight incision down
to the Umbilicus, then dividing the incision
directing one to the spine of the right, &
the other to the spine of the left Ilium,
and turning each part back.
But the best method is to begin
the incision at the Xephoid Cartilage
and going straight down to the Olsa Pubis
and then another transverse from the
Navel to the Loins each way.
The Thorax is opened by pushing off the
Teguments & Cutting the Cartilages by the Sternum.
Lect.



All the internal superficies of the cavity of the
Thorax, the ribs, cartilages of the ribs & convex side of the
Diaphragm except where the pericardium lies in contact wth.
it are lined with one continued, thin, nervous, very strong
membrane, internally very smooth called Pleura.
On the external superficies of this every where is the
cellular membrane wc. in very fat animals is often so enlarged
with fat as to lessen the capacity of the Thorax & these cause
a shortness of breath.
The Pleura when it gets round to the vertebra elevates itself
perpendicularly lowd. frenum wc. with the one on the other side
from a doable pleura called Mediastinum dorsale.
The same duplication is made of the Sternum when it is
called mediastinum pectorale.
The pleura likewise covers all the muscular circumference of
the diaphragm above the cellular membrane wc. arising up together
with the orb of the septum from the back sternum, from
the external membrane of the pericardium wc. is the third
cavity of the Thorax in the middle between the 2 cavities of
the pleura containing the Lungs & formed a conjunction of them
This membrane of the pericardium is lined internally with
a thin membrane wc. is a branch of the external membrane of
the Heart. The great vessels from the Heart as they pass
thro' the pericardium & go on beyond it or move also at above
the cellular one from the external membrane of the pericardium.
this membrane forming about to the pulmonary arteries & using wc. 
when they arise at the Lungs is expanded out & forms the extenal coat
of the Lungs. Kaan de Perspi Hippocrat. 


Lect. 41st:
Of the Pleura.
The Pleura is a fine membrane, which
lines all the cavity of the Thorax and
is reflected back over the Lungs.
There are two Pleura one on each
side, like two bladders beginning as we may
suppose at the sternum and going round
within the Ribs to the Vertebra of the
Back, then reflected back upon the
outside of the Lung (making the coat
of the Lungs) to the sternum; there
running in or uniting with the first
Fibres of the same and so on the other
side; where the two Pleura meet at
the sternum; they are not quite in
contact with each other, but there is
a small space left between which is
filled up with cellular Membrane.
Of


Constat pulmo duplici vasorum genere,
aerifero scilict & sanguifero.
Aerifera omnia vasa ortum ducunt ex una
trachea, quo mox a faucibus intitium capiens,
ante oesophagum, descendit, thoracem post
thymum intiat; post cavem descendentem & pericardii
apicem, as quartam thoracis vertebram, qua
est a superiore una tertia pars ipsius pulmonum
longitusinis divaricatur.
Hujus dein crura tendunt ad utrumque pulmonem,
& statim dividuntur, in homine dextrum in tres,
sinistrum in binos ramos, qui tune bronchia dicuntur,
as totidem pulmonum lobos, quos ubi ingressa funt,
disperguntur statim in ramos minores, & minores;
qui omnes ad obtusum angulum, respectutrancorum,
oviuntur.
Remi autum majors ingressi pulmones, pro
maxime parte, descendunt, pauci recti procedunt,
ubi ingrediuntur; aliivero adscendunt aeriferorum
truncorum, & horum ingressum est. quod
prater Eustachium meminen observasse video.
Ultimi


Of the Lungs.
The Lungs are Vascular Substances
composed chiefly of Air Vessels, and
Blood Vessels; the Air Vessels are
Ramifications of the Trachea Arteria,
and are called Bronchia; the blood
Vessels are ramifications of the Vena
and Arteria Pulmonalis; beside-which
they have an Artery wc. serves
to nourish them, called the Bronchial
Artery coming from the Ascending
Aorta together with Nerves and
Lymphatics, and some say also
Parenchyma which is perhaps no
more than cellular Membrane.
Some Anatomists suppose there are
little follicles or cells at the extremity
of the small Bronchial Vessels, which
if there is are not discernable.


Ultimi autem ramuli ommitunt cartilagineam
indolem, & expanduntur in vesiculas oblongas,
membranaceas, cavas, qua Malpighiana dicuntur,
ox quibus fiunt area, & lobuli, qui tandem pulmonum
lobos efficiunt.
Comitantur aerifera hac vasa, in omni decurser,
ad vesiculas usque, vasa Sanguifera, qua omnia
oriuntur ex arteria pulmonali, qua cordis dextro
ventriculs egressa, qua parte superiore ventriculs
sinistro jungitur, adscendit, mox se incurrat, arcum
facit, & sub aorta decumit. Descendit
The inside of the Trachea arteria is lined with a
membrane in which are small glands that secrete mucus 
for lubricating the its internal surfaces; in cold, this means
is sucked into great quantity—sometimes inspissated 
is spit up very thick especially in the morning.
Dissection has taught us that this membrane is the
seat of that disease in children called the Hives & is
found separated from the cartilages – nothing proves so useful
in this disease as large doses of 8. I have known 10 g of calom: given to 
a child 2 years old produced 2 copious stools & disease immediately vanished


The Lungs are divided into two Lobes,
by means of the Mediastinum and
Heart. The right Lobe is divided into
three Lobuli by fissures; and the
left Lobe is divided into two Lobuli.
In a natural state, the Lungs are
every were in contact with the Ribs,
so that there is no vacuity left.
The Trachea Arteria is composed of
cartilaginous Rings, which behind are not
quite shut but a small membrane between;
each of the cartilages are connected likewise
by membranes.
The Lungs are liable to inflammation,
and Ulceration. In inflammation of the
Lungs we should use plentiful bleeding,
oiluants, fomentations externally and
the steams of warm liquors particularly 
Vinegar, into the Lungs thro' the mouth.


x The ventricles are divided by a middle partition
called Septum Cordis.


Lect. 42d:
Of the Hearts.
The Heart is a strong muscular substance,
situated obliquely to the left
side, more than the right; part of the
inferior and or Apex in contact with
the Diaphragm, and pointing between
the sixth and seventh Ribs on the left
side; the Apex being likewise nigher
the sternum than the Basis.
The Heart is the Origin of the Veins
and Arteries.
There are four cavities in the Heart,
two Auricles, and two Ventricles; x one right
and one left, at the right Auricle the
Vena Cava enters, and at the left: the
Vena Pulmonalis; at the right Ventricle
the Arteria Pulmonalis egresses, and
the Aorta from the left.
M


x these cordae Tendineae arise from the Carnae 
Columnae.

At the entrance of the Vena Cava into
the right Auricle of the Heart are three
Valves called Valvula nobilis, and about
the middle of the Auricle there is a little
knob called Carna Sesamoidea: At the
entrance out of the right Auricle into the
right Ventricle and two valves called Valvulae 
bicuspides, connected by sou:e small tendinous
cords called Cordae Tendineae x; the internal
part of this Ventricle is rough & muscular
having many muscular Pillars, called
Carnae Columnae which serves for to
strengthen the motion of the Heart
and to work the blood so as to prevent
its concretion & forming Polypuses,-
which however sometimes happens.
After the blood has passed out of
the right Ventricle into the pulmonary Artery
it is prevented from returning by three
valves




Valves named Valvulae Semilunares.
There are likewise Valves at the
entrance between the left Auricle and
Ventricle named Valvulae Mitrales
fastened by the final Cordae Tendineaes
on the left side of the Heart.
The left Ventricle is larger and a
stronger & much thicker muscular bag
than the right Ventricle, its internal
part tougher and the Carnae Columnae
bigger. As the entrance out of the
left Ventricle into the Aorta are likewise
three Semilunar Valves.
The Heart is contained in a strong
Membranous bag called Pericardium
the internal part of which bag is very
smooth and lubricated with a juice
that continually transudes through the
same
H.




Same
Dr. Plott in  his History of Staffordshire
attests of his own knowledge the case of one
Mary Eagle who drew two quarts of
milk from her breasts every day besides
what her child sucked and that she
could make two pounds of butter
every week ever since she was
brought to bed which was above
five months when the Dr. saw her.
Borellus in his Hist: & Absence:
physioc-med: related an instance of
the like native in one Mary Caron
a Taylor’s wife of Bologna who afforded
milk enough for two children & made
Butter besides
Biog Dictionary Led: Esq:






Lect. 43d:
Of the Diaphragm
The Diaphragm is a large Muscle
between the Thorax and Abdomen, the
muscular fibres of which arise from the
internal part of all the ribs below the
sternum, and from the lower end of
the sternum, these fibres terminate in
a tendinous expansion which is nearly
in the middle of the Diaphragm, and
which is of an oblong figure coming
very nigh the sternum upon which
part the Apex of the Heart lies, and
from thence turning down towards
the Angle of the Ribs and is called
the oval tendon of the Diaphragm
the lower part of the Diaphragm is
likewise muscular and on each side
of the Vertebra are muscular Fibres
sent





Sent down some distance called the Crura
of the Diaphragm, these terminate
near the Origin of the Psoas muscles
which arise at the internal part of
the Vertebra of the Loins and pass out
of the Abdomen at the Inguen to be
inserted into the Os Femoris. it is
by making way through these muscles
that Abscesses of the Loins sometimes
fall down to the Thigh and are opened
and discharge their contents there.
There a three Apertures thro'
the Diaphragm, one of the right side
of the Vertebra through which the
Vena Cava goes, a second contiguous
to the Vertebra inclining a little to the
left thro' wc. goes the Aorta, a third
over the Aorta & exactly over the Vertebrae
through wc. the Oesophagus goes.
Of





Lecture 44th:
Of Respiration
Respiration is an alternate dilatation and
contraction of the Thorax the former performed
by Inspiration and the latter by Expiration.
The parts subservient to Respiration
are divided into Active and Passive
The active parts are the Ribs, Sternum,
Heart &c: acting upon the the passive
which are the Lungs themselves.
The dilatation of the Thorax happens
both in length and diameter; in length
by means of the Lungs pressing upon
the Diaphragm and thereby rendering
its convexity more plane, the diameter
is increased by the motion of the
intercostal muscles &c: Thus the
capacity




Capacity of the Thorax is increased
and as there is no vacuum between
the Lungs and ribs allowed of in a
natural state, the capacity of the Lungs
will also be increased and there will
be a vacuity in the Lungs wc. nature
not admitting of and by the pressure
of the Atmosphere rushing through
the Aspera Arteria they are soon
filled with Air making Inspiration.
The fresh Air that is drawn in
by Inspiration stretching the Bronchiae
and stimulating the same cause
them to contract and expel the Air
making Expiration, some Authors
imagine these are small Muscles
between




Between the cartilaginous Rings of
the Bronchiae which they call Musculi
Mesenchrondroeci serving to contract the
the same in Expiration.
The uses of Respiration are four,
1st For the circulation of the Blood, thus
in Inspiration the Lungs are distended
and the fine contorsions of the Arteries are
are elongated so as to allow, blood to pass
through them whereas in a collapsed state
the blood cannot pass through them.
in Expiration the Lungs collapsing push
the Blood through the Veins into the left
Auricle of the Heart.
2d. For sanguification by communicating
the Blood making it more florid & denser
3. For cooling the blood
4th. For Vocification, exclusion of [illegible] &c:




Of the Peritoneum
This membrane is similar to the pleura, being smooth
on one side & connected by cellular membrane on the other; it is
reflected from the contained path to the containing. It makes
a compleat bag 1st: covering the viscera by intimate connection,
& then covering the abdominal muscles loosely on the
inside. The peritoneum has been considered
as a double membrane true or false, the last is no
more than cellular membrane wch. connects the peritoneum
to the external parts. We may conceive that all
the viscera are behind or without the peritoneum, wch. 
running up on one side of a viscus is reflected back
on another so as to form an almost compleat 
cover to each viscus separately, so that by a very
nice dissection the peritoneum may be taken out
in a compleat bladder having no perforation at
all, leaving all the viscera undisturbed.




Lecture 45th:
Of the Stomach
The stomach is a large muscular bag
situate Obliquely from the Left Hypochondrium
to the Epigastrium and serves for
the reception of our food & digestion of
the same, it has an upper & lower curvature
called the lesser and greater curvatures
of the stomach.
There are two Orifices to the stomach;
the superior one called the Cardia which
enters it from the Oesophagus don't open
at the fundus of the same but obliquely,
at the side an inch or more from the
end. Towards the inferior end the
stomach grows smaller & turns up
opening into the Duodenum by an
Orifice called the Pylorus where there
is
J


The Nerves of the stomach come from the
par vagum.



Is a partial kind of a valve which does not
prevent the regurgitation of fluids into
the stomach being only a thickness of
the internal coat of the stomach.
The stomach is furnished with
Nerves and blood vessels. x
Some Anatomists say there are
small glands in the stomach, but if
so they are not easily discovered, there
is however a fluid discharged into the
stomach from the extremities of the
Arteries called the Gastric lymph
from the gastros the Greek name for the
stomach, there is likewise Lymphatics
which absorb the redundant fluids
& carrys it into the blood.
The coats of the Stomach are three
1st. coming from the peritoneum and is
called




called the Peritoneal Coat. 2d. Muscular
being composed of thin muscular fibres
running longitudinal and transversely
by which the capacity of the stomach
is decreased the readier, to expel its
contents. & 3d: Villous or internal Coat
which is thin.
Of the Intestines
The first Intestine next the stomach
is the Duodenum beginning at the
Pylorus and ascending two or three
Inches, has then two or three inflections
pulsing down & across the Vertebrae —
being all the way tied fast by a
duplicature of the Peritoneum to the
back, having no mesentery.
The Ductus Choledocus & ductus
Pancreaticus both enter the Duodenum
several




Several inches from the Pylorus, not
both by one Orifice but by two very
near together, next the Duodenum is
the Jejunum, & then the Ilium which
is the last of the small instestines.
The coats of the Intestines are
three the same as the Stomach, and
in the small intestines are anular
duplicatures of the internal Villous coat
forming what is called Valvulae Coniventes
which serve for two purposes, first to
make the passage rough & prevent
the Faeces, from passing on too fast
and secondly to give more capacious origin.
to the Lacteals
The Ilium enters the Caecum 
not at the end but about an Inch
there from obliquely the blind end only
being




Being called Caecum, where there is
an appendage called Apendicula Vermiformis.
At the entrance of the Ilium
into the great Intestines, there is a
Valve formed by the inner coat of the
Colon & called Valvula Colli which
in a sound state entirely prevents the
regurgitation of the Faeces or any fluids
passing, injected per Anum.
The Colon runs up the right
side then along under the stomach
and down the left side, surrounding
all the Abdomen, hence Clysters
beside discharging the Faeces serve
the purpose of a fomentation to the
contents of the Abdomen.
The Intestines are furnished with
blood vessels from the two mesenteries 
except


 


except the Rectum which receives
its from the Hemorrhoidals.
The Mesentery is a double membrane
formed by a duplicature of the Peritoneum
serving to connect the Intestines. & through
which which the blood vessels go to be distributed
to the Intestines, through it
likewise goes the Lacteals which are fine
Lymphatic or absorbent vessels arising
from the villous coat of the Intestines
and passing through the mesentery, they
terminate in the Receptaculum
Chyli, to be described hereafter, there
is also a great number of Glands in
the Mesentery through which the
Chyle passes, and by which it is
supposed to receive some alteration.
These glands are very small.




Lect. 46th
Of the Lacteals & Thoracic Duct
The Lacteals are an innumerable number
of small vessels arising as before said
from the villous coat of the Intestines &
running through the mesentery in the
duplicature of the same and through
many fine glands and terminate in the
Thoracic Duct serving to convey the Chyle
The Thoracic Duct is a small
canal running up the Vertebra of the
Spine between the Aorta & Vena Azygos
and under the Vena Cava until it gets
above the Heart then it turns a little to
the left and ascending empties itself in
to the subclavian Vein.
The lowest end of this Duct has been
called Receptaculum Chyli but improperly
as its no larger than the rest of the Duct
neither do all the Lacteals enter there, but some higher






Of Digestion
Digestion is that change of the Aliments
whereby they are filled for the nourishments
of the body, this is different from the
different juices mixed therewith and in
the different parts of the body.
The first change that happens to the
Aliments is in the mouth by means of
Mastication and mixing with the Saliva
by which it is somewhat dissolved and
fitted for more easy Deglutition
Saliva is a clear mucous transparent
fluid secreted by the Glands of the
Mouth in the great plenty, and is of great
use in digestion.
After the Aliments is sufficiently
masticated & mixed with the Saliva they
are by the Tongue pressing against
the roof of the Mouth forced into the
Pharynx




Pharynx and from thence through the
Oesophagus into the Stomach. The
Muscles employed in this act of deglutition
are very many, serving chiefly to
pull up the Oesophagus and to press the
food down through the same, and we
may very well conceive of the act of
Deglutition by that of drawing a stocking
on the Leg, part of the muscles drawing
up the Oesophagus as we draw up
a stocking upon the leg, and the rest
pushing down its contents as we push
down our leg into a stocking.
The manner in which our food is
digested in the stomach was by some
of the Antients reckoned to proceed from
heat
K




Heat, others reckoned it was performed
by means of trituration, and others again
from the different juices there mixed
imagined it was performed by Fermentation,
but modern Physiologists from
many observations, think it is performed
by all three jointly viz: Heat, friction
and Fermentation.
After the Aliments are sufficiently
digested in the stomach, by the contraction
thereof which is the beginning of the
peristaltic motion of the Intestines, they
are forced through the Pylorus into the
Duodenum, where it continues some
time and receives another change by
having the Bile and pancreatic juices
mixed therewith.
The







The Bile is an oily bitter, and attenuating
substance endued also with
a saponaceous virtue it will incorporate
with Oils and when so mixed they are
both soluble in water, it unites with
salt forming a green color. by which
it appears that the Bile is of great—
use in attenuating the viscid part of
the Aliments, and stimulating the—
Intestines, the latter we are assured—
of by this that Bile secreted and—
discharged into the Intestines in too great
a quantity causes a Diarrehea, and in
a Jaundice where the Bile returns into
the Blood and is not sent into the
Intestines a Costiveness happens
with while stools, and Boerhaave
says






Says the Gall of Animals is of use
in this case to supply the want of Gall
DeGraaf collected great quantities
of the Pancreatic juice from Animals
which he says is subacid it is reckoned
to be somewhat of the nature of the
Saliva, some reckoned it serves to
sheath the Acrimony of the Bile but
this in a natural state is not too Aerid
These two fluids being mixed with
the Aliments in the Duodenum the
fluid and nutritious particles of the
same are absorbed by the Lacteal vessels
and by them carried into the Thoracic
Duct to be conveyed into the Blood.
These Lacteals are in all the intestines,
but in the small ones in the 
Greatest 




Greatest plenty, That there are also
Lacteals in the Colon seems evident
1st. From the rout the colon makes round
the Abdomen, for if that is not for
absorbing the particles that may chance
to be not taken up by the vessels in
the small Intestines why did it not
go out strait like the Rectum and
immediately terminate in Ans?
2. From persons being known to have
lived a long time by Glysters, not being
able to get any thing thro' the Oesophasgus,
& it is known that they cannot
pass by the Valve of the Colon.
The contents of the Intestines are 
carried along by the Peristaltic motion
thereof




thereof. Vomiting is an inversion of
the peristaltic motion and is performed by
means of a deep inspiration which presses
the Diaphragm against the stomach &
a convulsive contraction of the stomach
by which its contents are thrown up
hence we learn that Emetics are good
in Fluxes by inverting the peristaltic
motion they stop the same.




Of the Bile
Bile is secreted in the Liver. It is
8 times as viscid as water. More
subject to concrete than any other
humour in the body. Its specific
gravity to water is as 010 to 795.
In a such quadrupeds & in the human
species the bile is very bitter, but
most so in carnivorous animals.
Recent bile easily mixess with water.
It mixes with oil by triture. Mixed
with water it partakes of the property
of Soap, dissolves oil so that it will
mix with water & takes out grease
spots. It dissolves resins & mixes
with balsams. It dissolves Myrrh
Bdellium & Wax like the yolk of
an Egg, & is supposed to dissolve
the Blood when mixed with it as
in a Jaundice.




The Ductus Choledochus may
may be compressed & stopped by
the Duodenum being distended with
flatus. Eating Mushrooms has
been known to distend the duodenum
greatly & trangulate the ductus
choledocus as it were with a
ligature. It may also be obstructed
by the contractions of the fibres of the 
intestine from stimuli as happens
in the Colica pictonum, biliosa,
inflammation of the duodenum, acrid
purges, glass of Antimony & poisons.
Hither we may refer the Jaundice
in Infants which is removed by
Rhubarb. Storck has seen the ductus
choledochus obstructed with a cheesy
coagulum. Hillary says this is
frequent in the warm Islands.
See Monro Ed: Ess: v. p 247 Baglivi
prax: med: Haller tom: 6. p 590


x about 4 fingers breadth below the pylorus.


Lect. 47th Of the Liver
The Liver is a large Viscus situated
immediately under the diaphragm mostly in
the right Hypochondrium extending over the Stomach
into the Epigastrium it is convex
above and concave below suspended by three
Ligaments one above to the Diaphragm one
broad on the upper part of the round ligament
from the Umbilicus which was the Umbilical
Vessel in a foetus state. There are several
fissures in the Liver 1st. Divide the great lobe
from the lesser one. 2d. divides the Lobulee
spigeli & the third where the Hepatic
Vessels enter;
The Vesica Fellis lies in a depness in
between the two lobes of the Liver from
where goes a duct remarkably contorted to
appearance about two inches when it joins
the hepatic duct, both of them united
form the Ductus comunis Cholidochus
which terminates in the Duodenum. x
The Coat of the Liver comes from
the
L

x sometimes called Tunica Glissoniana
*The hepatic Artery divides a little before it enters the
Liver one branch going to one lobe & the other to the other
Lobe; it serves to nourish the liver & is said to secrete a
small part of the Bile, some few of its evanescent frame has
terminating in the pori biliarii as is proved by injections.


The Peritoneum x beside which some Authors
describe another coat wc. is scarce to be
seen, The Gall Bladder has three coats
1st. from the Peritoneum, 2d: Muscular
& The 3d. Villous, appearing like a honey
comb inside. The Liver is furnished with
Veins Arteries & Nerves.
The Blood Vessels are the Hepatic *
Artery & Veins & the Vena Porta.
The Vena Porta is like an Artery first
in its Office & 2dly. in the thickness of its
coats; it arises from all the Viscera of the
Abdomen terminating in the Liver and
is supposed to carry the blood for the
secretion of the bile, 1st. From the longness
thereof & the smallness of the hepatic Artery.
2dly: By injections passing from it
into the biliary Duets &c:
It is certain however that the blood
being carried into the Liver, part of it is
converted


x The general opinion of the ancient
Anatomists was that the bile was conveyed
into the Gall Bladder by little ducts
running from the liver immediately
into the bladder which they called
ducti hepaticistics. Pechlin was the 
first who denied the existence of these ducts
in the human body, then Ruysch,
Cowper, Bidlow, Berger, Morgagni,
Heister, Ludwig, Carsons, Lieutaud, Ceyer,
& Cheselden. who says if a ligature be
applied round the cystic duct, or if it
be obstructed the gall bladder does not
become turgid. Bohnius emptied the
gall bladder of bile then tied a ligature
round the cystic duct & upon examining
the same several days afterwards found
no bile in the cyst itself but the part of
the duct between the ligature & liver was
greatly distended. Bianchus & Haller
have done the same. This clearly proves
that there is no communication between the
Liver & Gall bladder but by the cystic duct.
What was supposed to be Hepatocystic ducts
is demonstrated to be only blood vessels
by Ruysch, Guntz, Haller Morgagni & others.


converted into Bile & carried by the pori
Biliarii which all meeting together form
the hepatic duct though the hepatic duct
to the cystic then regurgitates into the Gall
Bladder; that the Bile regurgitates thus x
into the reservoir is proved 1st. by there being
no other passage though some supposed there
was by little ducts wc. they called cysto hepatic
ducts, but there is no such is evident from
the injections not passing through that way
 into the Cyst, & in a Viper the Gall Bladder
is vitiate some distance from the Liver.
Horses & Deer have no Gall Bladder.
That the Bile goes through the hepatic Cystic
Ducts into the Gall Bladder is proved 2dly:
by blowing into the hepatic duct the wind
passes free into the cystic than through
the ductus cholodochus.
The remainder of the Blood is received
by the Veins & carried back to the Heart
Diseases


x more frequently if not always the Jaundice
arises from an obstruction of the
Ductus communis Cholidocus
An obstruction of the cystic duct
alone will not occasion a Jaundice.


Diseases of the Liver are:
1st. Hydatides these are of two sorts
the first tumors composed of several lesser
cysts filled with a gelatinous matter, the
other a kind of vascular Cysts, the fluid
circulating through it.
2d. Inflammation this is best relieved
by plentiful bleeding warm relaxing and
stimulating applications &c: It sometimes
suppurates & even grows cancerous.
3d Scirrhi like other Glandular parts
4th. It gives origin to the Jaundice wc.
proceeds from an obstruction in the Cystic x
duct by wc. means the Bile is prevented
from going into the Gall bladder and
therefore returns into the Liver where it
is absorbed by the Veins or lymphatic
Vessels & carried into the blood & by that
means tinges the shin, the cystic duct
may be stopped by concretions tumors compressing
the




The same or more commonly by means of a
stone lodged therein: a stone or concretion
is best removed by Vomits which agitating
the parts serves to remove it or by friction
stimulating the same.
Some have imagined that a Jaundice
proceeds from a scirrhus Liver, but this
is proved to not be the cause as no Jaundice
can be unless the bile is absorbed after
it is perfectly made
Transient Jaundices sometimes
happens to Children from a spasm of the
Duodenum from acidities or otherwise
hinders the Bile from passing therein &
which is relieved as soon as the spasm
is removed.
Durable Jaundices happen when
the Obstruction of the Cistic duct cannot
be removed
Lect. 40th:
Pancreas is a long slender conglomerate
Gland situate obliquely under the stomach
between the spleen & Duodenum. each
little


x Haller supposes the pancreas secretes three times
as much fluid as the salival Glands.
* a costiveness and a pain in the region where this
gland is seated is the common symptoms of its being
obstructed.


little acini or knot supposed to be the extremity
of an Artery wound up in a knot and
the whole vascular like the liver and all
the other Glands of the body. from each
acini goes a small excretion Duct which
terminates in a larger duct in the middle
of the Pancreas & called the pancreatic
Duct & through which the pancreatic
juice flows into the duodenum, the
glands of the pancreas being the same
with those that discharge the Saliva
are supposed to secrete the same juice
and for the same Use. x
Diseases of the Pancreas are
Inflammation, Cancer, & Schirri, which *
are very difficult to be known until past
cure they are however removed much
in the same same manner as the same
Diseases on other parts, Soap is a very
good thing in this case which not only seen


x This appears very reasonable though it was
never taken notice of by any author before Mr. Monro.


Is a good resolvent but supplies the place
of this juice in digestion.
Sometimes a Diarrhea happens in a
Salivation and proceeds from a too great a
secretion of the pancreatic juice which being
the same with that of the saliva is supposed
to be effected in the same manner with
Mercury & is only to be removed by removing the cause. x
Omentum is a fatty double membrane
composed or formed by a duplicature of
of the Peritoneum it has an appendage
between the Liver & stomach called the
Omentum minor & may be inflated.
Uses of the Omentum are to lubricate
& keep the Intestines warm, and it is
supposed to supply oily particles to the
Bile and also the blood.
It is sometimes much distended with
Fat and in very lean subjects quite
reticular. Spleen




Of the Spleen
The Spleen is a roundish lobulated
Gland situated in the left Hypochondrium
it is furnished with blood Vessels and
but very few Nerves.
The Antients supposed its use
was to counterbalance the Liver, others
thought it contained a fluid called the
Atrabilis, but the moderns mostly
think that it is subservient to the
Liver, it has been taken out of several
animals without any apparent damage
and is not therefore a vital viscera.
It is subject to very few diseases,
scarce ever being inflamed schirrius or
cancerated, by reason of the fewness
of the nerves, its only subject to a
viscidity of its fluid and an enlargement
therefrom.
Lect.


x The arteries generally divide into three branches
and the vein into two before they enter the Kidneys.


Lect. 49th
Of the Kidneys
The Kidneys are two Glandular bodies
situate between the false ribs & Ilium.
the situation of the right Kidney is somewhat
lower than that of the left oweing
to the Liver being on that side. The
blood vessels of the Kidneys are an Artery
and a Vein called Renales or Emulgents
the right emulgent Artery is longer than
the left & the left Vein than the right.
These vessels enter at the Pelvis and
are distributed through the same. x
The external part of the Kidney is called
Cortical the thickness of which is irregular
and in this the Urine is secreted and
emptied into little ducts in the inner
part  
M


x the pelvis is an enlargement or expansion of the
of the upper part of the ureter where it enters the
Kidney or rather where the united urinary Tubes regress
out of it.


part of the same, which is called the
Mamillary part of the Kidneys.
The little ducts into which the Urine
is secreted are called Tubuli Urinarii
and are in number about a dozen,
these all unite in the Pelvis x forming the
Ureter which is a membranous canal
conveying the Urine from the Kidneys
to the Vesica Urinaria. The Ureter
as it enters the Pelvis of the Kidney
divides into three parts one going towards
each end and the other through
the middle. The coats of the Kidneys
are two, the first called Adipose and the
second Membranaceous.
There is an appendage to the 
Kidney called Glandula Renales or
Gland




Glandula Succentriari situate at the
top of the Kidneys its particular use
not known but supposed to be subservient
to the Kidneys.
Diseases of the Kidneys are,
Inflammation, Diabetes from a too
great laxness of the Vessels allowing
the red particles of the blood to pass
through them, gravel, Scirrhi &c:
Lect. 50th:
Of the Bladder
The Bladder is a membraneous Bag
situate in the Pelvis the upper part of
which is covered with the Peritoneum
but when it is very much distended it
protrudes about an Inch above the
Pelvis & being there covered with the
Peritoneum




Peritoneum & in this place is the upper
Operation for the Stone performed by
making an Incision into the Bladder
without cutting the peritoneum the doing
which would be of dangerous consequence.
The coats of the Bladder are three,
1st: the common coat 2d: muscular and
3d: Villous, the muscular coat at the
neck of the Bladder is thick & circular
and is called Sphincter.
The Ureters enter the Bladder one
on each side about an Inch from the
neck thereof by a small Orifice obliquely.
The situation of the Bladder is between
the Rectum & Olsa Pubis in men and 
between the Uterus & Pubis in women 
its use is a Reservoir to the Urine




Parts of Generation
Lect 51st
1st In a Male.
These are the spermatic Cord, Testes
Scrotum, Vesica Seminales, Prostate
Gland, and Penis.
The spermatic cord is composed of
the spermatic Artery and Vein, Nerves,
Lymphatics, & Vas deferens all included
in acellular coat and some have
supposed a muscular wc. they called
Cremaster wc. is not visible except where
it passes out of the Abdomen wc. it does
in an oblique manner through the rings
of the Abdomen, by which the Intestines
and Omentum sometimes falls thro' 
forming an Herniae Inguinalis or Jerotalis
along the side of the spermatic Cord
The


x Caput Gallinaginis


The vas deferens empty themselves somewhat
like the biliary ducts there being a passage
from them immediately into the Urethra, but
it commonly regurgitates into the Vesicula
Seminales & there kept till used.
Vesicula Seminales are two Glands situate
under the neck of the Bladder, composed of
little cells which communicate with each
each other, being reservoirs for the semen,
from each of these there goes a small duct
which opens into the Urethra at the 
Caput Galaginis, x where is a large Gland called
the Prostate Gland which secretes a fine
mucus to defend the Urethra from the acrimony
of the Urine.
The Scrotum is composed of skin Cellular
Membrane &c: next to which has been reckoned
a muscle called the Dartos which is not to be
discerned




discerned, and the first obvious Coat
is that wc. surrounds the Testicle much
as the Pleura or Peritoneum does the
contents within them this is called the
Tunica Vaginalis propria Testes, and
within that is a coat which adheres to
the substance of the Testicle called the 
Tunica Albuginea,
The substance of the Testicle is
wholly Glandular, the spermatic Artery
entering in at the side of the same and
distributed through the same terminating
in fine secretory ducts and these again
in excretory ducts which uniting into one
form the Vas deferens, The Epididymus
is an Appendage to the Testicle formed by
numerous convolutions of the excretory duct,
reckoned 6 times as long as the Spermatic Cord.




Lect. 52d:
Parts of Generation in Females.
These are either external or internal, the
external are the Mons Veneris on which
hair grows at a certain age
Labia or External Lips of the Orifice
at the upper part of wc. is a small body
called the Clitoris under which in a
small groove is the Iter ad Urinam
thro' which the urine passes & into which
the Catheter must be introduced in a
suppression of Urine, & we should be well
acquainted with this Orifice as the modesty
of women often denies us a sight of the
part, so that we must introduce the Catheter
by feeling, at the lower part where the
Labia unite is formed a Fraenum or
Fushet or Foushette.



x Iter externum ad Uterum



Nymphae are two spongy bodies
within the Labia within these in Virgins
is a circular membrane called Hymen
within these is the Iter externum ad Uterum x
Vagina is a membranous substance
furnished with rugae by wc. the Penis is
more titillated in Coitus, there is likewise
many small glands in the Vagina wc.
secrete a liquor to lubricate the same and
during the Venereal orgasm whether real
or imaginary there is sometimes so much
mucus secreted by these glands that
it has been discharged, in great quantities
so as to wet all the external parts, this
by some is reckoned the Female semen.
At the bottom of the Vagina is the
Iter internum ad Uterum, the Os Uteri or
Os Tincae. N Between


x or young Puppy



Between the Fushet and Anus, there is
a seam called Perinaeum, this in
difficult deliveries is sometimes lacerated
by the largeness of the Foetus & it is
necessary to prevent this accident for to
support the Perinaeum with the hand
while the Foetus advances
Uterus is a small body situate
obliquely between the Bladder & Rectum
its coats size near half an Inch thick
& its internal cavity very small; the
Neck of the Uterus is full of rugae wc. 
serve to allow the same to dilate for the
expulsion of the Foetus. The Os Tincae
resembles the mouth of a Tench x situate
at the bottom of the Vagina tho' not a
continuation thereof the Vagina being
inserted



x An demande si le corps de la matrice
etant renverse, & ayant tente inutiliment
va induction, elle montroit quilque
disposition a ve gangrener, e il conviendroit
pour lors de l’eactirper, apris
avoir porte une ligature le plus haut
qu’il veroit possible. En parsil cas
on ne devroit point balancer de faire
cette operation pour empecker que la
gangrene faisant du progres du cote
des parties interieures, elle ne causat
la mort a la malade. L'extirpation
de la matrice, quoique rare, never sit
point en cette occasion une operation
temeraire, son succes etant prour a
par plusieurs observations
Verdeer's Anal: v: 22 p 66
Rousset, dans son Traite de
Partes Caesares, dit qu'une femme
a la suite de pluesieurs accouchemens
laborieux, eut une precipitation de
matrice qui ne pouvant etre


inserted round the Os Tincae. From the
Fundus of the Uterus there goes off nearly
transversely on each side, a tube called the
Fallopian Tubes lying loose & growing
larger toward the further end wc. is fimbricated.
The Uterus is suspended by the
ligament lata & rotunda x
Ovaria are two glandular bodies
situate on each side of the Uterus inclosed
in cellular membrane in each of these
Ovaria are near 20 small Ova
Of Generation
This is perfomed per Coitus by the
Male’s introducing his Penis into the
Vagina, & perhaps into the Os Uteri tho'
this is denied by some at which time the
parts grow turgid by the venereal Orgasm
the Os Tincae opens & receives the male Semen
in which are Anamalcules, immediately
attended.


reduite, se gangrena, & tomba
d’elle-meme. La femme ne daigna
pas garder le lit, & elle Jouit d’une
parfaite vante’ pendant trois ans,
au bout desquels, etant morte d'uno
fievre continue, louverture de fon
corps fid voir que c’ etoit veritablement
le corps de la matrice, qui
par pourriture s’etoit s’epare
de lui-meme
Ibidem p168.


afterwards the Os Tinca closes
During the Orgasm the fallopian Tubes
grow erect & the Timbria seize the Ovaria
at wc. time some one or more of the Animalcule
ascend through the Fallopian Tubes & enter
the first ripe Ovum wc. has now burst
the cellular membrane by its turgidity, then
the Ovum is disengaged & carried by the
Fallopian Tube into the Uterus, and the
place where the Ovum was in the Ovarium
is soon after filled up by a yellowish substance
called Corpus Luteum, this I proved by
opening a Bitch in the Hornes of the Uterus
were 7 whelps in one three & the other four
& in the Ovaria were the same number of
Corpora Lutea, by alike experiment upon a
Bitch opened while the Dog was fastened
thereto, for dogs have no Vesicula Feminalis
are obliged to remain fastened to the Bitch
a




a long time while the Semen is excreted and
carried from the Testes by the Vas deferens
into the Uterus I found that the semen
was ejected immediately into the Uterus.
Though the preceeding Hypothesis seems
incredible and almost impossible, yet it
answers all the Phenomena of Generation
the best of any system yet advanced:
however the subject is extremely intricate
& no doubt is one of the Arcana natura
which the omniscient Jehovah of his
infinite goodness sees fit to hide from us.




Lect: 53d.
Of the Foetus its Nutrition &c.
The Ovum of the female wc. is foecundated in
the preceeding manner by the semen Masculinum is supposed
to contact also the membranes that envelop the foetus
with the Placenta, Umbilical Chord &c:
The Ovum lies in the Uterus 9 months, but for
the first two or three months the Placenta does not
adhere to the Uterus
The Chorionis the external coat of the Foetus it
is a thick spongy membrane.
The Amnios is within the Chorion it is very
thin and smooth, between these two membranes
some have described another called Alantois wch.
includes the Urine of the foetus carried there from ye. bladder by the
Urachus, this is found in some brutes but cannot
be discerned in the human species
The Placenta is made up of a congress of vessels.
How does the Placenta adhere to the Uterus? How is
the Foetus nourished? is it by the Mouth; the
Umbilical Vein, or by both together? Does red 
blood go immediately from the uterine Vessels of 
the


As first this want of Navel String, 2d: a diminution 
of the the Liquor Amnii, 3d. Mucus being found in the mouth
& stomach & meconium &c:
# 1st. A want of mouth or any passage into the
chylopoetic organs, 2d a corruption of the Liquor Amnii
3d. That the liquor Amnii is an exudation from the
foetus & consequently not fit for its nourishment &c:


the mother through the Placenta to the Foetus &
vice versa? from whence comes the Liqour of
the Amnios? these are question, that have been
differently solved by physiologists.
Some have imagined that the placenta adheres
to the Uterus by its vessels inosculating with those of
the Uterus, others imagine there is no continuation of
vessels by inosculation from the placenta to the
Uterus, but that the placenta adheres thereto by
a kind of cement; for (say they) if  it adhered otherwise
there must be a laceration (& consequently an inflammation & suppuration)
wc. does not happen when it is bro.' away.
As to the Nourishment of the foetus many have
imagined that it rec'd. nourishment by the mouth
& bring many arguments to prove it*, on the contrary
others deny that the Foetus receives any nourishment
by the mouth but wholly by the umbilical Chord -
this is the most viewed Opinion, but for a particular
acc't. of the Nutrition of the Foetus in Utero side
Med: Essays of Edinburgh and Dr. Shippen’s
Thesis for the connection of the Placenta to the Uterus
A




It was the rec'd. Opinion till of late by all who
allowed the foetus to be nourished by the umbilical
Chord that red blood was immediately conveyed from
the mother to the foetus; Their arguments for it are 1st.
that if the mother bleeds to death the Foetus will
be deprived of blood also. 2d. Injections pass from
the mother to the Foetus. 3d. that hemorrhages happen
upon a separation of the placenta from the
uterus. 4th that the umbilical Chord will bleed a
great quantity when cut &c: but the most modern
doctrine that now prevails & wc. answers all the
phenomena best is that red blood does not pass
immediately from the mother to the Foetus, for
before the placenta adheres to the Uterus it certainly
cannot, & then it must be nourished by absorption
of the Placentine vessels as well before as after
its adhersion to the Uterus; we have said
before that the placenta does not adhere to the
Uterus by inosculation of the Vessels, but by a
slight cementation, thence we suppose that
the


   


the small ends of the placentine Vessels open into
the mouths of the uterine ones, and as the mouths
of the uterine Vessels are so large near the
time of delivery as to admit a goose quill
whereas the mouths of the placentine Vessels
are so small as not to admit red blood
its very probable there are many of the
placentine vessels open into one of those of
the uterus.
These small placentine vasculae are part
of them supposed to absorb the chylous & ferrous
nutritious part of the blood in the uterine
vessels which the placenta forms into red
blood before it is conveyed to the Foetus;
The manner how the placenta acts in forming
this nutritious fluid into blood is
unknown, but it is supposed to perform
the office of Lungs in that particular.
The placentine vessels having absorbed
the nutritious particles of the mother’s blood
and


   


and the placenta formed it into red blood
it is conveyed by the umbilical Vein into
the Foetus, for its increase & nourishment,
while the superfluous & unnutritious part is reconveyed
by the umbilical Arteries into the
placenta & is absorbed by the uterine Vessels
and mixed with the blood of the mother;
thus instead of a reciprocal circulation between
the Foetus & Mother which was formerly Supposed,
and is still by some, there is only a
secretion of the fluids which pass from one
to the other. The Arguments brought to Support
this new doctrine are, 1st: That upon the mother’s
bleeding to death, the Foetus will not be deprived
of any of its blood this Dr. Shippen proved by
an experiment he made in Edinburgh before
Alexander Monro jun'r he bled a Bitch to
death then opened her and took out her whelps
which appeared to have lost not one drop of
blood




blood. 2d. That the umbilical Cord when cut
will not bleed but very little, no more than
the blood contained in the Placenta, this most
Midwives know & it is mentioned by Smellie:
but 3d. Lastly the greatest argument of all
is that Injections cannot be made to pass
from the placenta into the Vessels of the
uterus nor vice versa tho' it has been
repeatedly tried by the greatest Anatomists
notwithstanding what has been said by some
to the contrary.


   


   


   


   


   


   


   


   


   


   


   


A Course of Bandages
Bandages are very necessary to confine dressings
upon any external part of the body, injured either
by accident or by a necessary Operation.
Lect: 54th:
Bandages of the Head.
1st: Handkerchief doubled & made 3 square
put round the head & tied behind
2d: Grand Covre Chef a large square
handkerchief doubled to ab.t 2/3 the way &
laid on the head the single part so as to
reach the Nose, the double part the forehead,
wc. double part being uppermost must be
fastened under the Chin, the other then
turned up & tied behind in the nape of Neck
3d: Poormans Bandage of Galen
a piece of linen cut into 6 tails & laid
on the top of the head, the middle tails
fastened


   


fastened under the Chin the hind ones before
& the fore ones at last behind.
4th: Capaline a long doubleheaded bandage
4 or 5 fingers breadth wide to put round
the head
5th: Uniting Bandage double headed &
like the former with a slit near the middle
to be applied to a wound of the forehead.
6th: Scapha for bleeding in the frontal
vein going several times round the head
at last the first end turned over & tied behind
7th: Kiaster double headed for bleeding in
the Temporal Artery going several times
round the head then twisted round to a hard
knot over the Orifice & then part one end
over the crown the other under the Chin
and fastened.
8&9 Monos- & Bi-Ocular double headed
the first covering one Eye the last both Eyes
Lect.


   


Lecture 55th:
10 Accipiter a T Bandage for the Nose
going round & tail tied over the head.
11 A four tailed sling bandage for the
upper Lip.
12 A four tailed sling bandage for the
Chin the under half being the broadest.
13 Capistrum double headed bandage passing
from under the Chin to top of the head
then to neck & round to the Chin &c:
14. Divisive along double headed
rowler to keep up the head.
Bandages of the Trunk
15 Spica double headed for the shoulder
16 Star Bandage for a fracture of
the Clavicle a single headed rowler & if
necessary the Capaline may be applied
with it for greater safety.
17






17 For the Thorax the Jenriette or Napkin
& Scapulier the first going round the
body the latter slit going over the head &
fastened thereto.
18 Suspensor of Heliodorus for a diseased
Breast a X bandage
19 For Paracentesis a broad flannel roller
to go round & compress the Abdomen.
Lecture 56th:
20 Spica Inguinis double headed
for any disorder in the inguen.
21 T Bandage or Suspensor Scroti
beside wc. there are several others of less
note to these parts particularly the Truss
Bandages of the Extremities
22 Deloer for the Wrist
23 Spica Pollicis for the thumb.
24 Gauntlet ~ } for the fingers
25 Denigantlet 26




26 Eight tailed bandage for a broken
Patella &c:
27 For a simple Fracture Thypodesmus 
going round under the splints a single
headed roler & Epidesmus going over
the splints one roler very long may
serve for both.
28 For a compound Fracture where there
is a Wound &c: the 18 tailed bandage
together with splints Tape &c: and
lastly Junchs, Box, or Cradle &c:
if it is one of the Legs.




A Course of Operations
Lecture 57th:~
Of Sutures
There has been many sutures invented
most of which are out of use.
We ought to observe that a wound made
longitudinally in the direction of the ~
Fibres requires no sutures be it ever so
great, for by means of a bandage the
sides of the Wound is easily brought
together without suture.
But a wound made obliquely or
transversely requires a suture as no
Bandage can be made to keep the wound
together.
The intention of Sutures is to bring
the likes of a fresh wound in apposition, that the
vessels may inosculate & heal by the
first intention, the chief sutures are 
The




Glovers stitch, The interrupted suture,
The quilled suture, & the Gastroraphy,
The Glovers stitch is performed with
a strait needle & waxed thread single,
turned over and over.
The interrupted Suture is
made with a crooked needle & single waxed
thread the lips of the wound being brought
together first make a stitch in the middle the
Rule for which is to begin as far from the
edge of the wound as the wound is deep
making the needle come out at the bottom
of the wound & continued thro' on the contrary
side then tied not over the wound but on
one side, then make two other stitches near
each end wc. is mostly sufficient.
Quilled Suture is made with
a crooked needle as before with a double cord &
tied at the end with a quill on each side the Wound.
The




The Gastroraphy is performed when
the parietes of the Abdomen & Intestines
are cut. The intestine is to be saved up
with the Glovers stitch leaving a piece of
the thread at each end to lie out of the
wound of the Abdomen, then the Parietes
is to be stitched with the interrupted
Suture in a particular manner viz: on each
end of a waxed cord must be put a crooked
Needle, then take one needle & from within
the wound push it out then take the
other needle & do the same on the other side
of the wound, bringing them together
& tying the same, do so until you have
as many stitches as you think is
necessary




Of Trepaning
When it is necessary to perform this Operation
we should consider first the places where the Trepan
may be applied; there are 3 places where it is
improper to apply it viz: to the Sagital Suture,
the frontal Sinuses, & the Os Accipitis.
In Operating, an Incision must be made
of a good length through the scalp, the same opened
& the Cranium scraped, than having fixed upon
the place apply first the perforator & after that
the Trepan secundum Artem.
Of Fistula Lacrymalis
This operation is performed when the ductus
as Nasum is stopped & has formed in the
Lacrymal Sac &c: Sometimes compression
alone will cure this disease but when the Operation
is necessary its performed by making an incision
over the Sac at the bottom of the Orbit & half
the length of the same, into the Sac & cleaning
out





out the matter & if necessary making an Aperture
through the Os Unguis with a strong Probe or a
Trocar into the Nose.
Of the Polypus of the Nose
This is an excrescence growing in the Nose
in the Schneiderian Membrane, has different
degrees of firmness, in a recent state it is very
tender but by degrees grows harder until it gets
to a great firmness; the best time for extracting
it is when its so hard as not to break easily
with the Forceps but not so hard as to adhere
to the Schneiderian membrane too strongly.
Its extracted by taking hold of it with the
polypus Forceps & working it to one side and
the other backwards & forwards &c: until it is
loosened.




Extirpating the Tonsils.
This is best done by Ligature for fear of an
Hamorrhage if the Tonsils are largest at the
apex its an easy matter with proper Instruments
to pass the Ligature round its basis & make it
tight, but, it often happens that the Basis
is largest in this case a ligature put round woud
slip off therefore with a proper needle it must
be run through the middle of the Tonsils & tied on
each side cum node Chirurgica &c:
Of Amputation
Amputation is sometimes necessary but not near
so often as has been thought; all agree that it is
necessary in a Mortification, but then it must
not be performed until the mortification is stopped
& even new flesh begins to granulate.
In Amputating the Leg we must stand
between the legs that the saw may take the
Fibula before the Tibia is quite cut off.
we




We first apply the Tourniquet to the thigh
to stop the blood, then with a strait knife wc. 
is the best we make a circular incision with
two cuts round the leg or thigh through the
skin cellular membrane & fat about an Inch
below where we intend to cut off the Bone,
then an Assistant must pull up the skin
as high as possible, after wc. the Operator
must make a second Incision through the
muscles to the bone then if it’s the leg or
forearm the double edged scalpel must be
run between the bones to cut the interosseous
Ligament & Muscles, lastly the bone itself
must be cut off with the saw. & then the Arteries
taken up &c:
The Fingers are Amputated contrary to all
other parts at the Joins by cutting the flesh
as before then stretching it up & with the
scalpel beginning on the side take off the Joint.




Of Empiema
This is an operation for letting Pus Water or
Blood out of the cavity of the Thorax, oftenest
Pus, wc. comes from an inflammation & Suppuration,
when this is in but small quantities, the Lungs
by then great power of Absorption often carries
it off by Expectoration as we see in Pleurisies;
but when in great quantities the operation
must be performed very carefully for fear of
hurting the Lungs between the 6 & 7 or 7 & 8
Ribs with a common scalpel.
Of Bubonocele
This is the dangerousest operation in Surgery,
& not to be performed but when absolutely necessary;
when so it is done by making a long incision
from above the rings of the abdominal Muscles
almost to the bottom of the scrotum carefully
in to the Intestine thro' the Peritoneum or
Herniary Sac then dilate the passage by incision
& carefully reduce the Intestine.




Of Couching
This Operation is performed for the removal of a
Cataract or opacity of the crystaline Lens; there are
two ways of doing it, the old way of depressing the Lens
with a needle to the bottom of the Eye into the
vitreous humor wc. is done by running the needle abt.
1/10 of an Inch below the Cornea into the posterior
Chamber behind the Iris & depressing the Lens.
The other method, wc. is the new way, much in
vogue at present, & I think the best is to cut the
Cornea & extract the the crystalline Lens. In the
Old way the Lens is very apt to use after it has been
depressed wc. makes this new way preferable; it is
performed by a small knife with but one Edge wc.
is to enter near the place where the Needle enters & 
pushed thro' into the anterior chamber above the
Iris (taking care not to cut it) and out on the
other side cutting half or better of the Cornea, then
with the point of the knife cut the capsulae of the
Lens & its easily pressed out.




Of Lithotomy
This Operation is performed for extracting a 
stone out of the Vesica Urinariae; there has been
several methods invented to perform this operation
but the Lateral Operation or that invented by
Irene Jaques is the best & universally in use.
We are not to operate until we are certain
there is a stone in the Bladder & we can feel it
by sounding & all the other Surgeons present.
In Operating we first tye the patient on a
Table of a sufficient height lying on his back
by making a noose with a garter round the Wrist
then making him take hold of the bottom of
his foot with his hand putting the Garter round
his Instep & hand in form of 8 a sufficient number
of times, with an assistant to hold each knee
then introduce the Staff into the bladder, letting
a careful assistant hold the same bending the
top a little towards the right Groin is as that the
bend of the same may turn a little to the left
then




then the Operator setting down right before the
Patient must with a sharp scalpel make an incision
immediately upon the staff from the Base of the
scrotum to beyond the anus abt. an Inch to the
left of Cerines through the skin & fat, (this should
be made thus large that we may get at any Artery
if necessary) then make the incision shorter down
to the staff when we feel the staff bare we must
take the Gorget put the point of it into the Groove
of the staff then take hold of the staff from
your assistant & turn it over while you slip the
Gorget along the groove into the bladder, then
take out the staff, & introduce the Forceps upon
the groove of the Gorget, when they are in the
Bladder pull out the Gorget & gently feel for
the stone, when you find it take care to get good
hold of, it not being in too big a hurry; when you
have it fast extract it.
If the stone breaks take out what you can
with the Forceps & the rest with a scoop.
The wound must be drest gently wth. dry Lint.


Med. Hist.
MS.
B
158


Of Tapping












Of Injections
The ancients used to employ only
Ink for Injections (which answered the end
but very poorly) until the time of Ruysch 
who made his injections of wax, some of wc.
have since been improved; his method of
Injection was as follows viz. He first
laid open the hypogastrium & made two
incisions about an Inch long into the Aorta
& Vena Cava, then put the Subject in cold
water several days pressing out the blood
frequently. Next he put them in warm
water several days more & put two tubes
in the Artery one upwards & one downwards
& fastened them tightly.
His injection was only simple Suet
calomel with Cinnabar in cold weather &
in the Summer time he added a little white
wax & injected it gently when warm into
the vessels, then put the Subject into cold
water till the injection was cold, then dried
the preparation carefully or preserved it in
spirits of wine
Injections used by the modern are the follg:


Corroding Injection of Dr. Nicholls
Rx Wax 4 ounces Resin 3 ounces when
melted add Turpentine Varnish 3 ounces 
Dr. Hunter's Corroding Injections
Rx Wax 3 ounces Resin 3 ounces when melted
add Venice Turpentine 11 ounces 
Another
Rx Wax 4 ounces Resin 3 ounces when
melted add Oil of Turpentine 2 ounces 
Another
Rx Wax 4 ounces Resin 8 ounces or 10 ounces 
Tallow 3 ounces melt them together
The Injection is known to be of a
proper consistence by dropping some of
it when melted in water & when thoroughly
cold forming it into the shape of the Vessels
if upon Landing it breaks it is too hard
if it bends easily it is too soft & must
be mended. Those Injections which have
Turpentine Varnish, Venice Turpentine
or Oil of Turpentine in them must be
tried as above every time they are heated because
in heating they loose of their volatile oil


Of the Colours
To the foregoing Injections such a
quantity of colouring matter must be
added as will give them a bright colour
which must be determind by the Eye
Colours generally used are Vermillion
Kings Yellow, Blue Verditer & Flake
White. Other colours may be used.
They are generally to be mixed with the
Injections when they are melted; but
there are some objections to this rule
in some of the colours particularly the
blue Verditer & in some measure the Flake
White for Navy both ferment when mixed
with the foregoing Injections; to prevent
which it is necessary to melt some of the
Ingredients alone & add the colour to it before
the other Ingredients are added. The
following Experiments will particularize
these Exceptions
1 Blue Verditer with Tallow alone
causes no Fermentation
2 Blue Verditer with wax alone don’t
Ferment


3d. Blue Verditer with Resin alone
does ferment, therefore mix the blue
Verditer with the Tallow or Wax alone or
together & afterwards add the Resin
which causes a small froathing
If Turpentine Varnish, Venice
Turpentine or Oil of Turpentine be 
used mix your colour first with the
melted wax & then add either of these 
Ingredients with the Resin
These observations are equally true
of the Flake White
When we make a white Injection
instead of yellow Wax we use white.
It would seem that we have
not yet any Green Colour, but as blue
& yellow make a Green the blue Verditer
added to the yellow wax or Resin gives
us a fine green


Dr: Nicholls fine Injection
Rx Hard Brown Varnish & hard White
Varnish a 5 ounces Turpentine Varnish 2 ounces 
add the Colour & shake the Vial first
putting some shot therein to make them
mix. Either of the hard Varnishes will
do as well as both adding the same
proportion of Turpentine Varnish viz
1 to 5
Another
Rx Hard Brown Varnish & hard
White do. a 8 ounces Venice Turpentine 2 1/2 ounces 
mix these as the former
If we neglect being nice in our
proportions or from often heating these
Injections become too hard or Brittle.
We know when they are of a
proper consistence by the following
Experiment; Drop one drop of it upon
cold water which will immediately diffuse
itself over the whole surface when the
spirit will be immediately attracted by
the water & the gums with the Turpentine


will be left swimming on it, if this
will bear raising up without breaking
it is of a proper consistence, but if it
breaks its too hard & much be softened
till it is properly tenacious
Of Watery Injections
Glue dissolved in water alone makes
a good minute Injection; before it
is dissolved by heating its necessary
to steep it in water for 12 hours then
boil it upon the fire till the whole is
dissolved, afterwards strain it & drop
some of it upon a cold stone or any
cold substance to cool that you may
know its consistence; when it is somewhat
thicker than a common gelly
it is of a proper consistence
Isinglass & water prepared in
the same manner as the preceding ~
makes an Injection similar to it


Gum Arabic, Tragacanth, or
any of mucilaginous Gum dissolved
in Water to the consistence of Cream
& strained as the preceeding make a very
minute Injection
As the Colours mix difficultly with
with these watery Injections, they
ought first to be mixed well with
a little of the Injection & then the
remainder added to it.
Of Oily Injections
We often make Injections of almost
all Oils as Oil of Turpentine Hogs lard
Tallow &c: The oil of Turpentine is
rather too thin of itself but when added
to two parts Tallow is a good Injection
Butter or Hogs Lard make
of themselves a pretty good Injection


All fine Injections require more
Colours than coarse ones, for as it is to
run into much smaller vessels it of course
becomes more & more transparent and
therefore requires such a quantity of
colour as to render it opaque even
when it is most minutely separated on
diffused within in very small vessels or
on any surface
Of Common Injections
The corroding Injections are too hard
for several purposes & the fine ones
too soft therefore we need something
between them, some of which must
be softer than others
The hardest is Rx Resin 3 ounces Tallow 2 ounces 
Wax 1/2 ounce Colour sufficient for an Injectn.
is Rx Resin 2 ounces Tallow 2 ounces 
Colour sufficient for an Injection
These are generally used when
the part is intended to be dissected


Varnishes
Turpentine Varnish
Yellow Resin 14 lbs Oil of Turpentine
16 lbs, boil the water out of the Resin 
& then add the Oil of Turpentine from
the fire.
White Hard Varnish
Mastich & Gum Juniper a 1 grain 
Alcohol 8 grains ~
Brown Hard Varnish
Shell Lac & Seed Lac a 1 1/2 grains 
Gum Juniper 1 1/2 grains Alcohol Galls. 2 
clean the Gums from dirt & bruise
them pretty small then put them in
the spirits & dissolve them in a Sand heat
The Spirit of Sea Salt is the
corrosion commonly used by Anatomists


The part to be Injected must be
macerated in water blood warm 2 or 3
days so as to relax the vessels & soak
out all the blood in them, then having
a proper sized Syringe with pipes of
different sizes, fit one of the pipes
into the vessel & fasten it well with
a ligature bringing the ligature round
the cross piece to secure it the latter.
The part to be injected lying in the
warm water & the Syringe and
Injection being warm, the Syringe
is to filled with the Injection, the
end of it put into the pipe & kept fast
& the Embolus of the Syringe pressed
gently down with the breast till the
part is sufficiently injected or the
syringe when it is to be filled and
emptied as before if necessary ~
Med. Hist.
MS
B
158


















Med. Hist.
MS.
B
158