Page:The growth of medicine from the earliest times to about 1800.djvu/320

 upon an injury of a tendon or nerve trunk he recommends complete division of the wounded structure.

Part II. is devoted to the consideration of wounds of the different parts of the body, taken in regular order from the head to the feet. The descriptions, in each instance, are preceded by an adequate account of the region affected. In his discussion of fractures of the skull he speaks of the diagnostic value of the rough and jarring sound perceived by the patient when the physician taps with a rod upon the injured skull; and he also states that an aid to diagnosis may be derived from the fact that a person whose skull is fractured experiences pain at the seat of the injury when somebody passes the ends of his finger-nails along a string which the patient holds suspended between his teeth.[10] According to Neuburger the description which Lanfranchi gives of the various symptoms observed in cases of fracture of the skull is admirable. In the section relating to the treatment of such fractures he warns against the tendency to resort too readily to the use of the trephine, and expresses the belief that this instrument should be employed only when the fractured bone is depressed or when there is evidence of irritation of the dura mater.

Part III. deals with skin diseases and various forms of tumors, including those of the thyroid gland; and with diseases of the eye, the ear and the nasal cavities; with the various kinds of hernia; with renal and cystic calculi; with hemorrhoids, varicose veins, etc.; with abdominal dropsy; and with still other affections. In bloodletting he recommends the practice of opening the vein longitudinally. He is very emphatic in his manner of insisting that medicine and surgery should not be divorced, and that the operation of drawing blood should not be intrusted to barbers.

After the death or retirement of Lanfranchi during the first decade of the fourteenth century, Paris appears to have played, at least for a few years, a comparatively small part in the history of medical teaching. Her rivals at