of the arrow through the wound of entrance. The
wounds of the cranium are then to be treated like ordinary fractures
of that organ (f. 88c).

In wounds of the neck involving the jugular vein (_vena organica_),
Gilbert directs ligation of both extremities of the wounded vessel,
after which the wound is to be dressed (but not packed) with the
ordinary dressing of egg-albumen.

Wounds of nerves are treated with a novel dressing of earthworms
lightly beaten in a mortar and mixed with warm oil, and he professes
to have seen nerves not only healed (_conglutinari_), but even the
divided nerve fibres regenerated (_consolidari_) under this treatment.
In puncture of a nerve Gilbert surprises us (f. 179d) by the advice
to divide completely the wounded nerve, in order to relieve pain and
prevent tetanus (_spasmus_).

Goitre, not too vascular in character, is removed by a longitudinal
incision over the tumor, after which the gland is to be dragged out,
with its entire capsule, by means of a blunt hook. A large goitre in
a feeble patient, however, is better left alone, as it is difficult
to remove all the intricate roots of the tumor, and if any portion is
left it is prone to return. In such cases Gilbert says we shrink
from the application of the actual cautery, for fear of injury to
the surrounding vessels and nerves. Whatever method of operation is
selected, the patient is to be tied to a table and firmly held in
position.

Wounds of the trachea and oesophagus, according to Gilbert, are
invariably mortal.

In wounds of the thorax the ordinary dressing of albumen is to be
applied, but if blood or pus enters the cavity of the thorax, the
patient is directed to bend his body over a dish, twisting himself
from one side to another (_supra discum[10] flectat se modo hac modo
ilac vergendo_) until he expels the sanies through the wound, and to
always lie with the wound dependent until it is completely healed (f.
182d).

[Footnote 10: It is interesting to observe how the Latin discus
developed dichotomously into the English "dish" and the German
"Tisch." The former is doubtless the meaning of the word in this
place.]

In case an arrow is lodged within the cavity of the thorax, the
surgeon is directed to trepan the sternum (_os pectoris_), remove the
head of the arrow gently from the shaft, and withdraw the shaft itself
through the original wound of entrance. If the head is lodged beneath
or between the ribs, an opening is to be