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THE AUTHOR'S PREFACE.

dale. Upon the Approach of Winter again, I was determined to settle in the Practice of Phyfic and Surgery in Holland, at Amfterdam, partly from the Delight I had in the Country, and partly through the Sollicitations of the famous RUYSCH, who refpected me as a Son. Here therefore I stayed the Winter, and Part of the enfuing Spring, teaching Anatomy and Surgery to Students and Gentlemen, as RAW had done before me, who was now rejected for his ill Conduct or Milbehaviour.

The following Summer, in 1709, I had still a strong Defire to follow the Camp, to become more and more perfect in the Practice of Surgery; and Tournay being at that Time invefted by the confederate Army in Flanders, I was, by the Recommendations of my Friend RUYSCH, appointed Physician to the Camp-Hofpital for the Hollanders. I had now an Opportunity of performing all the chirurgical Operations which offered in the Camps and adjacent Cities, which I generally executed with Succefs. After the taking of Tournay,, the confederate Army marched to befiege Mons, near which Place the French Army was also affembled. That, however, did not prevent us from investing and taking the City; before which the numerous Army had fuch a bloody Battle, that the Wounded were brought in upon us in Crowds. Their Number continually increafing, from the uncommon Heat of the Combat, every Surgeon had now his Hands full of Bufinefs, and infinite Calls for the Practice of his Art: For the Wounded, on the Side of the Hollanders only, amounted to above Five thousand, 1 had here therefore an ample Occafion to extend the Bounds of my Practice, and was obliged to put on that Intrepidity of Mind, which CELSUS requires as an effential Qualification in a Surgeon; and for want of which, fome, who are, in other refpects, fkillful Operators, do frequently miscarry.

After the Army had entered into their Winter-Quarters, and the wounded Men recovered, I returned again to Amfterdam, where I continued my Anatomical and Chirurgical Demonstrations this Winter as before. In the mean time, I never refused my Affistance at the Operations of the other Surgeons there.

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Fig. 9. Reprefents the Manner in which the adult Patient should be placed and held for Lithotomy, according to ALGHISH; which is in part different from the Method of TOLET, and other modern Operators. A denotes the Pofture of the Patient; and B the Surgeon, as he holds the Catheter in his left Hand, and the Incifion-Knife in his Right. CC two of the Affiftants, who are placed on each Side of the Table, to fecure the Patient's Limbs, holding the Foot in one Hand, and the Knee in the other; D the Affiftant who kneels upon the Table, and by ftriding over the Patient, keeps his Body from rifing or moving, while with his Hands he draws up the Scrotum, and extends the Skin of the Perinæum. EE a Cufhion placed under the Patient; F a Veffel placed beneath the Patient to receive the Blood, and perhaps the Fæces, difcharged in the Operation; G denotes the Part of the Perinæum in which the Incifion is to be made. H the Cafe or Pouch for containing the Inftruments, to be faftened about the Waift of the Operator; this is reprefented by itself in Tab. XXX. Fig. 6.

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Fig. 4. Reprefents the left Breaft of a Woman, cancerous, and going to be amputated. A, the cancerous Breaft; B, the Arm extended, cc, the two femi-circular Plates, by which the Breaft is compreffed and elevated; D, the left Hand of the Surgeon holding the two Handles of the femi-circular brafs Plates; E, the right Hand, guiding the Handle of the falciform Knife, which is to be moved in the Direction, FGH, to divide the Breast.

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An EXPLANATION of the FOURTEENTH PLATE.

Fig. 1. Shews the Manner in which the Patient, Surgeon, and Affiftants are to be placed for amputating the Hand, or Arm. A denotes the Patient, B the Surgeon amputating with the Saw; C the Affiftant extending the Hand, D another Affiftant holding the Arm; E the Affiftant who holds the Patient's Body, and takes Care of the Tourniquet; Fdenotes the Difh or Veffel placed underneath to receive the Blood. Fig. 2. Represents the Pofition of the Patient, Surgeon, and his Affiftants amputating the Leg. A denotes the Patient feated in a Chair; B the Surgeon ; C the Affiftant who holds the Foot below the Calf; D the Affiftant who holds the Leg above the Knee: E a Veffel placed on the Floor, to catch what little Blood may be fpilt in the Operation.

Fig. 3. Denotes the most convenient Part for amputating the Leg at A, and the Thigh at B. But when the Disorder has extended itself higher up in the Thigh, it must be amputated proportionably above this Mark, though the Operation is then fo much the more dangerous.

Fig. 4. Represents the Thigh A, with the Leg amputated B, in which may be feen the Part for fixing the Tourniquet CD, for amputating the Foot in the Tarfus or Metataffus. The Tourniquet thus applied may also serve for amputating the Leg or Thigh, though not fo conveniently as when placed higher up. In this Figure you have alfo a View of the divided Artery extended a little by the Pliers E, and going to be tied to the Ligature and Knot F. There are fome indeed who do not approve of this Manner of tying the Ligature: But I have often experienced that it thus answers very well.

Fig. 5. Defcribes the Manner of amputating the Leg, fo as to preferve the Calf. The Line A B denotes the first Incifion to be made by the Scalpel, Tab. XIII. Fig. 1. or Fig. 3. The Line BC is the Courfe of the fecond Incifion, by which the Flesh of the Calf is feparated from the Bones of the Leg. CD the Place, where the Bones and reft of the Leg are amputated. Some reverfe this Course of Incifion, and first perforate the Calf with a double-edged Scalpel, Tab. XIII. Fig. 3. in Line C, and then they direct the Knife in the Course B A. But the firft Method is, in my Opinion, moft eligible. Fig. 6. Represents the Manner of reflecting back the Calf of the Leg towards the Ham, after it has been feparated from the Bones of the Leg by Incifion: which done, the Surgeon next incides the Integuments, Flesh, and Perioftæum in the Line B, and then faws off the Bones there.

Fig. 7. Denotes a Leg just amputated with the Calf A depending, to see the Ends of the two Bones: B the Tibia, and C the Fibula.

a GARENGEOT finds Fault with this Method, De Inftrument. Chirurg. tom. II. p. 219. But LA MOTTE, another of our most eminent modern Surgeons, very much approves of it.

Fig. 8:

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