made into the nearest
intercostal space, the ribs forced apart by a suitable wedge and
the head thus extracted. The wound through the soft parts is to be
kept open by a tent greased with lard and provided with a suitable
prolongation (_cauda aliqua_) to facilitate its extraction and prevent
its falling into the cavity of the chest.

Wounds of the heart, lungs, liver, stomach and diaphragm are regarded
as hopelessly mortal (f. 233d), and the physician is advised to have
nothing to do with them. Wounds of the heart are recognized by the
profuse haemorrhage and the black color of the blood; those of the
lung by the foamy character of the blood and the dyspnoea; wounds of
the diaphragm occasion similar dyspnoea and are speedily fatal; those
of the liver are known by the disturbance of the hepatic functions,
and wounds of the stomach by the escape of its contents. Wounds of
the intestine are either incurable, or at least are cured only with
the utmost difficulty. Longitudinal wounds of the spine which do not
penetrate the cord may be repaired, but transverse wounds involving
the cord, so that the latter escapes from the wound, are rarely, if
ever, cured by surgery. Wounds of the kidneys are also beyond the art
of the surgeon. Wounds of the penis are curable, and if the wound is
transverse and divides the nerve, they are likewise painless.

_Si vene titillares in coxis abscidantur homo moritur ridendo._ A
passage which I can refer only to the erudition and risibility of our
modern surgeons and anatomists. The ticklish _vene titillares_ are to
me entirely unknown.

Modern abdominal surgeons will probably be interested in reading
Gilbert's chapter on the treatment of wounds of the intestines in the
thirteenth century. He says (f. 234c):

If some portion of the intestine has escaped from a wound of the
abdomen and is cut either longitudinally or transversely, while the
major portion remains uninjured; if the wound has existed for some
time and the exposed intestine is cold, some living animal, like a
puppy (_catulus_), is to be killed, split longitudinally and placed
over the intestine, until the latter is warmed, vivified by the
natural heat and softened. Then a small tube of alder is prepared, an
inch longer than the wound of the intestine, carefully thinned down
(_subtilietur_) and introduced into the gut through the wound and
stitched in position with a very fine square-pointed needle, threaded
with silk. This tube or