Compleat Surgeon/Introduction
THE Compleat Surgeon: OR, THE Whole ART OF SURGERY Explain'd, &c.
CHAP. I.
[edit]Of the Qualifications of a Surgeon, and of the Art of Surgery.
[edit]Who is a Surgeon?
A Person skill'd in curing Diseases incident to Humane Bodies by a methodical Application of the Hand.
What are the Qualifications of a good Surgeon in general?
They are three in Number: viz. Skill in the Theory, Experience in the Practical part, and a gentle Application of the Hand.
Why ought a Surgeon to be skilful?
Because without a discerning Faculty he can have no certainty in what he doth.
Why must he be experienc'd?
Because Knowledge alone doth not endue him with a dexterity of Hand requisite in such a Person, which cannot be acquir'd but by Experience, and repeated Manual Operations.
Why must he be tender-handed?
To the End that by fit Applications he may asswage those Pains which he is oblig'd to cause his Patients to endure.
What is Chirurgery or Surgery?
It is an Art which shews how to cure the Diseases of Humane Bodies by a methodical Manual Application. The Term being derived from the Greek Word Χεὶρ, signifying a Hand and Ἔργον, a Work or Operation.
After how many manners are Chirurgical Operations usually perform'd?
Four several ways.
Which be they?
I. Synthesis, whereby the divided Parts are re-united; as in Wounds. II. Diæresis, that divides and separates those Parts, which, by their Union, hinder the Cure of Diseases, such is the continuity of Abscesses or Impostumes which must be open'd to let out the purulent Matter. III. Exæresis, which draws out of the Body whatsoever is noxious or hurtful, as Bullets, Arrows, &c. IV. Prosthesis adds some Instrument or Body to supply the defect of those that are wanting; such are Artificial Legs and Arms, when the Natural ones are lost. It also furnishes us with certain Instruments to help and strengthen weak Parts, such as Pessaries, which retain the Matrix in its proper place when it is fallen, Crutches to assist feeble Persons in going, &c.
What ought to be chiefly observed before the undertaking an Operation?
Four things; viz. 1. What the Operation to be perform'd is? 2. Why it is perform'd? 3. Whether it be necessary or possible? And 4. The manner of performing it.
How may we discern these?
The Operation to be perform'd may be known by its Definition; that is to say, by explaining what it is in it self: We may discover whether it ought to be done, by examining whether the Distemper cannot be cur'd otherwise: We may also judge whether it be possible or necessary, by a competent Knowledge of the Nature of the Disease, the Strength of the Patient, and the Part affected: Lastly, the manner of performing it may be found out, by being well vers'd in the Practice of Surgery.
What are the Fundamental Principles of Surgery?
They are Three in number: viz. 1. The knowledge of Man's Body. 2. That of the Diseases which require a Manual Operation. 3. That of proper Remedies and Helps upon every Occasion.
How may one attain to the Knowledge of Humane Bodies?
By the study of Anatomy.
How may one learn to know the Distempers relating to Surgery, and the Remedies appropriated for them?
Two several ways; viz. 1. By the reading of good Books, and Instructions receiv'd from able Masters of that Art. 2. By practice and the Observation of what is perform'd by others upon the Bodies of their Patients.
What are the Diseases in general that belong to Surgery?
They are Tumours, Impostumes, Wounds, Ulcers, Fractures, Dislocations, and generally all sorts of Distempers whereto Manual Operations may be applyed.
What are the Instruments in general which are commonly used in Surgery for the curing of Diseases?
They are Five; viz. the Hand, Bandages, Medicines, the Incision-Knife, and Fire.
What is the general Practice which ought to be observ'd in the Application of these different helps?
Hippocrates teacheth us, in saying, that when Medicines are not sufficient, recourse may be had to the Incision-Knife, and afterward to Fire; intimating that we must proceed by degrees.
Are there any Distempers that may be cured by the Surgeon's Hand alone?
Yes, as when a simple and small Dislocation is only to be reduced.
CHAP. II.
[edit]Of Chirurgical Instruments, portable and not portable.
[edit]What do you call portable and not portable Instruments?
Portable Instruments are those which the Surgeon carries in his Lancet-Case with his Plaister-Box; and not portable are those that he doth not carry about him, but is oblig'd to keep at home; the former being appointed for the ready help which he daily administers to his Patients, and the others for greater Operations.
What are the Instruments which a Surgeon ought to have in his Plaister-Box?
These Instruments are a good pair of Sizzers, a Razor, an Incision-Knife streight and crooked, a Spatula, a greater Lancet to open Impostumes, and lesser for letting Blood. They likewise carry separately in very neat Lancet-Cases, a hollow Probe made of Silver or fine Steel; as also many other Probes, streight, crooked, folding, and of different thickness; a Pipe of Silver or fine Steel, to convey the cauterizing Button to a remote Part, without running the hazard of burning those that are near it; another Pipe or Tube serving instead of a Case for Needles, which have Eyes at one end for sowing; a Carlet, or thick triangular Needle; a small File; a Steel Instrument to cleanse the Teeth; a Fleam; a pair of crooked Forceps to draw a Tooth; a Pelican; a Crow's Bill; several sorts of Raspatories; a Hook to hold up the Skin in cutting, &c.
What are the Instruments which a Surgeon ought to keep in his Repository to perform the greater Operations?
Some of them are peculiar to certain Operations, and others are common to all. The Instruments appropriated to particular Operations, are the Trepan for opening the Bones in the Head, or elsewhere: The Catheters or Probes for Men and Women afflicted with the Stone, or difficulty of making Water. Extractors, to lay hold on the Stone in Lithotomy, and to gather together the Gravel; large crooked Incision-Knives, and a Saw, to make Amputations of the Arms or Legs; great Needles with three Edges, to be used in making Setons; small Needles to couch Cataracts; other Needles; thin Plates and Buckles to close a Hair-Lip, &c.
May not the Salvatory be reckon'd among the portable Instruments?
Yes, because the Balsams, Ointments, and Plaisters contain'd therein, are means whereof the Surgeon makes use to restore Health.
CHAP. III.
[edit]Of Anatomy in general; and in particular of all the Parts whereof the Humane Body is compos'd.
[edit]What is Anatomy?
It is the Analysis or exact Division of all the Parts of a Body, to discover their Nature and Original.
What is requisite to be observ'd by a Surgeon before he goes about to dissect a Body?
Two things; viz. The external Structure of the Body, and the Proportion or Correspondence between the outward Parts, and those that are within.
Why so?
Because without this exterior and general Knowledge, the Surgeon wou'd be often mistaken in the Judgment he is to pass concerning a Dislocation or Wound, inasmuch as it is by the Deformity which he perceives in the Member, that he knows the Dislocation, as it is also by the means of the Correspondence which the outward Parts have with the inward, that he is enabled to draw any certain Consequences relating to a Wound, which penetrates into the Body.
What is a Part?
It is that whereof the whole Body is compos'd, and which partakes of a common Life or Sensation with it.
How many sorts of Parts are there in a Humane Body?
We may well reckon up Fifteen distinct Parts, which are the Bone, the Cartilage, the Ligament, the Tendon, the Membrane, the Fibre, the Nerve, the Vein, the Artery, the Flesh, the Fat, the Skin, the Scarf-Skin, the Hair, and the Nails.
What is a Bone?
It is the hardest and driest Part of the whole Body, and that which constitutes its principal Support.
What is a Cartilage or Gristle?
It is a yielding and supple Part, which partakes of the Nature of a Bone, and is always fasten'd to its Extremities, to mollifie and facilitate its Motion.
What is a Ligament?
It is a Membranous Contexture usually sticking to the Bones to contain them; as also sometimes to other Parts, to suspend, and retain them in their proper place.
What is a Tendon?
It is the Tail or Extremity of the Muscles, made by the re-union of all the Fibres of their Body, which serves to corroborate it in its Action, and to give Motion to the Part.
What is a Membrane?
It is a Nervous Part, the use whereof is to adorn and secure the Cavities of the Body on the inside, and to wrap up or cover the Parts.
What is a Fibre?
They are fleshy Lines of which the Body of a Muscle is compos'd.
What is a Nerve?
It is a long, white, and thin Body, consisting of many Fibres, enclos'd within a double Tunick, and design'd to carry the Animal Spirits into all the Parts, to give them Sense and Motion.
What is an Artery?
It is a Canal compos'd of Four Coats, that carreyth with a kind of Beating or Pulse even to the very Extremity of the Parts, the Blood full of Spirits, which proceeds from the Heart, to distribute to them at the same time both Life and Nourishment.
What is a Vein?
It is a Canal made likewise of Four Tunicles, which receives the Arterial Blood, to carry it back to the Heart.
What is Flesh?
It is a Part which is form'd of Blood thicken'd by the natural Heat; and that constitutes the Body of a Muscle.
What is Fat?
It is a soft Body made of the Unctuous and Sulphurous part of the Blood.
What is the Derma or Skin?
It is a Net compos'd of Fibres, Veins, Arteries, Lymphatick Vessels and Nerves, which covers the whole Body to defend it from the Injuries of the Air, and to serve as a universal Emunctory: It is very thin in the Face, sticking close to the Flesh, and is pierc'd with an infinite number of imperceptible Pores, affording a Passage to insensible Transpiration.
What is the Epiderma, or Scarf-Skin?
It is a small fine Skin, transparent and insensible, having also innumerable Pores for the discharging of Sweat, and other Humours by imperceptible Transpiration: It is extended over the whole inner Skin, to dull its too exquisite Sense, by covering the Extremities of the Nerves which are there terminated. It also renders the same Skin even and smooth, and so contributes very much to Beauty.
What is the Hair?
The Hairs are certain hollow Filaments planted in the Glandules of the Skin, from whence their Nourishment is deriv'd. They constitute the Ornament of some Parts, cover those which Modesty requires to be conceal'd, and defend others from the injury of the Weather.
What is a Nail?
The Nails are a Continuity of the Skin harden'd at the end of the Fingers, to strengthen and render them fit for Work.
CHAP. IV.
[edit]Of the general Division of a Humane Body.
[edit]How is the Humane Body divided before it is dissected, in order to Anatomical Demonstration?
Some Anatomists distinguish it into Similar and Dissimilar Parts, appropriating the former Denomination to all the simple Parts of the Body taken separately, as a Bone, a Vein, a Nerve, &c. but they attribute the Name of Dissimilar to all those Members that are compos'd of many Similar or Simple Parts together; such are the Arms, Legs, Eyes, &c. wherein are contain'd all at once, Bones, Veins, Nerves, and other parts.
Others divide it into containing and contained Parts, the former enclosing the others, as the Skull includes the Brain, and the Breast the Lungs; whereas the contained Parts are shut up within others; as the Entrails within the Belly, the Brain within the Skull, &c.
Others again divide the whole Body into Spermatick and Sanguineous Parts; the former being those which are made at the time of Formation; and the latter all those that are grown afterward by the Nourishment of the Blood.
Are there not also other Methods of dividing the Humane Body?
Yes: Many Persons consider it as a Contexture of Bones, Flesh, Vessels and Entrails, which they explain in four several Treatises, whereof the first is call'd Osteology, for the Bones; the second Myology, for the Muscles; the third Angiology, for the Veins, Arteries and Nerves, which are the Vessels; and the fourth Splanchnology, for the Entrails.
But lastly, the most clear and perspicuous of all the Divisions of the Body of Man, is that which compares it to a Tree, whereof the Trunk is the Body, and the Branches are the Arms and Legs. The Body is divided into three Venters, or great Cavities, viz. the Upper, the Middle, and the Lower, which are the Head, the Breast, and the lower Belly. The Arms are distributed into the Arms properly so called, the Elbow and Hands; and the Legs in like manner into Thighs, Shanks, and Feet: The Hands being also subdivided into the Carpus or Wrist, Metacarpium or Back of the Hand, and the Fingers; as the Feet into the Tarsus, Metatarsus, and Toes. This vision is at present follow'd in the Anatomical Schools.
CHAP. V.
[edit]Of the Skeleton.
[edit]Why is Anatomy usually begun with the Demonstration of the Skeleton, or Contexture of Bones?
Because the Bones serve for the Foundation Connexion, and Support of all other Parts of the Body.
What is the Skeleton?
It is a gathering together, or Conjunction of all the Bones of the Body almost in their Natural Situation.
From whence are the principal differences of the Bones derived?
They are taken from their Substance, Figure, Articulation, and Use.
How is all this to be understood?
First then, with respect to their Substance, there are some Bones harder than others; as those of the Legs compared with those of the Back-Bone. Again, in regard of their Figure, some are long, as those of the Arm; and others short, as those of the Metacarpium. Some are also broad, as those of the Skull and Omoplatæ or Shoulder-Blades; and others narrow, as the Ribbs. But with respect to their Articulation, some are joined by thick Heads, which are received into large Cavities, as the Huckle-Bones with those of the Hips; and others are united by the means of a simple Line, as the Chin-Bones. Lastly, with relation to their Use; some serve to support and carry the whole Body, as the Leg-Bones, and others are appointed to grind the Meat, as the Teeth; or else to form some Cavity, as the Skull-Bone, and those of the Ribs.
What are the Parts to be distinguished in the Bones?
They are the Body, the Ends, the Heads, the Neck, the Apophyses, the Epiphyses, the Condyli or Productions, the Cavities, the Supercilia or Lips, and the Ridges.
The Body is the greatest Part, and the middle of the Bone; the Ends are the two Extremities; the Heads are the great Protuberances at the Extremities; the Neck is that Part which lies immediately under the Head; the Apophyses or Processes are certain Bunches or Knobs at the Ends of the Bones, which constitute a Part of them; the Epiphyses are Bones added to the Extremities of other Bones; the Condyli or Productions are the small Elevations or Extuberances of the Bones; the Cavities are certain Holes or hollow places; the Supercilia or Lips are the Extremities of the Sides of a Cavity, which is at the End of a Bone; the Ridges are the prominent and saliant Parts in the length of the Body of the Bone.
How are the Bones join'd together?
Two several ways, viz. by Articulation and Symphysis.
How many sorts of Articulations are there in the Bones?
There are generally two kinds, viz. Diarthrosis and Synarthrosis.
What is Diarthrosis?
Diarthrosis is a kind of Articulation which serves for sensible Motions.
How many kinds of Diarthroses, or great Motions are there?
There are Three, viz. Enarthrosis, Arthrodia, and Ginglymus.
Enarthrosis is a kind of Articulation which unites two Bones with a great Head on one side, and a large Cavity on the other; as the Head of the Thigh-Bone in the Cavity of the Ischion or Huckle-Bone.
Arthrodia is a sort of Articulation, by the means whereof two Bones are join'd together with a flat Head receiv'd into a Cavity of a small depth. Such is the Head of the Shoulder-Bone with the Cavity of the Omoplata or Shoulder-Blade; and that of the Twelfth Vertebra of the Back with the first of the Loins.
Ginglymus is a kind of Articulation which unites two Bones, each whereof hath at their Ends a Head and a Cavity, whereby they both receive and are received at the same time, such is the Articulation in the Bones of the Elbow and the Vertebræ.
What is Synarthrosis?
Synarthrosis being opposite to Diarthrosis, is a close or compacted Articulation, destitute of any sensible Motion.
How many sorts of Synarthroses, or close Articulations are there?
There are Three. viz. Sutura, Harmonia, and Gomphosis.
A Suture is that which joins together two Bones by a kind of Seam or Stitch, or by a Connexion of their Extremities dispos'd in form of a Saw, the Teeth whereof are reciprocally let one into another: Such are the Sutures of the Skull-Bones.
Harmonia is the uniting of two Bones by a simple Line; as the Bone of the Cheek with that of the Jaw.
Gomphosis is a kind of close Articulation, which unites two Bones after the manner of Nails or Wooden Pins fixt in the Holes made to receive them: Such is that of the Teeth in their Sockets.
What is Symphysis?
Symphysis is the uniting of two Bones by the interposition of a Medium, which ties them very streight together, being also threefold: Such is the Connexion of the Knee-Pan or Whirl-Bone of the Knee, and the Omoplata or Shoulder-Blade.
Are not these three kinds of Articulations or Symphyses distinguish'd one from another?
Yes; for tho' they are all made by the means of a third Body intervening, which joins them together; nevertheless every one of these various Bodies gives a different Denomination to its respective Articulation: Thus the Articulation which is caus'd by a Glutinous and Cartilaginous Substance, is properly call'd Synchondrosis; as that of the Nose, Chin, Os Pubis, &c. But an Articulation which is made by a Ligament is termed Synncurosis, as that of the Knee-Pan. Lastly, that which is wrought by the means of Flesh, bears the Name of Syssarcosis; as the Jaw-Bones, the Os Hyoides, and the Omoplata or Shoulder-Blade.
Have the Bones any sense of Feeling or Motion?
They have neither; for their sense of Pain proceeds from nothing else but their Periostium, or the Membrane with which they are cover'd, and their Motion is perform'd only by the Muscles that draw them.
Doth the Marrow afford any Nutriment to the Bones?
No, all the Bones are nourish'd by the Blood, as the other Parts; but the Marrow is to the Bones what the Fat is to the Flesh; that is to say, it is a kind of Oil or Unctuous Substance, which moistens, and renders them less brittle.
Are all the Bones of the same Colour?
No, they follow the Temperament and Constitution of the Persons.
How many in number are the Bones of the Humane Skeleton?
There are two hundred and fifty usually reckon'd, viz. 61 in the Head, 67 in the Trunk or Chest, 62 in the Arms and Hands, and 60 in the Legs and Feet; but the true Number cannot be exactly determin'd, by reason that some Persons have more, and others fewer; for some have more Ossa Sesamoidea, Teeth and Breast-Bones than others: Again, some have many indentings in the Lambdoidal Suture, and others have none at all.
Can you rehearse the Number of the Bones of the Head?
There are Fifteen in the Skull, and Forty six in the Face.
The Fifteen of the Skull are the Coronal for the fore-part of the Head; the Occipital for the hinder-part; the two Parietals for the upper-part and each side; the two Temporals for the Temples; the Os Sphenoides or Cuneiforme, which closeth the Basis or bottom of the Skull; the Os Ethmoides, or Cribriforme, situated at the Root of the Nose; and the four little Bones of the Ear on each side, viz. the Incus or Anvil; the Stapes or Stirrup; the Malleolus or Hammer; and the Orbiculare or Orbicular Bone.
Of the Forty six of the Face, Twenty seven are counted in the Upper-Jaw, viz. the two Zygomatick, or the two Bones of the Cheek-Knots; the two Lachrymal in the great Corners of the Eyes toward the Nose; the two Maxillar, that receive the Upper-Teeth, and which form part of the Palate of the Mouth, and the Orbits of the Eyes; the two Bones of the Nose; the two Palate-Bones which are at its end, and behind the Nostrils; the last being single is the Vomer, which makes the Division of the lower part of the Nostrils; and there are generally Sixteen Upper-Teeth. The Lower-Jaw contains Nineteen Bones, viz. sixteen Teeth; two Bones that receive them; and the Os Hyoides, which is single, and fix'd at the Root of the Tongue.
How are the Teeth usually divided with respect to their Qualities?
Into Incisive or Cutters, Canine or Dog-Teeth, and Molar or Grinders: There are eight Incisive, and four Canine, which have only one single Root; as also twenty Molar, every one whereof hath one, two, or three Roots.
Can you recite the Number of the Bones of the Trunk or Chest?
There are generally thirty and three in the Spine or Chine-Bone of the Back, viz. seven Vertebra's in the Neck, twelve in the Back, five in the Legs, five, six, and sometimes seven in the Os Sacrum, three or four in the Coccyx, and two Cartilages at its end.
There are twenty nine in the Breast, viz. twenty four Ribs, two Clavicles or Channel-Bones and commonly three Bones in the Sternum. The Hip-Bones are likewise divided into three, viz. Ilion, Ischion and Os Pubis.
Do you know the Number of the Bones of the Arms?
There are thirty and one Bones in each Arm, that is to say, the Omoplata or Shoulder-Blade; the Humerus or Shoulder-Bone; the two Bones of the Elbow call'd Ulna, and Radius; eight little Bones in the Carpus or Wrist; five in the Metacarpium or Back of the Hand; and fourteen in the Fingers, three to every one except the Thumb, which hath only two.
Can you give us a List of the Bones of the Leg in their Order?
There are thirty Bones in each Leg, viz. the Femur or great Thigh-Bone, the Knee-Pan or Whirl-Bone on the top of the Knee; the Tibia, greater Focile, or Shin-Bone; and the Perone or Fibula, or lesser Focile, which are the two associated Bones of the Leg; seven little Bones in the Tarsus; five in the Metatarsus; and fourteen in the Toes; that is to say, three to every one, except the great Toe, which hath only two.
Thus the Number of Bones of the Humane Skeleton amounts to two hundred and Fifty, without reckoning the Sesamoides, the Indentings of the Skull, and some others which are not always to be found.
CHAP. VI.
[edit]Of Myology, or the Anatomy of the Muscles of a Humane Body.
[edit]What is a Muscle?
It is the principal Organ or Instrument of Motion; or it is a Portion of Flesh, wherein there are Veins, Arteries, Nerves, and Fibres, and which is cover'd with a Membrane.
How many parts are there in a Muscle?
Three, viz. the Head, the Belly, and the Tail: The Head is that part thro' which the Nerve enters; the Belly is the Body or Middle of the Muscle; and the Tail is the Extremity, where all the Fibres of the Muscle are terminated to make the Tendon or String which is fasten'd to the Part whereto it gives Motion.
Have all the Muscles their Fibres streight from the Head to the Tail?
No, some have them streight, others transverse, and others oblique or circular, according to the several Motions to which they are appropriated.
How many sorts of Muscles are there with respecting to their Action?
There are two different kinds, viz. the Antagonists and the Congenerate; the former are those that produce opposite Motions; as a Flexor and an Extensor, a Depressor and a Levator. The Congenerate are those that contribute to one and the same Action; as when there are two Flexors or two Extensors, and then one supplies the defect of the other; whereas when one of the Antagonist Muscles is cut, the other becomes useless, and void of Action.
How is the Action of a Muscle perform'd?
It is done by Contraction and Extension; the former causeth the Antagonist to swell, and the other compels it to stretch forth in length.
What is Aponeurosis?
It is the continuity of the Fibres of a Tendon which makes a Connexion that serves to strengthen the Muscle in its Motion.
CHAP VII.
[edit]Of the Myology, or Anatomy of the Muscles of the Head.
[edit]How many Muscles are there appointed to move the Head, and which be they?
The Head is mov'd by the means of fourteen Muscles, seven on each side; of these, two serve to depress it, eight to lift it up, and four to turn it round about.
The two Depressors are call'd Sternoclinomastoidei; they take their Rise in the Sternum, at the Clavicles, and proceed obliquely to join the Apophysis Mastoides.
Of the four Elevators on each side the first is the Splenius, which begins at the five Vertebræ of the Back and the three lower ones of the Neck, and ascending obliquely, cleaves to the hinder part of the Head. The second, named Complexus or Trigeminus, having its beginning as the Splenius, sticks in like manner to the hinder part of the Head, and they form together a figure resembling that of S. Andrew's Cross. The third is the Rectus Major, which proceeding from the second Vertebra of the Neck, shoots forward to join the hinder part of the Head. The fourth is the Rectus Minor, which begins at the first Vertebra of the Neck, and ends likewise in the hinder part of the Head.
The two Muscles on each side, which move the Head circularly, are the Obliquus Major and Minor; the greater Oblique taking its rise from the second Vertebra of the Neck, goes to meet the first; but the lesser Oblique hath its Origine in the hinder part of the Head, and proceeds to join the other obliquely in the first Vertebra.
How many Muscles are there in the Lower-Jaw, and which be they?
The Lower-Jaw hath twelve Muscles which cause it to move; that is to say, six on each side, whereof four serve to close and two to open it.
The first of the Openers is the Latus, which beginning at the top of the Sternum, Clavicle, and Acromion, cleaves on the outside to the bottom of the Lower-Jaw-Bone. The second of the Openers is the Digastricus, which takes its rise in a Fissure lying between the Occipital Bone and the Apophysis Mastoides, from whence it passeth to the bottom of the Chin on the inside.
The first of the Shutters is the Crotaphites or Temporal Muscle, which hath its Origine at the bottom, and on the side of the Os Coronale, the Os Parietale, and the Os Petrosum, from whence it is extended till it cleaves to the Apophysis Coronoides of the Lower-Jaw, after having passed above the Apophysis of the Zygoma: Its Fibres are spread from the Circumference to the Center, and it is covered again with the Pericranium, which renders its Wounds very dangerous; so that the least Incisions as can be, ought to be made therein.
The second is the Pterygoideus or Aliformis Externus, whose rise is in the Apophysis Pterygoides, from whence it sets forward till it stick between the Condylus and the Coronal of the Lower-Jaw.
The third is the Masseter, which hath two Sources or Beginnings, and as many Insertions; the first Source thereof is at the Cheek-Knot or Ball of the Cheek, and the second at the lower part of the Zygoma. The first Insertion is at the outer Corner of the Jaw, and the second in the middle part, by that means forming the Figure of the Letter X.
The fourth is the Pterygoideus or Aliformis Internus, which hath its beginning in the Apophysis Pterygoides, and is terminated in the inner Corner of the Jaw; so that Mastication or Chewing is perform'd by the means of these four Muscles.
How many Muscles are there in the Face, and which be they?
There are two for the Forehead, call'd Frontal, whose Origine is in the upper part of the Head, from whence they descend by streight Fibres, until they are fasten'd in the Skin of the Forehead near the Eye-Brows, where they are re-united: Their Action or Office is to draw the Skin of the Forehead upward, whereto they stick very close.
There are also two others call'd Occipital, which have their Beginning in the same place with the preceeding, but they descend backward, and cleave to the Skin of the hinder part of the Head, which they draw upward.
There are two Muscles to each Eye-Lid, one whereof is termed the Attollens or Elevator and the other the Depressor. The Elevator takes its rise in the bottom of the Orbit of the Eye, and is fastned by a large Aponeurosis to the edge of the upper Eye-Lid. The Shutter or Depressor, call'd also the Orbicular, hath its Origine in the great Canthus, or Corner of the Eye, passeth over the Eye-Lid upward, and is join'd to the lesser Corner of the same Eye, being extended along its whole Compass.
The Eyes have each six Muscles, viz. four Recti and two Obliqui; the Recti or streight Muscles are the Elevator, the Depressor, the Adductor, and the Abductor. The first of these call'd Elevator, or Superbus, draws the Eye upward, as it is pull'd downward by the Depressor or Humilis; the Adductor or Bibitorius draws it toward the Nose, and the Abductor or Indignarorius toward the Shoulder: All these small Muscles have their Originals and Insertions in the bottom of the Orbit through which the Optick Nerve passeth, and are terminated in the Corneous Tunicle, by a very large Tendon.
The first of the Oblique ones is term'd the Obliquus Major, and the other Obliquus Minor, because they draw the Eye obliquely. These Muscles cause Children to squint when they do not act together. The Obliquus Minor is fasten'd at the outward part of the Orbit near the great Corner, and draws the Eye obliquely toward the Nose: But the Obliquus Major is fixt in the inner part of the Orbit, and ascends along the Bone to the upper part of the great Corner, where its Tendon passeth thro' a small Cartilage nam'd Trochlea, and is inserted in the little Corner with the lesser Obliquus Minor, to draw the Eye obliquely toward the lesser Corner.
The Ear, altho' not usually endu'd with any sensible Motion, nevertheless hath four Muscles, viz. one above, and three behind; the first being situated over the Temporal, and fasten'd to the Ear to draw it upward: The three others have their beginning in the Mammillary Apophysis, and are terminated in the Root of the Ear, to draw it backward.
There are also three Muscles in the inner part of the Ear, whereof the external belonging to the Malleus or Hammer lies under the exterior part of the Bony Passage which reacheth from the Ear to the Palate of the Mouth, being fixt in a very oblique Sinuosity which is made immediately above the Bone that bears the Furrow, into which is let the Skin of the Tympanum or Drum. The internal Muscle lies hid in a Bony Semi-Canal, in the Os Petrosum; one part of which Semi-Canal is without the Drum, and clos'd on the top with a Passage that leads from the Ear into the Palate. But the other part within the Drum advanceth to the Fenestra Ovalis, and is inserted in the hinder part of the Handle of the Malleus. The Muscle of the Stapes or Stirrup is also hid in a Bony Tube, almost at the bottom of the Drum, and fixt in the Head of the Stapes.
The Nose hath seven Muscles, that is to say, one common and six proper; the common constitutes part of the orbicular Muscle of the Lips, and draws the Nose downward with the Lip. Of the six proper Muscles of the Nose, four serve to dilate it, being situated on the outside, and two to contract it, which are placed in the inside.
The two first Dilatators of a Pyramidal Figure, take their rise in the Suture of the Forehead, and are fasten'd by a large Filament to the Alæ of the Nose. The two other Dilatators resembling a Myrtle-Leaf have their Source in the Bone of the Nose, and are inserted in the middle of the Ala.
The two Restrictors are Membranous, beginning in the internal part of the Bone of the Nose and adhering to the inner Ala of the Nostril.
The Lips have thirteen Muscles, viz. eight proper, and five common: Of the proper there are four for the Upper-Lip, and as many for the Lower: with two common for each, and the odd one.
The first of the proper of the Upper-Lip bears the Name of the Incisivus, its Origine being in the Jaw, in the place of the Incisive Teeth and its Insertion is in the Upper-Lip.
The second is the Triangulis, Antagonist to the former; its Rise is on the outside, at the bottom of the Lower-Jaw; and it is implanted in the Upper-Lip, near the Corner of the Mouth.
The third being the Quadratus, springs from the bottom of the Chin before, and cleaves to the edge of the Lower-Lip.
The fourth is the Caninus, Antagonist to the Quadratus, beginning in the Upper-Jaw-Bone and being terminated in the Lower-Lip near the Corner of the Mouth.
The first of the common is the Zygomaticus, the Origine whereof is in the Zygoma and its Insertion in the Corner of the Mouth, to draw it toward the Ears; so that it is the Muscle which acts when we laugh.
The second of the common is the Buccinator or Trumpeter, which is swell'd when one sounds a Trumpet. It hath its rise at the Root of the Molar Teeth of both the Jaws, and is extended quite round about the Lips.
The odd Muscle, or the thirteenth in number, is the Orbicular, which makes a Sphincter round about the Lips to close or shut them up.
The Uvula or Palate of the Mouth hath four Muscles, whereof the two first are the Peristaphylini Externi, taking their rise from the Upper-Jaw, above the Left Molar Tooth, and being ty'd to the Palate by a thin Tendon.
The two others are the Peristaphylini Interni, which have their beginning in the Apophysis Pterygoides on the inside, and likewise stick to the Palate.
The Tongue, altho' all over Musculous and Fibrous, yet doth not cease to have its peculiar Muscles, which are eight in Number.
The first of these is call'd Genioglossus, taking its rise in the lower part of the Chin, from whence it is extended till it cleave to the Root of the Tongue before, to cause it to go out of the Mouth.
The second is term'd Styloglossus, its Rise being in the Apophysis Styloides, from whence it passeth to the side above the Tongue, to lift it up.
The third bearing the Name of Basiglossus, commenceth in the Basis or Root of the Os Hyoides, and thence insinuates it self into the Root of the Tongue, to draw it back to the bottom of the Mouth.
The fourth is the Ceratoglossus, deriving its Original from the Horn of the Os Hyoides, and cleaving to the side of the Tongue to draw it on one side: The Action of these Muscles of both sides together, causeth an Orbicular Motion in the Tongue. To these some add a fifth Pair of Muscles, call'd Myloglossus, which serves to draw it obliquely upward.
What is the Action of the Os Hyoides in the Throat, and how many Muscles hath it?
The use of the Os Hyoides is to consolidate the Root of the Tongue; and it hath five Muscles on each side, which keep it as it were hung up.
The first of these, call'd the Geniohyoideus hath its beginning in the Chin on the inside, and adheres to the top of the Os Hyoides, which it draws upward.
The second is the Mylohyoideus, whose Origine is in the inner side of the Jaw, from whence it cleaves side-ways to the Root of the Os Hyoides, which it draws upward, and to one side.
The third is the Stylohyoideus, which after it hath taken its rise in the Apophysis Styloides, is fasten'd to the Horn of the Os Hyoides, to draw it toward the side.
The fourth is the Coracohyoideus, which springing up from the Apophysis Coracoides of the Omoplata, cleaves to the Root and side of the Os Hyoides, to draw it downward and to the side.
The fifth is the Sternomohyoideus, that hath its beginning in the Bone of the Sternum on the inside and is inserted in the Root of the Os Hyoides, which it draws downward.
How many Muscles hath the Larynx?
There are fourteen, viz. four Common, and ten Proper. The first Pair of the Common is the Sternothyroideus or Bronchycus, which proceeding from the inside, and the top of the Sternum, ascends along the Cartilages of the Wind-Pipe, and is terminated in the bottom of the Scutiformis or Buckler-like Cartilage, which it draws downward. The second is the Hyothyroideus, which ariseth from the Root of the Os Hyoides, and is inserted in that of the Scutiforme. This Muscle serves to lift up the Larynx, as also to dilate the bottom of the Scutiformis, and to close its top.
The first Pair of the Proper is the Cricothyroideus Anticus, which deriving its Original from the hinder and upper part of the Cricoides, or Ring-like Cartilage, is fixt in the upper and lateral part of the Scutiformis, to close or shut it up.
The second is the Thyroides.
The third is the Cricoarytenoideus Lateralis, which proceeds from the side of the Cricoides within, and is fasten'd to the bottom and side of the Arytenoides, which it removes to dilate the Mouth of the Larynx.
The fourth is the Thyroarytenoideus, which arising from the fore-part on the inside of the Scutiformis, is terminated on the side of the Arytenoides, to close the Orifice of the Larynx.
The fifth is the Arytenoideus, which having its Source in that place where the Cricoides is united to the Arytenoides is inserted in its upper and lateral part, to close the Larynx.
How many Muscles hath the Pharynx?
It hath seven, the first whereof is the Oesophagieus, which takes its rise from the side of the Scutiformis or Buckler-like Cartilage, and passing behind the Oesophagus or Gullet, is fasten'd to the other side of the Cartilage. It thrusts the Meat down by locking up the Pharynx as a Sphincter.
The second named Stylopharingæus, springs from within the Acute Apophysis of the Os Sphenoides, or Cuneiforme, and is inserted obliquely in the side of the Pharynx, which it dilates by drawing it upward.
The third, call'd Sphenopharyngæus, proceeds from the Apophysis Styliformis, and is terminated in the side of the Pharynx, which it dilates by drawing its sides.
The fourth Pair is the Cephalopharyngæus which ariseth from the articulation of the Head with the first Vertebra, and closeth the Larynx.
How many Muscles are there in the Neck, and which be they?
There are four Muscles in the Neck on each side, viz. two Flexors, and two Extensors. The Flexors are the Scalenus and the Rectus or Longus; and the Extenders are the Spinatus and the Transversalis.
The Scalenus or Triangularis hath two remote Sources, viz. one in the first Rib, and the other in the Clavicle, and is fasten'd to the third and fourth Vertebra of the Neck.
The Rectus or Longus begins in the side of the four upper Vertebra's of the Back, and is join'd to the upper Vertebra's of the Neck, and the hinder part of the Head.
The Spinatus hath its Origine in the fourth and fifth upper Vertebra's of the Back, and is fasten'd to all the six lower Vertebra's of the Neck.
The Transversalis springs forth out of the upper Vertebra's of the Back, and cleaves to the Extremity of the four Vertebra's of the Neck.
CHAP. VIII.
[edit]Of the Myology or Anatomy of the Muscles of the Chest; or of the Breast Belly, and Back.
[edit]How many Muscles are there in the Breast, and which be they?
The Breast hath fifty seven Muscles, that is to say, thirty that serve to dilate it, twenty six whose Office is to contract it, and the Diaphragm or Midriff, which partakes of both Actions.
The thirty which dilate the Breast are equally plac'd to the number of Fifteen, viz. the Subclavius, the Serratus Major Anticus, the two Serrati Postici, and the eleven external Intercostals.
The twenty six which contract the Breast are likewise equally rank'd to the Number of thirteen on each side, viz. the Triangularis, the Sacrolumbus, and eleven internal Intercostals.
The Subclavian takes up the whole space between the Clavicle and the first Rib: Its Original being in the internal and lower part of the Clavicula, and its insertion in the upper part of the first Rib.
The Serratus Major is a large Muscle having seven or eight Indentings or Jaggs. It takes its rise in the interior Basis of the Omoplata or Shoulder-Blade, and its Jaggings are inserted in the five lower true Ribs, as also in the two upper spurious Ribs.
The Serratus Posticus Superior, begins with a large Aponeurosis in the Apophyses of the three lower Vertebræ of the Neck, and of the first of those of the Back; then passing under the Rhomboid, it is join'd obliquely by four Indentings to the four upper Ribs.
The Serratus Posticus Inferior, commences in like manner with a large Aponeurosis in the Apophyses of the three lower Vertebra's of the Back, and of the first of those of the Loins, and is afterwards fasten'd by four Digitations to the four lower Ribs.
The eleven External Intercostal Muscles are situated in the spaces between the twelve Ribs passing obliquely and on the outside from the back part to the fore part. They take their rise below the Upper Rib, and have their Insertion above the lower Rib.
The Triangularis is the first of those that contract the Breast, and possesseth the inward part of the Sternum: Its Original is in its lower part, and its Insertion in the top of the Cartilages of the two upper Ribs.
The Sacrolumbus hath its Source in the hinder part of the Os Sacrum, as also in the Vertebra's of the Loins, and ascending from thence, insinuates it self into the hinder part of the Ribs, to every one of which it imparts two Tendons, one whereof sticks on the outside, and the other on the inside. This Muscle is fleshy within, and fibrous without.
The Eleven Internal Intercostals, contrary to the External, derive their Original from the top of every lower Rib, and ascend obliquely from the back-part to the fore-part, till they are join'd to the lower Lip of every upper Rib: Thus these Internal Muscles, with the External, form, by the opposition of their Fibres, a Figure resembling a Burgundian Cross.
The Diaphragm or Midriff is esteem'd as the fifty seventh Muscle of the Breast, and serves as well for its dilatation as contraction. It separates the Thorax or Chest from the lower Belly, and is tied circularly to all the Extremities of the Bastard Ribs, immediately under the Xiphoides, or Sword-like Cartilage.
Modern Anatomists have discover'd that the Diaphragm is compos'd of two Muscles, viz. one Upper, and the other Lower; so that the Upper cleaves to the Extremities of the Spurious Ribs, and is terminated in a flat Tendon in the middle, which hath been always taken for its Nervous part. The Lower begins with two Productions, the longest whereof being on the right side, ariseth from the three upper Vertebra's of the Loins, and the other on the Left from the two Vertebra's of the Back, till it is lost in the Aponeurosis of the Upper Muscle.
How many Muscles are there in the Back and the Loins, and which be they?
There are three in each side, viz. one for Flection, and the other for Extension.
The Triangularis is the Flexor, taking its rise in the hinder part of the Rib of the Os Ilion, and the inner part of the Os Sacrum, in passing from whence it is joined to the last of the Bastard Ribs, and to the transverse Productions of the Vertebra's of the Loins.
The Extensors are the Sacer, and the Semi-spinatus, which make the Waste streight, and are so interwoven along the Back-Bone, that one would imagine that there were as many Pairs of Muscles as Vertebra's, affording Tendons to all.
The Sacer springs from behind the Os Sacrum, as also from the hinder and upper Extremity of the Os Ilium, and is inserted in the Spines of the Vertebra's of the Loins and Back.
The Semi-spinatus hath its Source in the Spines of the Os Sacrum, and is join'd to all the transverse Productions of the Vertebra's from the Back to the Neck, being exactly situated between the Sacer and the Sacrolumbus.
CHAP. IX.
[edit]Of the Myology, or Anatomy of the Muscles of the lower Belly.
[edit]How many Muscles are there in the lower Belly, and which be they?
There are generally ten, five on each side, that is to say, two Obliqui, one ascending, and the other descending; one Transversus, one Rectus, and two Pyramidal, of which last, nevertheless, there is sometimes only one, and sometimes none at all.
The Obliquus Descendens, which is the first, hath its Original by digitation in the sixth and seventh of the true Ribs, in all the spurious Ribs, and in the transverse Apophyses of the Vertebra's of the Loins, and comes near to the Serratus Major Anticus of the Breast; from whence it proceeds to the external Rib of the Os Ilion, and is terminated by a large Aponeurosis in the Linea Alba or White Line, which separates the Muscles that are on each side of the Abdomen or lower Belly.
The Obliquus Ascendens ariseth from its Source in the upper part of the Os Pubis, and in the Ridge of the Hip-Bone, till it cleaves to the Apophyses of the Vertebra's of the Loins in the Extremities of all the Ribs, and in the Xiphoides or Sword-like Cartilage, and is terminated in the White Line by a large Aponeurosis.
The Rectus being situated between the Aponeuroses of the Obliquus, takes its rise in the Cartilages of the Ribs, in the Xiphoides and the Sternum, and enters into the Os Pubis, having many nervous parts to corroborate it in its length.
The Transversus having its beginning in the transverse Apophyses of the Vertebra's of the Loins, is fasten'd to the internal Rib of the Os Ilium, and within the Cartilages of the lower Ribs, and is terminated by a large Aponeurosis in the Linea Alba, passing over the Rectus, and sticking to the Peritonæum.
The Oblique Muscles, and the Transverse, have Holes toward the Groin, to give Passage to the Spermatick Vessels of Men, and to a round ligament of the Matrix in Women; so that Ruptures or Burstenness happen through these parts in both Sexes, although the Holes of these three Muscles are not situated one over-against another.
The Pyramidal, so named by reason of its Figure, is situated in the lower Tendon of the Rectus, its Origine being in the upper and external part of the Os Pubis; but it is terminated in the White Line, three Fingers breadth above the Pubes, and sometimes even in the Navel itself. These Muscles are not found in all Bodies for there are sometimes two, sometimes only one, and sometimes none.
The use of the Muscles of the lower Belly is to compress all the contain'd parts, in order to assist them in expelling the Excrements.
How many Muscles are there in the Testicles?
They have each of them one, call'd Cremaster; this Muscle takes its rise from the Ligaments of the Os Pubis, and by the dilatation of its Tendon covers the Testicle, which it draws upward.
How many Muscles hath the Penis?
It hath two Pair, viz. the Erectores or Directores, and the Dilatantes: The Erectores arise from the internal part of the Os Ischion, under the beginning of the Corpora Cavernosa, where they are inserted, and retake their Fibres in their Membranes. The Dilatantes or Acceleratores have their Source in the Sphincter of the Anus and slipping from thence obliquely under the Ureter, are join'd to the Membrane of the Nervous Bodies.
How many Muscles are there in the Clitoris?
It hath two Erectors which spring forth from the Protuberance of the Os Ischion, and are inserted in the Nervous Bodies of the Clitoris. There are also two others suppos'd to be its Elevators, which proceed from the Sphincter of the Anus, and are terminated in the Clitoris.
How many Muscles are there in the Anus?
There are three, viz. the Sphincter, and two Levatores. The Sphincter is two Fingers broad, to open and close the Rectum. This Muscle being double, is fasten'd in the fore-part to the Penis in Men, and to the Neck of the Matrix in Women, as also behind to the Coccyx, and laterally to the Ligaments of the Os Sacrum, and the Hips.
The two Levatores arise from the inner and lateral part of the Os Ischion, and are fasten'd to the Sphincter of the Anus, to lift it up after the expulsion of the Excrements.
The Bladder hath also a Sphincter Muscle to open and shut its Orifice.
CHAP. X.
[edit]Of the Muscles of the Omoplatæ, or Shoulder-Blades, Arms, and Hands.
[edit]How many ways doth the Omoplata or Shoulder-Blade move, and what are its Muscles?
The Omoplata moves upward, downward, forward, and backward, by the means of four proper Muscles, which are the Trapezius, the Rhomboides, the proper Levator, and the lesser Pectoral, or Serratus Minor Anticus.
The Trapezius or Cucullaris hath its beginning in the back part of the Occiput, or hinder part of the Head, in the Spines of the six lower Vertebra's of the Neck, and of the nine upper of the Back, in passing from whence it is implanted in the Spine of the Omoplata or Shoulder-Blade, and the external part of the Clavicula, as far as the Acromion. This Muscle produceth many Motions by reason of its different Fibres, drawing the Shoulder-Blade obliquely upward, downward, and forward.
The Rhomboides is situated over the Trapezius, its rise being in the Apophyses of the three lower Vertebra's of the Neck, and of the three upper of the Back, but it is afterward join'd to the whole Basis or Root of the Omoplata, which it draws backward.
The proper Levator commenceth in the Transverse Apophyses of the four first Vertebra's of the Neck, by different Progressions, but is afterward re-united, and inserted in the upper Corner of the Omoplata, which it draws upward.
The lesser Pectoral, or Serratus Minor Anticus, is situated under the great Pectoral, its rise being by Digitation or Indenting in the second, third, and fourth of the upper Ribs, and its Insertion in the Apophysis Coracoides of the Shoulder-Blade, which it draws forward.
How many Motions are there in the Humerus, or Arm; which be they, and what are its Muscles?
The Arm performs all sorts of Motions by the help of nine Muscles: For it is lifted up by the Deltoides and the Infra-Spinatus; it is depress'd by the Largissimus, and the Rotundus Major; it is drawn forward by the Pectoralis Major, and the Coracoideus; it is drawn backward by the Infra-Spinatus, and the Rotundus Minor. It is drawn near the Ribs by the Subscapularis, and its circular Motion is performed when all these Muscles act together successively.
The Deltoides or Triangular hath its beginning in the whole Spine of the Omoplata, the Acromion, and half the Clavicula, and by its point cleaves with a strong Tendon to the middle of the Arm.
The Infra-Spinatus takes its rise in the Cavity that lies above the Spine of the Omoplata, which it fills, passing over the Acromion, until it is join'd to the Neck of the Shoulder-Bone, which it surrounds with a large Tendon.
The Largissimus, otherwise call'd Ani-scalptor, covers almost the whole Back, proceeding from a large and Nervous Stock, in the third and fourth lower Vertebra of the Back, the five Vertebra's of the Loins, the Spine of the Os Sacrum, the hinder part of the Lip of the Hip-Bone, and the external part of the lower Bastard-Ribs, in passing from whence it insinuates it self into the lower Corner of the Omoplata, as also into the upper and inner part of the Humerus.
The Rotundus Major, or Teres Major, having its Origin in the external Cavity of the lower Corner of the Omoplata, is confounded with the Largissimus, and adheres with it by the same Tendon to the upper and inner part of the Humerus, a little below the Head.
The greater Pectoral hath its Source in half the Clavicula, on the side of the Sternum; covers the fore-part of the Breast, and is fasten'd by a short, broad, and nervous Tendon, to the top of the Shoulder-Bone, on the inside, between the Biceps and the Deltoides.
The Coracoideus or Coracobrachyæus, beginning in the Apophysis Coracoides of the Omoplata or Shoulder-Blade, adheres to the middle of the Arm on the inside, which with the Pectoral it draws forward.
The Infra-Spinatus fills the Cavity which lies below the Spine of the Omoplata, its Origine being in the lower Rib of the Omoplata, from whence it passeth between the Spine and the Rotundus Minor, to cleave to the Neck of the Shoulder-Bone, which it embraceth, and draws backward.
The Rotundus Minor, or Teres Minor, proceeds from the lower Rib of the Omoplata, and adheres to the Neck of the Shoulder-Bone with the Infra-Spinatus to draw it in like manner backward.
The Sub-scapularis or Immersus is situated entirely under the Omaplata, proceeding from the internal Lip of the Basis or Root of the same Omoplata, and being terminated in the Neck of the Arm-Bone, which it causeth to lie close to the Ribs.
How many Motions are there in the Cubitus or Elbow, and what are its Muscles?
The Cubitus or Ulna is endu'd with two sorts of Motions, viz. that of Flection and that of Extension, the former being perform'd by the help of two Muscles, that is to say, the Biceps, and the Brachiæus Internus; and the later by eight others, which are the Longus, the Brevis, the Brachiæus Externus, and the Anconeus.
The Biceps is a Muscle with two Heads, one whereof proceeds from the Apophysis Coracoides, and the other from the Cartilaginous edge of the Glenoid Cavity of the Omoplata or Shoulder-Blade: These two Heads descend along the fore-part of the Arm, and are united in one and the same Body, from whence springs forth a Ligament, which is inserted in a tuberosity situated in the upper and fore-part of the Radius.
The Brachiæus Internus is a small fleshy Muscle, lying hid under the Biceps, which takes its rise in the upper and fore-part of the Humerus, and is implanted in the upper and inner-part of the Radius, to bend the Elbow with the Biceps.
The first of the four Extenders is the Longus having two Sources, viz. one situated in the lower Rib of the Omoplata, near its Neck, and the other descending to the hinder-part of the Arm, till it is tyed to the Olecranum or Ancon, by a strong Aponeurosis, which is common thereto, with the Brevis, and the Brachiæus Externus.
The Brevis or short Muscle of the Elbow arising from the hinder and upper-part of the Humerus, is fasten'd to the Olecranum with the Longus.
The Brachiæus Externus is a fleshy Muscle which proceeds from the hinder part of the Humerus, and adheres to the Olecranum with the Brevis and the Longus.
The Anconeus or Cubitalis being situated behind the Fold of the Cubitus, is the least Muscle of all; it springs from the Extremity of the Arm-Bone, at the end of the Brevis and the Longus, and in descending is inserted between the Radius and the Cubitus or Ulna, three or four Fingers breadth below the Olecranum.
How many Muscles hath the Radius, and which are its Motions?
The Radius is endu'd with a twofold Motion by the means of four Muscles: Of these the Rotundus and Quadratus cause that of Pronation, as the Longus and the Brevis that of Supination.
The Pronator Superior Rotundus, or round Muscle of the Radius, commenceth from the inner Apophysis of the Shoulder-Bone, in a very fleshy Stock, and is terminated obliquely by a Membranous Tendon in the middle and exterior part of the Radius.
The Pronator Inferior Quadratus, springing forth from the bottom and inside of the Cubitus, is fixt in the lower and outward part of the Radius by a Tail as large as its Head. This Muscle lying hid under the others near the Wrist, is that which jointly with the Rotundus, turns the Arm with the Palm of the Hand downward, which is the Motion of Pronation.
The Longus is the first of the Supinators, whose Origine is three or four Fingers breadth above the external Apophysis of the Arm-Bone; from whence it passeth along the Radius, and cleaves to the inner-part of its lower Apophysis.
The Brevis, or the second of the Spinators arising from the lower part of the Inferior Condylus, and the external of the Humerus, is twisted round about the Radius, going forward from the hinder-part till it is united to its upper and forepart. This Muscle, with the Longus, serves to turn the Arm and the Palm of the Hand upward, and produceth the Motion of Supination.
How many sorts of Motions belong to the Wrist, and what are its Muscles?
Two several Motions are perform'd by the Wrist, viz. one of Flection, and the other of Extension, three Muscles being appropriated to the former, and as many to the later: But it ought to be observed, that a strong Ligament, call'd the Annular, appears here, which, surrounding all the Tendons of the Muscles as it were a Bracelet, holds them together, and elsewhere serves to unite the two Bones of the Elbow. The three Flexors or Bending Muscles of the Wrist are the Cubitæus Internus, the Radiæus Internus, and the Palmaris.
The Cubitæus Internus derives its Original from the part of the Arm-Bone, passeth under the Annular Ligament, and is ty'd by a thick Tendon to the small Bone of the Wrist, which is plac'd above the others.
The Radiæus Internus proceeds from the same place with the Cubitæus, and is fasten'd to the first Wrist-Bone which supports the Thumb. It lies along the Radius, and passeth under the Annular Ligament.
The Palmaris is reckon'd among the Flexors of the Wrist, although situated in the Palm of the Hand. It ariseth from the inner Process or Knob of the Arm-Bone, and is united by a large Tendon to the first Phalanges of the Fingers, slipping under the Transverse or Annular Ligament and sticking under the Skin of the Palm of the Hand.
The three extending Muscles of the Wrist are the Cubitæus Externus, and the Radiæus Externus or the Longus, and the Brevis.
The Cubitæus Externus taking its rise from the hinder-part of the Elbow, passeth under the Annular Ligament, and adheres to the upper and outward-part of the Bone of the Metacarpus that stayeth the little Finger.
The Radiæus Externus, or the Longus, having its Origine in the edge of the lower part of the Arm-Bone, slides from thence along the Radius on the outside, extends it self under the Annular Ligament, and cleaves to the Wrist-Bone, which stayeth the Fore-Finger.
The Brevis or short Muscle of the Wrist springs from the lower part of the same Edge; afterwards it runs along the Radius, passeth under the Annular Ligament, and is terminated in the Bone of the Carpus or Wrist, which stayeth the Middle Finger. But we must take notice, that besides these six Muscles, there is also Caro quædam quadrata, or a square piece of Flesh under the Palmaris, which seems to arise from the Thenar, and sticks to the eighth Wrist-Bone. It is supposed that this Musculous piece of Flesh serves with the Hypothenar of the little Finger, to make that which is call'd Diogenes's Cup.
How many Motions are there in the Fingers, and what are their Muscles?
The Fingers are bent, extended, and turn'd from one side to the other by the means of twenty-three Muscles, whereof ten are proper, and thirteen common: The former are those that serve all the Fingers in general, and the other those that are particularly serviceable to some of them: The Common are the Sublimis, the Profundus, the common Extensor, the four Lumbricales, and the six Interossei.
The Sublimis or Perforatus, arising from the internal part of the lower Process of the Humerus or Shoulder-Bone is divided into four Tendons, which run below the Annular Ligament of the Wrist, and are inserted in the second Phalanx of the Bones of the four Fingers, after having stuck in passing to those of the first Phalanx, to help to bend it. It is also observed that every one of these Tendons hath a small cleft in its length, to let in the Tendons of the Profundus.
The Profundus or Perforans lies under the Sublimis, deriving its Original from the top of the Cubitus and Radius. It creeps along these two Bones, and is divided into four Tendons, which pass under the Annular Ligament, and slip into the Fissures of the Tendons of the Sublimis, to adhere to the third Phalanx of the Fingers, which they bend with the Sublimis: So that these two Muscles make together the bending of the Fingers.
The Extensor Magnus is that which extends the four Fingers. It springs from the external and lower Process of the Arm-Bone, and is divided into four flat Tendons, which pass under the Annular Ligament, and cleave to the second and third Phalanx of the Fingers.
The four Lumbricales or Vermiculares are in the Palm of the Hand, to draw the Fingers to the Thumb: They proceed from the Tendons of the Profundus, and the Annular Ligament, extend themselves along the sides of the Fingers and are inserted in their second Articulation, to cause the drawing toward the Thumb.
The three Interossei Interni, and the three Externi, are situated between the four Bones of the Metacarpium, as well on the inside of the Hand as without: They have their beginning in the Intervals or Spaces between the Bones of the Metacarpium, are united with the Lumbrical, and fixt in the last Articulation of the Bones of the Fingers, to produce the Motion of drawing back or removing from the Thumb.
The Thumb is mov'd by five particular Muscles; one whereof serves to bend it, two to extend it, one to remove it from the Fingers, and another to draw it to them.
The Flexor of the Thumb takes its rise from the upper and inner part of the Radius, passes under the Annular Ligament, as also under the Thenar, and adheres to the first and second Bones of the same Thumb to bend it.
The two Extensors of the Thumb are the Longior and the Brevior: The former proceeding from the upper and outward part of the Cubitus, ascends above the Radius, and is ty'd with a forked Tendon to the second Bone of the Thumb. The Brevior hath the same Origin with the Longior, keeps the same Track, passes under the Annular Ligament, and is terminated in the third Thumb-Bone.
The Thenar removes the Thumb from the Fingers, and forms that part which is call'd the Mount of Venus: It hath its Source in the first Bone of the Carpus or Wrist, and the Annular Ligament, and is inserted in its second Bone.
The Antithenar draws the Thumb to the other Fingers, having its Origine in the Bone of the Metacarpus, that stayeth the middle Finger, and its Insertion is in the first Bone of the Thumb.
The Muscle which serves to extend the Fore-Finger, is call'd Indicator: It proceeds from the middle and outer part of the Cubitus, and is fixt by a double Tendon in the second Articulation of the Fore-Finger, as also in the Tendon of the great Extensor of the Fingers.
That which draws the Fore-Finger to the Thumb is term'd Adductor: It commenceth in the fore-part of the first Thumb-Bone, and is terminated in the Bones of the Fore-Finger.
That which removes the Fore-Finger from the Thumb is known by the Name of Abductor, which arising out of the external and middle part of the Bone of the Elbow, and passing under the Annular Ligament, cleaves to the Lateral and outward part of the Bones of the Fore-Finger.
The Little-Finger hath two proper Muscles, viz. an Extensor and an Abductor.
The Extensor springs from the lower part of the Condylus of the Arm-Bone, and is fasten'd by a double Tendon in the second Articulation of the Little-Finger, and in the Tendon of the Extensor of all the others.
The Abductor, call'd also Hypothenar, hath its beginning in the small Bone of the Wrist, which is situated over the others, and is terminated in the first Bone of the Little-Finger on the outside.
CHAP. XI.
[edit]Of the Muscles of the Thighs, Legs, and Feet.
[edit]What are the Motions of the Thighs?
The Thigh performs five kinds of Motions; for it is bent, extended, drawn within side and without, and turn'd round: All these Motions are produc'd by the means of fourteen Muscles, viz. three Flexors, three Extensors, three Adductors, three Abductors, and two Obturators for the Circular Motion.
The Flexors of the Thigh are the Psoas, Iliacus, and Pectineus.
The Psoas or Lumbaris is situated inwardly in the Abdomen, on the side of the Vertebra's. It proceeds from the transverse Apophyses of the two lower Vertebra's of the Back, and of the upper of the Loins, and lying on the inner Face of the Os Ilion, sticks to the lesser Trochanter or Rotator.
The Iliacus Internus hath its Origine in all the Lips of the inner Cavity of the Os Ilion, and being joyn'd by a Tendon to the Lumbaris, is inserted with it in the lesser Trochanter.
The Pectineus takes its rise from the fore-part of the Os Pubis, and is united before to the Thigh-Bone a little below the lesser Trochanter.
The Extensors of the Thigh are the Glutæus Major, Medius, and Minimus.
The Glutæus Major springs forth out of the lateral part of the Os Sacrum, as also the hinder and outer part of the Os Ilion and Coccyx, and enters into the Thigh-Bone, four Fingers breadth below the great Trochanter or Rotator, being the thickest of all the Muscles of the Body.
The Glutæus Medius, deducing its Original from the hinder and outward part of the Os Ilion, is inserted three Fingers breadth below the great Trochanter.
The Glutæus Minimus ariseth from the bottom of the Cavity of the Os Ilion, and is fasten'd to a small Hole near the great Trochanter.
The Adductors of the Thigh are the Triceps Superior, Medius, and Inferior.
The Triceps Superior hath its beginning in the top of the Os Pubis, and is terminated in the top of a Line, which is on the inside of the Thigh.
The Triceps Medius proceeding from the middle of the Os Pubis, is inserted in the Thigh-Bone a little lower than the Triceps Superior.
The Triceps Inferior hath its Source in the bottom of the Os Pubis, and is implanted in the Thigh-Bone, a little lower than the Triceps Medius. Some Anatomists make only one Muscle of these three, attributing thereto three Originals and three Insertions. These Muscles serve to draw the Thighs one against another.
The Abductors of the Thigh are the Iliacus Externus, or Pyriformis, the Quadratus, and the Gemelli.
The Pyriformis arising from the upper and lateral part of the Os Sacrum, and the the Os Ilion cleaves to the Neck of the great Trochanter.
The Quadratus or square Muscle of the Thigh takes its Origine from the external Prominence of the Os Ischion, and adheres to the outward part of the great Trochanter.
The Gemelli or Twin Muscles arise from two small Knobs in the hinder-part of the Ischion and insinuate themselves into a small Cavity in the Neck of the great Trochanter.
The Circular Motion of the Thigh is performed by the means of two Muscles, named the Obturatores Externi and Interni.
The Obturator Internus springs from the inner Circumference of the Oval Hole of the Ischion and its Tendons passing between the two Gemelli are inserted in a small Cavity at the Root of the great Trochanter or Rotator.
The Obturator Externus ariseth from the outward Circumference of the same Hole of one Ischion, and is terminated in the side of the other near the great Trochanter.
What are the Motions of the Leg, and what are its Muscles?
The Leg is mov'd four several ways, that is to say, it is bent, extended, and drawn inward and outward, by the means of eleven Muscles viz. three Flexors, four Extensors, two Adductors and two Abductors.
The three Flexors of the Leg are the Biceps, the Semi-nervosus, and the Semi-membranosus.
The Biceps hath two Heads, the longer whereof cometh out of the bottom of the Prominence of the Ischion, and the other from the middle and exterior part of the Femur, and is terminated in the outward and upper part of the Epiphysis of the Perone or Fibula.
The Semi-nervosus hath its Origine in the Knob of the Ischion, and is join'd backward to the top of the Epiphysis of the Tibia. These three Muscles are plac'd in the back-part of the Thigh below the Buttocks.
The four Extensors of the Leg are the Rectus, the Vastus Internus, the Vastus Externus, and the Crureus.
The Rectus or streight Muscle of the Leg takes its rise from the fore-part and the bottom of the Ilion, and descends in a right Line: It covers with its Tendon, which is common to the three following, the whole Knee-Pan, and adheres to the top of the Tibia, on the fore-part.
The Vastus Internus, being situated on the inside of the Thigh, hath its beginning in the top of the Thigh inwardly, and a little below the lesser Trochanter or Rotator: Afterward it is ty'd to the Tibia by a large Tendon, common thereto with the preceeding.
The Vastus Externus is plac'd on the outside of the Thigh, springing from the top and the fore-part of the Femur, being united by the same Tendon with the two preceeding.
The Crureus proceeds from the top, and the fore-part of the Thigh-Bone, between the two Trochanters; then covering the whole Bone, it is also fasten'd to the Leg-Bone with the three preceeding Muscles, after having cover'd the Knee-Pan with their common Tendon, which serves likewise as a Ligament to the Knee.
The two Adductors of the Leg are the Sartorius and the Gracilis.
The Sartorius or the Longissimus draws the leg inward, deriving its Original from the upper Spine of the Ischion; from whence it descends obliquely thro' the inside of the Thigh, and cleaves to the top on the inside of the Tibia.
The Gracilis hath its Origine in the fore-part at the bottom of the Os Pubis, and its Insertion in the top of the Tibia on the inside.
The two Abductors of the Leg are the Fascia lata, and the Poplitæus.
The Fascia lata, or the Membranosus, is as it were a kind of large Band, which covers all the Muscles of the Thigh. It proceeds from the outward Lip of the Os Ilion, is ty'd by a large Membrane to the top of the Perone or Fibula and sometimes descends to the end of the Foot.
The Poplitæus, or Sub-poplitæus, arises from the lower and external Condylus of the Thigh-Bone, passeth obliquely from the outside to the inside, till it is lost in the upper and inner part of the Leg-Bone under the Ham.
What are the Motions of the Foot, and what are its Muscles?
The Foot performs two Motions by the help of nine Muscles, as being bent by two, and extended by seven.
The two Flexors are the Crureus Anticus, and the Peronæus Anticus.
The Crureus or Tibiæus Anticus, is plac'd along the Tibia, and takes its rise from its upper and fore-part: Afterward it is bound by two Tendons to the first Os Cuneiforme, or Wedge-like Bone, and to that of the Metatarsus or Instep, which stayeth the great Toe, after having pass'd under the annular Ligament.
The Peronæus Anticus springs from the middle and outward-part of the Perone or Fibula, and insinuating it self thro' the Cleft which is under the external Malleolus before, sticks to the Bone of the Metatarsus that supports the little Toe.
The seven Extensors of the Foot are the two Gemelli, or the Soleus, the Plantaris, the Crureus Posticus, and the two Peronæi Postici.
The Gemelli are the Interior and the Exterior; the former having its Source in the inner Condylus, and the other in the outward and lower of the Thigh-Bone; from whence they extend themselves till they are fasten'd to the Talus or Ankle-Bone by a Tendon common to them, with the two following.
The Soleus ariseth from the top on the back-part of the Leg-Bone and Perone, and confounding its Tendon with that of the Gemelli, sticks close to the Talus.
The Plantaris, which lies hid between the Gemelli and the Soleus, hath its Origine from the Exterior Condylus of the Thigh-Bone; then uniting its Tendon with the preceeding, it adheres to them; and this common Tendon is call'd Chorda Achillis.
The Crureus or Tibiæus Posticus, springs from the back-part of the Leg-Bone, from whence extending it self downward, it passeth thro' the Fissure in the Internal Malleolus, and cleaves to the inner-part of the Os Scaphoides.
The Peronæi, or Fibulæi Postici, are otherwise call'd the Longus and the Brevis, whereof one proceeds from the upper and almost fore-part of the Perone, terminating in the upper-part of the Bone, that supports the great Toe in the Metatarsus, and the other from the lower part of the Perone, adhering in like manner to the Bone with which the little Toe is sustain'd.
With what Motions are the Toes endu'd, how many Muscles have they, and which be they?
The Toes are bent and extended, as also drawn inward and outward, by the means of twenty two Muscles, of which sixteen are Common, and six Proper. The former are two Flexors, two Extensors, four Lumbricales, and eight Interossei. The first Flexor is nam'd Sublimis, and the other Profundus.
The Sublimis or Perforatus derives its Original from the lower and inner-part of the Talus and is fixt in its proper place by four cleft Tendons, which are inserted in the upper-part of the Bones of the first Phalanx of the four Toes. It is situated under the Sole of the Feet.
The Profundus or Perforans hath its beginning in the top and back-part of the Leg-Bone and Perone, slips under the Malleolus Internus thro' the Sinus Calcaris, and makes four Tendons which pass thro' the Fissures of the Tendon of the Sublimis, and cleaves to the Bones of the last Phalanx of the Toes, to bow them.
The first Extensor is call'd the Common, and the other the Pediæus.
The Common Extensor, or the Longus, takes its rise from the top and fore-part of the Tibia in the place of its joyning with the Perone or Fibula, and divides it self into four Tendons, which after having pass'd under the Annular Ligament, are inserted in the Articulations of every Toe.
The Pediæus or the Brevis, being plac'd over the Foot, proceeds from the Annular Ligament, and the lower-part of the Perone, and sends forth four Tendons, which are fixt to the first Articulation of the four Toes on the outside, Thus this Muscle, together with the Longus, causeth their Extension.
The four Lumbrical Muscles of the Toes arise from the Tendons of the Profundus, and a Mass of Flesh at the Sole of the Feet. They are joyn'd by their Tendons with those of the Interossei Interni, and adhere inwardly to the side of the first Bones of the four Toes, to incline them toward the great Toe.
The Abductors, or those Muscles that remove the Toes from the great Toe, are the eight Interossei, whereof four are call'd Externi, and as many Interni. The former take their rise in the Spaces between the Bones of the Metatarsus, and are terminated outwardly in the side of the first Bones of the Toes. The Internal lie in the bottom of the Foot, and take up the Spaces between the five Bones of the Metatarsus. They arise from the Bones of the Tarsus, and the Intervals between those of the Metatarsus, and are implanted with the four Lumbricales inwardly, in the upper-part of the Bones of the first Phalanx of the four Toes.
Of the six Proper Muscles of the Toes, there are four appointed for the great Toe, which cause it to perform the Motions of Flexion, Extension, and drawing forward or backward. The two others are the Adductor of the second Toe to the great Toe, and the Abductor of the little Toe, call'd Hypothenar.
The Proper Flexor of the great Toe, arises from the top of the Perone or Fibula, on the back part, passeth thro' the Ancle-Bone on the inside to the sole of the Foot, and is fasten'd to the Bone of the last Phalanx.
The Proper Extensor of the great Toe springs from the middle of the fore-part of the Perone, passeth over the Foot, and hath its Insertion in the upper-part of the Bone of the great Toe.
The Proper Adductor of the great Toe, or the Thenar, taking its rise inwardly on the side of the Talus, the Ossa Schaphoidea and Innominata, extends it self over the outward-part of the Bone of the Metatarsus, which stayeth the great Toe, and adheres to the top of the second Bone of the great Toe, which it draws inward.
The proper Abductor of the great Toe, or the Antithenar, draws it toward the other Toes. It derives its Origine from the Bone of the Metatarsus, which supports the little Toe, slides obliquely over the other Bones, and cleaves to the first Bone of the great Toe on the inside.
The Adductor appropriated to the second Toe hath its Source in the first Bone of the great Toe, on the inside, and sticks close to the Bones of the second Toe, which it draws to the great Toe.
The Abductor of the little Toe, or the Hypothenar, proceeds from the outward part of the Bone of the Metatarsus, that stayeth the little Toe, and is inserted in the top of the little Toe, on the outside, to remove it from the others.
| A List of all the Muscles in the Humane Body. | |
| The Fore-head hath two Muscles | 2 |
| The hinder-part of the Head | 2 |
| The Eye-Lids | 4 |
| The Eyes | 12 |
| The Nose | 7 |
| The Ears on the outside | 8 |
| The Ears on the inside | 6 |
| The Lips | 13 |
| The Tongue | 8 |
| The Uvula, or Palate of the Mouth | 4 |
| The Larynx | 13 |
| The Pharynx | 7 |
| The Os Hyoides | 10 |
| The Lower Jaw | 12 |
| The Head | 14 |
| The Neck | 8 |
| The Omoplatæ or Shoulder-Blades | 8 |
| The Arms | 18 |
| The Elbows | 12 |
| The Radii | 8 |
| The Wrists | 12 |
| The Fingers | 48 |
| The Breast, or the Parts of Respiration | 57 |
| The Loins | 6 |
| The Abdomen or lower Belly | 10 |
| The Testicles | 2 |
| The Bladder | 1 |
| The Penis | 4 |
| The Clitoris | 4 |
| The Anus | 3 |
| The Thighs | 30 |
| The Legs | 22 |
| The Feet | 18 |
| The Toes | 44 |
| Total 425 | |
CHAP. XII.
[edit]Of the Anatomy of the Nerves, Arteries, and Veins in general.
[edit]What is the Structure of the Nerves?
The Nerves are round white Bodies enclos'd in a double Membrane, communicated to them from the two Meninges of the Brain: Their Office is to convey the Animal Spirits into all the Parts.
Where is the Root and first beginning of all the Nerves?
All the Nerves take their Original from the Medulla Oblongata, and that of the Spine.
How is the distribution of them made thro' the whole Body?
It is directly perform'd by Conjugations or Pairs, whereof one goes to the Right-hand, and the other to the Left: There are nine Pairs of them that proceed from the Medulla Oblongata and enter into the Skull; and a Tenth that comes from the Marrow which lies between the Occipital and the first Vertebra of the Neck. It passeth thro' the Hole of the Dura Mater, thro' which the Vertebral Artery enters, to distribute its Branches into several Parts.
To what Use are the nine Pairs of Nerves appropriated, which proceed from the Root of the Brain?
They are chiefly design'd for the Senses, and also for the Motion of their Organs, of which the Ancients discover'd only seven.
The first Pair of Nerves is call'd the Olfactory, and serves for the Smelling.
The second Pair is the Optici or Visorii Nervi, and bestows upon the Eyes the Faculty of seeing.
The third is term'd Motorii Oculorum, being serviceable for the Motion of the Eyes.
The fourth Pair is nam'd Oculorum Pathetici, which shews the Passion of the Mind in the Eyes, whereto it imparts a String as well as to the Lips.
The fifth is call'd the Gustative, and appropriated to the Taste, because it sends Twigs more especially to the Tongue, as also to the Fore-head, Temples, Face, Nostrils, Teeth, and Privy-Parts.
The Sixth is likewise for the Taste, and goes to the Palate.
The seventh is the Auditive Nerve, that enters into the Os Petrosum, where it divides it self into many Branches, which when gone forth, are distributed to the Muscles of the Tongue, Lips, Mouth, Face, Fore-head, Eye-Lids, &c.
The eighth is the Os Vagum, or wandering Pair, which is united to the Intercostal Nerve, as also to the Recurrent, Diaphragmatick, Mesenterick, &c.
The ninth Pair, after having form'd a Trunk with the eighth, disperseth its Twigs several ways, whereof one is join'd with the Twig to the tenth, to be distributed together into the Muscle Sternohyoideus, and into the Tongue.
The Intercostal and Spinal are not Pairs of Nerves, but only Branches or Twigs of other Pairs.
What is the Distribution and Use of the thirty Pairs of Nerves that proceed from the Spinal Marrow?
There are seven that go forth from the several Vertebra's of the Neck, twelve from those of the Back, five from the Loins, and six from the Os Sacrum, according to the following Progression.
The first of the seven Pairs of Nerves of the Neck proceeds from between the Occipital Bone and the first Vertebra, nam'd Atlas, its Fibres being lost in the Muscles of the hinder-part of the Head and Neck.
The second Pair springs from between the first and second Vertebra of the Neck; the Fibres whereof are lost in the Muscles of the Head, and in the Skin of the Face.
The third Pair issueth from between the second and third Vertebra of the Neck; and its Fibres are lost in the Flexor Muscles and Extensors of the Neck.
The fourth, fifth, sixth, and seventh Pairs proceed from between the Vertebra's, as before, but their Fibres are lost in the Neck of the Omoplata, in the Arm, and in the Diaphragme or Midriff. Here it ought to be observ'd by the way that the Arms receive Branches not only from the four last Pairs of the Nerves of the Neck, but also from the two first Pairs of the Back, which are extended even to the end of the Fingers: Whence it happens that in the Palsie of the Arms, Remedies are usually apply'd to the Vertebra's of the Neck; and that in Phlebotomy or letting Blood, care must be taken to avoid pricking the Nerve, which accompanies the Basilick Vein in the Elbow.
The twelve Pairs of Nerves that have their Beginning from between the Vertebra's of the Back, are each of them divided into two Branches, as the others; and their Branches are distributed in like manner to the Muscles of the Breast, and to those of the Back and Abdomen.
The five Pairs which take their Rise from between the Vertebra's of the Loins, have thicker Branches than the others, and the distribution of them is made to the Muscles of the Loins, Hypogastrium, and Thighs.
Of the six Pairs of Nerves that proceed from the Os Sacrum, the four Upper with the three Lower of the Loins, send forth Fibres of Nerves to the Thigh, Leg, and Foot; and the two last Pairs impart Nerves to the Anus, Bladder, and privy Parts.
What is the Structure of the Arteries?
The Arteries are long and round Canals, consisting of four sorts of Tunicks or Membranes, which have their Rise from the left Ventricle of the Heart, from whence they receive the Blood, and convey it to all the Parts of the Body for their Nourishment.
What is the Construction of these four Tunicks or Membranes of the Arteries?
The first being thin and Nervous in its outward Superficies, is in the Inside a Plexus or Interlacement of small Veins and Arteries, and Fibres of Nerves, which enter into the other following Tunicks, to nourish them.
The second sticking close to the former, is altogether full of whitish Glandules, that serve to separate the serous Particles of the Blood.
The third is intirely Musculous, and interwoven with Annular Fibres.
The fourth is very thin, and hath its Fibres all streight.
Whence proceeds the Pulse or beating of the Arteries?
It is deriv'd from the Heart, and exactly answers to its Motion of Diastole and Systole.
By what Name is the first Trunk of the Arteries call'd, and what is the Effect of the Distribution made thence to the whole Body?
The first Trunk of the Arteries is nam'd Aorta, or the thick Artery, which proceeds immediately from the left Ventricle of the Heart, whereto it communicates before its departure from the Pericardium, one or two small Branches call'd the Coronary: Afterward it is divided into two Branches, whereof one goes upward, and is term'd the Ascending Artery; and the other downward, under the Denomination of the Descending Artery.
The Ascending Artery ariseth upward along the Aspera Arteria or Wind-Pipe, to the Clavicles, and is there divided into two Branches, call'd the Subclavian Arteries, one whereof goes forward to the Right side, and the other to the Left; and they both send forth on each side divers Branches, which take their Names from the several Parts, whereto they are distributed; such are the Carotides or Soporales Interni & Externi, which pass to the Head; the Mediastina; the Intercostal; the Axillar, and others.
The Descending Artery, before its departure from the Breast, affords certain Branches to the Pericardium, Diaphragm, and lower Ribs; afterward it penetrates the Diaphragm, and constitutes seven double Branches. The first is of those that are call'd Cœliack, and which go to the Liver and Spleen. The second Branch contains the Upper Mesenterick. The third the Emulgent, which pass to the Reins. The fourth the Spermatick, which are extended to the Genitals. The fifth the Lower Mesenterick. The sixth the Lumbar. And the seventh the Muscular. But assoon as the great Trunk is come downward to the Os Sacrum, it divides it self into two thick Arteries nam'd the Iliack, which are distributed on both sides, each of them making two Internal and External Branches, which likewise impart Sprigs or lesser Arteries, to the Bladder, Anus, Matrix, and other adjacent Parts: Then the Master-Branch forms the Crural Arteries on the inside of the Thighs, which are communicated by multiplying their Number even to the ends of the Toes, in passing over the External Ancle-Bones of the Feet.
What is the Structure of the Veins?
The Veins are long and round Canals made of four kinds of Tunicks or Membranes, whose Office it is to receive the Blood that remains after the Nourishment is taken, and to carry it back to the Heart to be reviv'd.
What is the Form of the four Tunicks that make the Canals of the Veins?
The first is a Contexture of Nervous and streight Fibres. The second is a Plexus of small Vessels that carry the Nourishment. The third is all over beset with Glandules thro' which are filtrated the serous Particles of the Blood contain'd in the Vessels of the second Tunicle. The fourth is a Series of Annular and Musculous or Fleshy Fibres.
Which are the most numerous, the Arteries or the Veins?
The Number of the Veins exceeds that of the Arteries; and there are scarce any Arteries without Veins accompanying them.
Where is the Beginning and Original of all the Veins?
All the Veins have their Root in the Liver, and two of the three great Trunks that proceed from thence, are call'd Vena Portæ, and Vena Cava; and the third is twofold, viz. the ascending and the descending.
The Vena Portæ is distributed to all the Parts contain'd in the lower Belly, and terminated in the Fundament; where it makes the Internal Hæmorrhoidal Veins.
The Vena Cava is immediately divided into two thick Branches, one whereof ariseth upward to the Right Ventricle of the Heart, and forms the ascending Vena Cava; as the other goes downward to the Feet, and constitutes the descending.
What is the Distribution of the ascending Vena Cava?
It perforates the Diaphragm, goes to the Heart, and ascends from thence to the Clavicles, after having communicated to the Midriff in passing, a small Branch call'd the Phrenicus; as also one or two to the Heart, nam'd the Coronary; and some others to the upper Ribs, besides the single Branch, term'd Azygos, only on the right side. But the Trunk of the ascending Vena Cava, being once come up to the Clavicles, is divided into two Branches, well known by the Name of the Subclavian, one whereof Shoots forth toward the Right side, and the other toward the Left; and they both make various Ramifications like to those of the thick ascending Artery, by producing the Cervicalis or Soporalis, and the Internal and External Jugulars that go to the Head; as also the Axillars, which pass to the Arms and Shoulders, forming the Cephalick, the Median, and the Basilick on the inside of the Elbow.
The descending Vena Cava in like manner accompanieth the Ramifications of the Aorta, or thick descending Artery, to the fourth Vertebra of the Loins, where it sends forth two Branches, nam'd the Iliack, one whereof goes to the Right side, and the other to the Left, both inwardly and outwardly; imparting divers Twigs or lesser Branches to all the Parts contain'd in the Abdomen or lower Belly, even as far as the Fundament, where it makes the External Hæmorrhoidal Veins. Afterward the outward Branch of the Iliack descends in the Thigh, to form the Crural, and others, as far as the Saphæna, together with those that are situated at the end of the Feet.
CHAP XIII.
[edit]Of the Anatomy of the Abdomen, or lower Belly.
[edit]What is the clearest Division of the Human Body into various Parts, and that which is most followed in the Anatomical Schools?
It is that which constitutes three Venters, that is to say, the Upper, the Middle, and the Lower, which are the Head, the Thorax or Breast and the Abdomen or lower Belly, together with the Extremities, which are the Arms and Legs.
What is the lower Belly?
It is a Cavity of the Body that contains the nourishing parts, as the Reins, the Bladder, and all those that are appropriated to Generation in both Sexes.
What is to be consider'd outwardly in the lower Belly?
Its different Regions, and the several parts therein contain'd.
What are these Regions?
They are the Epigastrick, the Umbilical, and the Hypogastrick.
What is their Extent?
It is from the Xyphoides or Sword-like Cartilage to the Os Pubis, the division whereof into three equal Parts, constitutes the three different Regions; the Epigastrium being the first upward, the Umbilicus the second, and the Hypogastrium the third.
What Are the Parts contain'd in the Epigastrium, and what Place do they possess therein?
The Parts contain'd in the Epigastrium are the Liver, the Spleen, the Stomach, and the Pancreas or Sweet-bread, which lies underneath: The Stomach takes up the middle before, the Liver being plac'd on the Right side, and the Spleen on the Left; so that these two sides of the Epigastrick Region, are call'd the Right and Left Hypochondria.
What Parts are there contain'd in the Umbilical Region, and what is their situation?
They are the most part of the thin Intestines or small Guts, viz. the Duodenum, the Jejunum, and the Ileon, which have their Residence in the middle, where they are encircled with a Portion of the two great Guts, Cæcum and Colon, that take possession of the Sides, otherwise call'd the Flanks. The Reins or Kidneys are also in this Place, above, and somewhat backward.
What Parts are there contain'd in the Hypogastrium, and of what Place are they possest?
The greater part of the thick-Guts, Cœcum, and Colon, are enclos'd therein, with the entire Rectum; there is also a Portion of the Ileon, which hides it self in the sides of the Ilia, or Hip-Bones: In the middle under the Os Pubis, the Bladder is situated on the Gut Rectum in Men, and the Matrix in Women lies between the Rectum and Bladder.
After what manner is the opening of a Corps or dead Body perform'd at a publick Dissection?
It is begun with a Crucial Incision in the Skin from underneath the Throat downward, traversing from one side to another in the Umbilical Region; then this Skin is pull'd off at the four Corners, and the Panicula Adiposa is immediately discover'd: Under this Fat lies a Fleshy Membrane, call'd Membrana Carnosa; and after that, the common Membrane of all the Muscles of the lower Belly. Thus we have taken a View of what Anatomists commonly term the five Teguments, that is to say, the Epiderma or Scarf-Skin, the Derma or true Skin, the Panicula Adiposa, the Panicula Carnosa or Membranus Carnosa, and the common Membrane of the Muscles.
The five Teguments being remov'd, we meet with as many Muscles on each side, viz. the descending Oblique, the ascending Oblique, the Transverse, the streight, and the Pyramidal, by the means whereof the Belly is extended and contracted. Afterwards appears a Membrane nam'd Peritonæum, which contains all the Bowels, and covers the whole lower Belly, being strongly fasten'd to the first and third Vertebra's of the Back. The Fat skinny Net which lies immediately under the Peritonæum, is call'd Epiploon and Omentum, or the Caul; it floats over the Bowels, keeping them in a continual Suppleness necessary for their Functions, maintains the Heat of the Stomach, and contributes to Digestion.
It remains to take an Account of the Bowels viz. the Stomach, Mesentery, Liver, Spleen, Kidneys, Bladder, and Guts, together with the Parts appointed for Generation, which in Men are the Spermatick Vessels, the Testicles, and the Penis; and in Women, the Spermatick Vessels, the Testicles or Ovaries, the Matrix, and its Vagina or Neck.
What is the Stomach?
It is the Receptacle of the Aliments or Food convey'd thither thro' the Oesophagus or Gullet, which is a Canal, or kind of streight Gut that reacheth from the Throat to the Mouth of the Stomach. The Stomach it self is situated immediately under the Diaphragm or Midriff, between the Liver and the Spleen, having two Orifices, whereof the Left is properly call'd Stomachus, or the Upper, and the Right (at its other Extremity) Pylorus, or the lower Orifice. Its Figure resembleth that of a Bag-Pipe, and the greater part of its Body lies toward the Left side. It is compos'd of three Membranes, viz. one Common, which it receives from the Peritonæum; and two Proper; the two uppermost being smooth, and the innermost altogether wrinkled.
What is the Pancreas or Sweet-bread?
It is a Fat Body, consisting of many Glandules wrapt up in the same Tunicle, being situated under the Pylorus or lower Orifice of the Stomach: It helps Digestion, and hath divers other uses; but its principal Office is to separate the serous Particles of the Blood, to be convey'd afterward into the Gut Duodenum, by a Canal or Passage, nam'd the Pancreatick. This Juice serves to cause the Chyle to ferment with the Choler, in order to remove the grosser Particles from those that ought to enter into the Lacteal Vessels.
Into how many sorts are the Guts distinguish'd?
There are two sorts, viz. the thin and the thick.
How many thin or small Guts are there?
Three; that is to say, the Duodenum, the Jejunum, and the Ileon.
How many thick Guts are there?
Three likewise; viz. the Cœcum, the Colon, and the Rectum.
Why are some of them call'd thin Guts, and others thick?
Because the thin are smaller, being appointed only to transport the Chyle out of the Stomach into the Reserver; whereas the thick are more large and stronger, serving to carry forth the gross Excrements out of the Belly.
Are the six Guts of an equal length?
No, the Duodenum, which is the first of the thin Guts, is only twelve Fingers breadth long. The Jejunum, being the second, so call'd because always empty, is five Foot long: The third is nam'd Ileon, by reason of its great Turnings which oblige it to pass to the Os Ilion, where it produceth a Rupture; it extends it self almost twenty Foot in length.
The first of the thick Guts, known by the Name of Cœcum, is very short, and properly only an Appendix or Bag of a Finger's length. That which follows is the Colon, being the largest of all, and full of little Cells, which are fill'd sometimes with Wind and other Matters that excite the Pains of the Colick. It encompasseth the thin Guts, in passing from the top to the bottom of the Belly, by the means of its great Circumvolutions, and is from eight to nine Foot long. The last is the Rectum or streight Gut, so nam'd, because it goes directly to the Fundament: It is no longer than ones Hand, but it is fleshy, and situated upon the Os Sacrum, and the Coccyx or Rump-Bone.
What is the Peristaltick Motion of the Guts?
It is the successive Motion and Undulation, whereby the Guts insensibly push forward from the top to the bottom, the Matters contain'd in them; and that Motion which on the contrary is perform'd from the bottom to the top, is term'd the Antiperistaltick as it happens in the Iliack Passion, or twisting of the Guts, call'd Domine Miserere, by reason of its intolerable Pain.
What is the Mesentery?
It is a kind of Membrane somewhat fleshy, which is join'd to the Spine in the bottom and middle of the Belly, and by its folding, keeps all the Guts steady in their place; it is all over beset with red, white, and Lymphatick Vessels; that is to say, those that carry the Blood, Chyle, and Lympha, which serves to cause this last to run more freely, and to ferment. Three notable Glandules are also observ'd therein, the greatest whereof lies in the middle, and is nam'd Asellius's Pancreas; the two other lesser are call'd Lumbar Glandules, as being situated near the Left Kidney. From each of these Glandules proceeds a small Branch; and both are united together to make the great Lacteal Vein, or Thoracick Canal. This Tube conveys the Chyle along the Vertebra's of the Back to the Left Subclavian Vein; from whence it passeth into the ascending Vena Cava, and descends in the Right Ventricle of the Heart, where it assumes the form of Blood; from whence it passeth to the Lungs thro' the Pulmonary Artery; then it returns to the Heart thro' the Pulmonary Vein, and goes forth again thro' the Left Ventricle of the Heart, between the Aorta or great Artery, to be afterward distributed to all the Parts of the Body. This is the ordinary Passage for the Circulation of the Chyle, and the Sanguification of the Heart.
What is the Liver?
The Liver, being the thickest of all the Bowels, is plac'd in the Right Hypochondrium, at the distance only of a Fingers breadth from the Diaphragm; its Figure much resembling that of a thick piece of Beef: It is Convex on the outside, and Concave within; its Substance is soft and tender, its Colour and Consistence being like coagulated Blood: It is cleft at bottom, and divided into two Lobes, viz. one greater, and the other less: Its Office is to purifie the Mass of Blood by Filtration; and it is bound by two strong Ligaments, the first whereof adheres to the Diaphragm, and the second to the Xiphoides or Sword-like Cartilage. Two great Veins take their Rise from hence, viz. the Vena Portæ, and the Vena Cava, which form innumerable Branches, as it were Roots in the Body of the Liver. The Gall-Bladder is fasten'd to the hollow part thereof, and dischargeth its Choler into the Gut Duodenum, thro' the Vessels that bear the Name of Meatus Choledochi, or Ductus Biliares. This Choler is not a meer Excrement, but on the contrary of singular Use in causing the Fermentation of the Chyle, and bringing it to perfection.
What is the Spleen?
The Spleen is a Bowel resembling a Hart's Tongue in shape, and situated in the Left Hypochondrium, over-against the Liver: Its length is about half a Foot, and its breadth equal to that of three Fingers; its Substance being soft, as that of the Liver, and its Colour like dark coagulated Blood: It is fasten'd to the Peritonæum, Left Kidney, Diaphragm, and to the Caul on the inside; as also to the Stomach by certain Veins, call'd Vasa Brevia; nevertheless these Ligatures do not hinder it from wandering here and there in the lower Belly, where it often changeth its place, and causeth many dreadful symptoms by its irregular Motions. Its Office is to Subtilize the Blood by cleansing and refining it.
What are the Reins?
The Reins or Kidneys are Parts of a Fleshy Consistence, harder and more firm than that of the Liver and Spleen: They are both situated in the sides of the Umbilical Region, upon the Muscle Psoas, between the two Tunicks of the Peritonæum; but the Right is lower than the Left: Their Shape resembleth that of a French Bean, and they receive Nerves from the Stomach, whence Vomitings are frequently occasion'd in the Nephritical Colicks: They are fasten'd to the Midriff, Loins, and Aorta, by the Emulgent Arteries; as also to the Bladder by the Ureters. The Right Kidney likewise adheres to the Gut Cæcum, and the Left to the Colon. Their Office is to filtrate or strain the Urine in the Pelves or Basons, which they have in the middle of their Body on the inside, and to cause it to run thro' the Vessels call'd Ureters into the Bladder.
Immediately above the Reins on each side, is a flat and soft Glandule, of the thickness of a Nut; they are nam'd Renal Glandules, or Capsulæ Atribiliariæ, because they contain a blackish Liquor, which (as they say) serves as it were Leaven for the Blood, to set it a fermenting.
What is the Bladder?
It is the Bason or Reserver of Urines, of a Membranous Substance as the Stomach, being plac'd in the middle of the Hypogastrick Region; so that it is guarded by the Os Sacrum behind, and by the Os Pubis before: Two Parts are to be distinguish'd therein, viz. its Bottom and Top; by its Membranous Bottom it is join'd to the Navel, and suspended by the means of the Urachus, and the two Umbilical Arteries which degenerate into Ligaments in adult Persons: As by its fleshy Neck, longer and crooked in Men, and shorter and streight in Women it cleaves to the Intestinum Rectum in the former, and to the Neck of the Womb in the latter. Lastly, its Office is to receive the Urines to keep them, and to discharge them from time to time.
What are the Genitals in Men?
They are the Spermatick Vessels, the Testicles, and the Penis. The Spermatick Vessels are a Vein and an Artery on each side; the former proceeding from the Aorta, or thick Artery of the Heart; and the other from the Branches of the Vena Cava of the Liver. These Arteries and Veins are terminated in the Body of the Testicles, which are two in Number, enclos'd within the Scrotum.
The Office of the Testicles is to filtrate the Seed, which is brought thither from all the parts of the Body, thro' the Spermatick Vessels, called Præparantia, and afterwards to cause it to pass thro' others nam'd Deferentia, to the Vesiculæ Seminales, from whence it is forc'd into the Ureter, thro' two small and very short Canals.
The Penis or Yard is a Nervous and Membranous Part, well furnish'd with Veins and Arteries, containing in the middle the Canal of the Ureter: Its Extremity, which consists of a very delicate and spongy sort of Flesh, is call'd Balanus, or Glans, and the Nut, the Skin that covers it being nam'd the Præputium, or the Fore-Skin. Thus by the means of this swell'd Part, and stiff thro' the affluence of the Spirits, the Male injects his Seed into the Matrix of the Female, to propagate his Kind.
What are the Parts appropriated to Generation in Women?
They are the Spermatick Vessels, the Ovaries or Testicles, and the Matrix. The Spermatick Vessels are a Vein and an Artery on each side, as in Men: The Ovaries or Testicles, situated on the side of the bottom of the Matrix, are almost of the same bigness with those of Men, but of a round and flat Figure. The Vesiculæ, or little Bladders which they contain, are usually term'd Ova or Eggs by Modern Anatomists; and the Vessels that pass from these Testicles or Ovaries to the Cornua of the Uterus, are call'd Deferentia or Ejaculatoria.
The Matrix, Uterus or Womb, is the principal Organ of Generation, and the place where it is perform'd, resembling the Figure of a Pear with its Head upward, and being situated between the Gut Rectum and the Bladder: It is of a fleshy and membranous Substance, retain'd in its place by four Ligaments, fasten'd to the bottom; whereof the two upper are large ones, proceeding from the Loins, and the two lower round, taking their Rise from the Groin, where they form a kind of Goose-Foot, which is extended to the Os Pubis, and the flat part of the Thighs; which is the cause that Women are in danger of Miscarrying when they fall upon their Knees.
The Exterior Neck of the Womb, call'd Vagina, is made almost in form of a Throat or Gullet, extending it self outwardly to the sides of the Lips of the Pudendum, and being terminated inwardly at the internal Orifice of the Matrix, the shape whereof resembleth that of the Muzzle or Nose of a little Dog. The outward Neck of the womb is fasten'd to the Bladder and the Os Pubis before, and in the hinder part to the Os Sacrum: Between the Lips of the Pudendum lie the Nymphæ, which are plac'd at the Extremity of the Canal of the Bladder, to convey the Urines; and somewhat farther appear four Caruncles, or small pieces of Flesh, at the Entrance of the Vagina, which when join'd together make the thin Membrane call'd Hymen.
CHAP. XIV.
[edit]Of the Anatomy of the Thorax, Breast, or middle Venter.
[edit]What is the Breast?
It is a Cavity in which the Heart and the Lungs are principally enclos'd.
What is to be consider'd outwardly in the Breast?
Its extent, and the situation of the Parts therein contain'd.
What is its extent?
It is extended from the Clavicles to the Xiphoides, or Sword-like Cartilage on the fore-part, and bounded on the hinder by the twelfth Vertebra of the Back, having all the Ribs to form its Circumference, and the Diaphragm for its Bounds at bottom, separating it from the Abdomen or lower Belly.
What is the situation of the Parts contain'd in the Breast?
The Lungs take up the upper Region, and fill almost the whole Space, descending at the distance of two Fingers breadth from the Diaphragm; the Heart is situated in the middle, bearing its Point somewhat towards the Left side, under the Lobes of the Lungs, which are divided by the Mediastinum that distinguishes them into the Right and Left Parts,
How is the Breast Anatomiz'd or open'd?
After the dissection of the five Teguments, and the removal of the Muscles, as in the lower Belly, the Anatomist proceeds to lift up the Sternum or Breast-Bone, by separating it from the Ribs; then it is laid upon the Face, or else entirely taken away, to the end that the internal Parts of the Breast may be more clearly discover'd; whereupon immediately appear, the Heart, the Lungs, the Diaphragm, and the Mediastinum, which sticks to the Sternum throughout its whole length.
What is the Heart?
It is a most noble Part, being the Fountain of Life, and the first Original of the Motion of all the others; on which account it is call'd Primus vivens, & ultimum moriens; that is to say, the first Member that begins to live, and the last that dies.
What Parts are to be consider'd in the Heart?
Its fleshy Substance, with all its Fibres turn'd round like the Skrews of a Vice; its Basis, Point, Auricles, Ventricles, large Vessels, Pericardium and Ligatures or Tyes: The Basis is the uppermost and broadest part; the Point is the lowermost and narrowest part; the two Auricles or small Ears being as it were little Cisterns or Reservers, that pour the Blood by degrees into the Heart, are situated on each side above the Ventricles. The Ventricles, which are likewise two in Number, are certain Cavities in its Right and Left Sides. The large Vessels are the Aorta or great Artery, and the Vena Cava together with the Pulmonary Artery and Vein. The Pericardium is a kind of Bag fill'd with Water, wherein the Heart is kept; which is fasten'd to the Mediastinum by its Basis, and to the large Vessels that enter and go out of its Ventricles.
What are the Terms appropriated to the continual beating of the Heart?
They are Diastole and Systole, from whence proceed two several Motions, the first whereof is that of Dilatation, and the other of Contraction, communicated to all the Arteries which have the same Pulse.
To what use serves the Water contain'd in the Pericardium?
It prevents the drying of the Heart by its perpetual Motion.
What are the Lungs?
They are an Organ serving for Respiration, of a soft Substance, and porous as a Sponge, being all over beset with Arteries, Veins, Nerves, and Lymphatick Vessels, and perforated with small Cartilaginous Tubes, that are imparted to it from the Wind-Pipe, and are call'd Bronchia. Their Natural Colour is a pale Red, and marbl'd dark Brown; and their whole Body is wrapt up in a fine smooth Membrane, which they receive from the Pleuron. They are suspended by the Wind-Pipe, by their proper Artery and Vein, and by the Ligatures that fasten them to the Sternum, Mediastinum, and frequently to the Pleuron it self: They are also divided into the Right and Left Parts by the Mediastinum; having four or five Lobes, whereof those on the Left side cover the Heart. Their continual Motion consists in Inspiration, to take in the Air, and Expiration, to drive it out. The Larynx makes the Entrance of the Wind-Pipe into the Lungs, and the Pharynx that of the Oesophagus or Gullet, at the bottom of the Mouth to pass into the Stomach.
CHAP. XV.
[edit]Of the Anatomy of the Head, or upper Venter.
[edit]What is the head?
It is a bony Part, that contains and encloseth the Brain within its Cavity.
What is most remarkable in the outward parts of the Head?
The Temporal Arteries, the Crotaphitæ, or Temporal Muscles, and the Sutures of the Skull.
Why are these things considerable?
The Temporal Arteries are of good Note, because they are expos'd on the outside, lying even with the Skin. The Crotophite Muscles are so likewise, in regard that they cannot be hurt without danger of Convulsions, by reason of the Pericranium with which they are cover'd. And the Sutures, because the Meninges of the Brain proceed from thence to form the Pericranium.
What is the Pericranium?
It is a Membrane that lies under the thick hairy Skin of the Head, and immediately covers the Skull.
What are the Meninges?
They are two Membranes that enclose the Substance or Marrow of the Brain.
What is a Suture?
It is a kind of thick Seam or Stitch, that serves to unite the Bones of the Skull.
How many sorts of Sutures are there?
There are two sorts, viz. the true, and the false or Bastard.
What are the true Sutures?
They are three in number, namely the Sagittal, the Coronal, and the Lambdoidal.
What is the disposition or situation of the true Sutures?
The Sagittal is streight, beginning in the middle of the Fore-head, and sometimes at the root of the Nose, and being terminated behind, at the joining of the two Branches of the Lambdoidal Suture.
The Coronal appears in form of a Crown, passing to the middle of the Head, and descending thro' the Temples, to finish its Circumference in the Root of the Nose.
The Lambdoidal Suture is made like an open Pair of Compasses, the Legs whereof are extended toward the Shoulders; and the Button is in the top of the Head backward.
What are the Bastard Sutures?
They are those that are call'd Squamous or scaly.
What is the disposition of natural situation of these false Sutures?
They are plac'd at the two sides of the Head, and make a Semi-Circle of the bigness of the Ears, round the same Ears.
What difference is there between the true and spurious Sutures.
The true Sutures are made in form of the Teeth of a Saw, which enter one into the other; and the false or Bastard ones are those that resemble the Scales of Fishes, which are join'd together by passing one over the other.
What is the Use of the Sutures?
The Ancients were of Opinion, that they were made to hinder the Fracture of one Skull-Bone from passing thro' the whole Head; but there is more reason to believe that they have the three following Uses, that is to say, 1. To promote the transpiration of the Brain. 2. To give Passage to the Vessels that go to the Diploe. 3. To retain the Meninges, and to support the Mass of the Brain, which is cover'd by them.
What are the Names of the Bones that compose the Skull?
The Bone of the fore-part of the Head is call'd Sinciput, or the Fore-head-Bone, as also the Frontal or Coronal Bone. The Bone of the hinder-part, enclos'd within the Lambdoidal Suture, is term'd the Occipital. The two Bones that form the upper-part, and are distinguish'd by the Sagittal Suture, bear the Name of Parietals, one being on the Right side, and the other on the Left. And those behind the Ears are call'd Temporal, Squamosa, or Petrosa. These also are distinguish'd into the Right and Left Temporals, and are join'd to the bottom of the Parietal by a bastard squamous Suture.
What is most remarkable in the thickness of the Skull-Bones?
The Diploe, which is nothing else but a Plexus or Contexture of small Vessels, that nourish the Bones, and in the middle of their thickness make the distinction of the first and second Tablature of the Bones; whence it sometimes happens that an exfoliative Trepan, or Semi-Trepan, is sufficient, when the first of these two Tables is only broken, the other remaining entire.
Is the Brain which is preserv'd in the Skull all of one Piece, or one equal Mass?
No, it is distinguish'd by the means of the Meninges into the Brain it self, and the Cerebellum or little Brain; the Brain, properly so called, takes up almost the whole Cavity of the Skull, and the Cerebellum is lodg'd altogether in the hinder-part, where it constitutes only one entire Body; whereas the former is divided into the Right and Left Parts by the Meninges, which cut it even to the bottom; whence these Foldings are call'd Falx; i. e. a Scythe or Sickle.
What is chiefly remarkable in the Substance of the Brain?
The Ventricles or Cavities which are found therein, together with the great Number of Veins, Arteries, Lymphatic Vessels, and Nerves, that carry Sense to all the Parts of the Body, and Spirits for their Motion.
An exact Historical Account of all the Holes of the Skull, and the Vessels that pass thro' them.
To attain to an exact Knowledge of all the Holes with which the inside of the Basis of the Skull is perforated, they are to be consider'd either with respect to the Nerves, or to the Sanguinary Vessels.
There are nine Pairs of Nerves that arise from the Medulla Oblongata, and go forth out of the Skull through many Holes hereafter nam'd.
The first Pair is that of the Olfactory Nerves, appropriated to the Sense of Smelling, which are divided below the Os Cribiforme, or Sieve-like Bone, into divers Threads, that passing into the Nose through many Holes with which this Bone is pierc'd, are distributed to the inner Tunick of the Nose.
The second Pair is that of the Optick or Visual Nerves, that pass into the Orbits of the Eyes, thro' certain peculiar Holes made in the Os Sphenoides, or Wedge-like Bone, immediately above the Anterior Apophysis Clinoides.
In the Portion of the Os Sphenoides, that makes the Basis of the Orbit, lies a Fissure about seven or eight Hairs breadth long, which is to be observ'd chiefly at the bottom, that is to say, below the Hole, thro' which the Optick Nerve passeth; where it is almost round, and larger than at the top, where it is terminated in a very long and acute Angle.
There are many Pairs of Nerves that enter into the Orbit thro' this Fissure, viz. 1. The third Pair, call'd the Motorii Oculorum. 2. The fourth Pair, nam'd Pathetici, by Dr. Willis. And 3. The whole sixth Pair. Besides these three Pairs, which go entire thro' this Cleft, there is also a Passage for the upper Branch of the foremost Fibre of the fifth Pair, which the same renowned Physician calls the Ophthalmick Branch. Beyond the lower-part of the said Fissure, toward the hinder-part of the Head, is to be seen in the Os Sphenoides on each side, a Hole that doth not penetrate the Basis of the Skull, but makes a kind of Ductus, about an Hair's breadth long, which is open'd behind the Orbit on the top of the Space between the Apophysis Pterygoides, and the third Bone of the Jaw; thro' this Ductus runs the lower Branch of the foremost Fibre of the fifth Pair.
About the length of two Hairs breadth beyond these Ductus's, we may also discover in the Os Sphenoides, or Wedge-like Bone, two Holes of an Oblong and almost Oval Figure, which are plac'd in the hindermost sides of that of the Os Sphenoides, and gives passage to the hindermost Fibre of the fifth Pair.
The Hole thro' which runs the Auditory Nerve, that makes the seventh Pair, is in the middle of the hinder-part of the Os Petrosum, that looks toward the Cerebellum: This Hole being very large, is the Entrance of a Ductus that is hollow'd in the Os Petrosum, and which sinking obliquely from the fore-part backward, for the depth of about two Hairs breadth, forms as it were the bottom of a Sack, the lowermost part whereof is terminated partly by the Basis of the Cochlea, and partly by a Portion of the Mouth of the Vestibulum. At the bottom of this Ductus are many Holes, but the most considerable is that of the upper-part, thro' which passeth a Portion of the Auditory Nerve. This is also the Entrance of another Ductus made in the Os Petrosum, which is open'd between the Apophysis Mastoides and Styloides: These other Holes afford a Passage to the Branches of the soft Portion of the same Auditory Nerve.
Below this Ductus there is a remarkable Hole form'd by the meeting of two hollow Cuts the larger whereof is in the Occipital Bone and the other in the lower-part of the Apophysis Petrosi: From the middle of the upper-part of this Hole issueth forth a small Prominence or bony Point, whereto is join'd an Appendix of the Dura Mater, which divides the Hole into two parts; so that thro' the foremost Orifice passeth the Nerve of the eighth Pair, and that which is call'd the Spinal Nerve. We shall have occasion hereafter to shew the Use of the hinder Orifice.
Near the great Hole of the Occipital Bone from whence proceeds the Medulla Oblongata, we may observe a Hole almost round and oblong thro' which passeth the Nerve of the ninth Pair. This Hole is entirely situated in the Occipital Bone, and making a little Way in the Bone passeth obliquely from the back-part forward. In the inside of the Skull this Hole is sometimes double, but its two Entrances are re-united in the outward-part of the Skull; and the two Branches that form the Origine of this Nerve and which pass thro' these two Holes, are likewise re-united at their Departure, These are the Passages of the nine Pairs of Nerves that proceed from the Medulla Oblongata, and it remains only to show that Paths thro' which the Intercostal Nerve goes forth, as also that of the tenth Pair. The Intercostal runs out of the Skull thro' the Ductus that gives Entrance to the Internal Carotick Artery. As for the tenth Pair, in regard that it ariseth from the Marrow which is enclos'd between the Occipital Bone and the first Vertebra, it goes forth thro' the Hole of the Dura Mater, where the Vertebral Artery enters.
To know well the Holes thro' which the Vessels that belong to the inner-part of the Head enter, and issue forth, it is requisite to distinguish them into those which are distributed to the Dura Mater, and those that are appointed for the Brain. The Vessels of the Dura Mater, are Branches of the Carotick or Vertebral Arteries.
In the Os Sphenoides, or Wedge-like Bone, behind the Hole thro' which passeth the hindermost Fibre of the fifth Pair of Nerves lies another small Hole, almost round, that gives Entrance to a Branch of the External Carotick Artery, which in entring, immediately adheres to the Dura Mater, and forms many Ramifications to overspread the whole Portion of this Membrane, which covers the sides, and the upper-part of the Brain.
At the bottom and top of the lateral outward part of the Orbit of the Eye, above the acute Angle, for want of the Os Sphenoides, there is a Hole thro' which passeth an Artery, being a Twig of a Branch of the Internal Carotick, which is diffus'd in the Eye, and distributed to almost the whole Portion of the Dura Mater, that covers the fore-part of the Brain.
The Vertebral Artery in entring into the Skull, furnisheth it on each side with a considerable Branch, which is dispers'd throughout the whole Portion of the Dura Mater that covers the Cerebellum.
As for the Veins that accompany these Arteries, they almost all go out of the Skull thro' the same Holes where the other enters.
There are four thick Arteries which convey to the Brain the Matter with which it is nourish'd, and that whereof the Spirits are form'd, viz. the two Internal Caroticks, and the two Vertebrals.
The Internal Carotick Arteries enter into the Skull thro a particular Ductus made in the Temporal Bone, the Mouth thereof being of an Oval Figure and situated in the outward part of the Basis of the Skull, before the Hole of the Internal Jugular. This Ductus extends it self obliquely from the back-side forward, and after having made about three Hairs breadth in length, is terminated in the hinder-part of the Os Sphenoides. The Artery traverseth the whole winding Compass of this Ductus, which resembles the Figure of the Roman Letter S, and at the Mouth of the same Ductus runs under the Dura Mater along the sides of the Os Sphenoides to the Anterior Apophyses Clinoides, where it riseth up again, to perforate the Dura Mater, and to adhere to the Root of the Brain. These Vessels, in like manner, after their departure from the Bone of the Temples to the place where they pierce the Dura Mater, make a second Circuit in form of the Roman Character S. At the place where these Carotick Arteries penetrate the Dura Mater, they send forth a thick Branch, which enters into the Orbit of the Eye, by the lower-part of the Hole, thro' which the Optick Nerve hath its Passage.
The Vertebral Arteries proceeding from the Holes of the transverse Apophyses of the first Vertebra, turn about in passing under the upper oblique Apophyses of the seven Vertebra's: Afterward they perforate the Dura Mater, and running under the Marrow, enter into the Skull thro' the Occipital Hole; then inclining one toward another, they are re-united, and form only one single Trunk.
The Veins that bring back the Blood from the Substance of the Brain, are emptied into the Sinus's of the Dura Mater, which are all discharg'd into those that are call'd Lateral, which last go out of the Skull immediately under the Nerves of the eighth Pair, thro' the hinder-part of the Hole made by the meeting of the Occipital Bone, and the Apophysis Petrosa. These Lateral Sinus's fall into the Internal Jugulars, which are receiv'd into a considerable Sinking hollow'd on each side in the outward, part of the Basis of the Skull, which is nam'd the Pit or Hole of the Internal Jugular.
In the upper and hinder-part of the Hole, from whence the lateral Sinus's issue forth, is to be seen an opening in the Extremity of a Ductus, the Mouth whereof lies behind the Condyli, which are on the sides of the Occipital Trunk: This Ductus is extended about the length of two Hairs breadth in the Bone, and the Canal enclos'd therein is open'd immediately into the Vertebral Sinus: So that one might affirm it to be as it were its Original Source. Whence it appears that the Blood contained in the lateral Sinus's is emptied thro' two places; the greater Portion thereof descending in the Jugulars from the Neck, and the other in the Vertebral Sinus's: Sometimes those Ductus's are four only on one side, another while both are stopt up, and the Blood contain'd in the lateral Sinus's is discharg'd into the Internal Jugulars.
Behind the Apophysis Mastoides on each side is a remarkable Hole, thro' which passeth a thick Vein, which brings back part of the Blood that hath been distributed to the Teguments and Muscles, which cover part of the Occiput or hinder-side of the Head: This Vein is open'd into the lateral Sinus's at the place where they begin to turn about. But in the Heads of some Persons, this Hole is found only on one side, and even sometimes not at all, in which case the Blood contain'd in the Vessels falls into the External Jugulars, with which the Branches of this Vein have a Communication.
In each Parietal Bone on the side of the Sagittal Suture, at a little distance from the Lambdoidal, appears a Hole, thro' which passeth a Vein, that brings back the Blood of the Teguments of the Head, and dischargeth it self into the upper Longitudinal Sinus. These Holes are sometimes on both; and then the Blood contain'd in the Branches of this Vein runs into the External Jugulars.
In the middle of the Sella of the Os Sphenoides, we may observe one or two small Holes thro' which (according to the Opinion of some Modern Anatomists) the Lympha contain'd in the Glandula Pituitaria is thrown into the Sinus of the edge of the Os Sphenoides; nevertheless it is certain, that these Holes are fill'd only with Sanguinary Vessels, which carry and bring back the Blood of the Bones and Membranes, whereof those Sinus's are compos'd; besides that, these Holes are rarely found in adult Persons.
Between the Spine of the Coronal Suture and the Crista Galli, is a Hole which serves as an Entrance for a Ductus, which sinks from the top to the bottom, the length of about two Hairs breadth in the thickness of the inner Table of the Coronal: The Root of the upper Longitudinal Sinus is strongly implanted in this Hole, which also affords a Passage to some Sanguinary Vessels appointed for the Nourishment of this inner Table.
Many other small Holes are found in divers places of the Basis of the Skull; the chief whereof are those that are observ'd in the Apophysis Petrosa, and give Passage to a great number of Vessels that serve for the Nutriment of that part of the Temporal Bone which is call'd the Tympanum, or Drum: The other Holes are principally design'd for the Vessels that are serviceable in the nourishing of divers parts of the Basis of the Skull.
After what manner is the opening of the Head or Skull perform'd?
It is done by sawing it asunder round about and above the Ears; then it is taken off, after having before cut off the Hair, and made a Crucial Incision in the Skin from the fore-part to the hinder, and from one Ear to the other; as also after having pull'd off and laid down the four Corners to the bottom.
How is the Brain anatomiz'd?
It is done by cutting it Superficially, and by Leaves, in order to discover by little and little the Ventricles, Vessels, and Nerves, with their Original Sources, &c. Or else it is taken entire out of the Skull, (the Nerves having been before examin'd) and laid down; so that without cutting any thing, all the parts of the Brain may be set in their proper places, to find out those that are sought for.
CHAP. XVI.
[edit]Of Straps, Swathing-Bands, Bandages, and Bolsters.
[edit]What is a Strap?
It is a kind of Band commonly made use of for the Extension of the Members in the reducing of Fractures and Luxations; or else in binding Patients, when it is necessary to confine them, for the more secure performing of some painful Operation: These sorts of Ligatures have different Names, according to their several Uses, and often bear that of their Inventer.
What is the Matter whereof these Straps are compos'd?
They may be of divers sorts, but are usually made of Silk, Wooll, or Leather.
What is a Swathing-Band?
It is a long and broad Band, that serves to wrap up and contain the Parts with the Surgeons Dressings or Preparatives.
Of what Matter are these Swathing-Bands made?
They are made at present of Linnen-Cloth but in the time of Hippocrates, were made of Leather or Woollen-Stuff.
How many sorts of Swathing-Bands are there in general?
There are two sorts, viz. the Simple and Compound; the former are those that are smooth, having only two ends; and the other are those which are trimm'd with Wooll, Cotton, or Felt, or that have many Heads, that is to say, Ends, fasten'd or cut in divers places according as different Occasions require.
What are the Conditions requisite in the Linen-Cloth, whereof the Swathing-Bands are made?
It must be clean, and half worn out, not having any manner of Hem or Lift.
What are the Names of the different Swathing-Bands?
There are innumerable, but the greater part them take their Denominations from their Figure or Shape; as the Long, Streight, Triangular, and those which have many Heads, or are trimm'd.
What is A Bandage?
It is the Application of a Swathing-Band to any Part.
How many sorts of Bandages are there?
As many as there are different Parts to be bound; some of them being Simple, and others Compound: The former are those that are made with an uniform Band; as the Bandage call'd the Truss, and divers other sorts: The Compound are those that consist of many Bands set one upon another, or sew'd together; or else those that have many Heads. They have also particular Names taken from the Inventers of them, or from their Effect; as Expulsive Bandages to drive back, Attractive to draw forward, Contentive to contain, Retentive to restrain, Divulsive to remove, Agglutinative to rejoin, &c.
There are others whereto certain peculiar Names are appropriated; as Bridles for the lower Jaw, Slings for the Chin, the back part of the Head, Shoulder, and Perinæum; Scapularies for the Body, after the manner of the Scapularies of Monks; Trusses for Ruptures; Stirrups for the Ankle-Bones of the Feet, in letting Blood, and upon other Occasions. Lastly, there are an infinite Number of Bandages, the Structure whereof is learnt by Practice, in observing the Methods of able Surgeons, who invent them daily, according to their several Manners; and the first Ideas of these can only be taken in reading Authors that have treated of them.
What are the general Conditions to be observ'd in the Bandages?
There are many, viz. 1. Care must be taken that the Bands be roll'd firm, and that they be not too streight nor too loose. 2. They are to be untied from time to time in Fractures, they must also be taken away every three or four Days, to be refitted. 3. They must be neatly and conveniently roll'd, that the Patient may not be uneasie or disquieted.
What ought to be observ'd in fitting the Bolsters?
Care must be taken to make them even, soft, and proportionable to the bigness of the Part affected; to trimm them most in the uneven places, that the Bands may be better roll'd over them, and to keep them continually moisten'd with some Liquor proper for the Disease as well as the Bands.
- In treating of every Disease in particular, we shall shew the manner of making the particular Bandage that is convenient for it.