Page:The growth of medicine from the earliest times to about 1800.djvu/540

 *lisher, bears the title: "Traité des hernies contenant une ample déclaration de toutes leurs espèces, etc." (a book of 554 pages, 8vo). This work goes very thoroughly into the subject of hernia in all its bearings, and also deals with several other important surgical topics, such as genito-*urinary diseases (in both the male and the female), affections of the eyes, hare-lip, tumors, wounds in general, dislocations, fractures, amputations, etc.; in short, it is a fairly complete and decidedly original treatise on general surgery. When Franco wrote the smaller work (that of 1556), he was settled at Lausanne; but in 1561 he was living in Orange, which at that time was the capital of a Principality that belonged to the House of Nassau. A few brief citations from the larger of the two treatises will suffice to give our readers some idea of the manner in which Franco deals with the subject-matter of the book.

Franco, says von Gurlt, was one of the first surgeons—perhaps the very first—to perform the operation required for the relief of strangulated hernia and at the same time to furnish a description of the manner in which it should be performed. After mentioning the fact that the strangulation of a portion of the intestine is attended with considerable danger to the patient's life, Franco proceeds to consider the subject in greater detail:—

Owing to the large amount of the fecal matter and gas contained within the portion of the intestine that is imprisoned in the scrotum, and also owing to the inflamed condition of the parts, it is frequently not possible to push the bowel back through the narrow aperture in the peritoneum; and this condition of things is apt to be aggravated by the constipation or by the efforts at vomiting that frequently accompany such strangulation. The vomiting, it is true, may in certain cases facilitate the desired reduction, but in others it does harm, especially by forcing more fecal matter into the scrotum. If the conditions described are permitted to continue unrelieved, death may certainly be expected to result. In a few cases the timely administration of medicine internally may overcome the difficulty, but, if this measure fail to produce the desired