[24.] By an assistant.) I read ministro instead of sinistro, which is in Linden.—See Morgagni, Ep. vi. p. 147.
[25.] Sometimes upon account of their health. Interdum valetudinis causa.) Some of the older editions insert before this, Interdum vocis, Sometimes on account of their voice. I do not know how this came to be dropped afterwards: for it is certain this was one very common reason for infibulating.
[26.] Sticks where that grows narrower.) In Almeloveen and Linden, Nonnunquam etiam prolapsus in ipsam fistulam calculus, qui subinde ea extenuatur.——-Which I think is capable of no sense, and have therefore taken the liberty to follow Morgagni’s conjecture qua for qui. Ep. i. p. 38.
[27.] Being first slightly anointed with oil, &c. Leniter prius unctos oleo simul in anum ejus demittit.) The old editions, without any mention of the oil, have, Leniter prius unum deinde alterum in anum ejus demittit; that is, Introduces gently the fore and middle fingers, first the one and then the other.
[28.] Come out prone, that is, with its end foremost, ut pronus exeat.) This Constantine changed in the margin into Ut ne pronus exeat, which Linden received into the text. Constantine explains prone by lying on its side, and says it is hardly possible to extract an oblong stone in that posture, supposing, no doubt, that it must necessarily lie across the orifice. See Morgagni, Ep. v. p. 128.
[29.] Then in that part where the bottom of the wound is straiter, &c. Deinde ea parte qua strictior ima plaga est.) Thus all the printed copies read. This passage has given rise to a variety of opinions on the nature of the first and second wound: some imagining that the first, which is called the lunated incision, was concave towards the rectum; others, on the contrary, from the word coxæ being used for the ilia as well as the ischia, believed it was concave towards the scrotum.
Then, with respect to the transverse incision made through the neck of the bladder, some have thought that the word transverse was used as it regarded the first wound, so that the second incision was nearly perpendicular to the first, and the urethra was divided longitudinally; others again have supposed, that the incision was made transverse, with regard to the course of the urethra, that is, the neck of the bladder was opened transversely.
Though all the printed copies agree in the above reading, yet Morgagni informs us that instead of Qua strictior ima plaga est, his ancient MS has Qua resima plaga est, which would determine the convexity of the lunated incision to be towards the rectum; because in that case the cornua of the lunated incision would point to the superior part of the body. But this reading does not fix the direction of the plaga transversa, whether it was called so in respect of the parts, or the first incision: nor does that ingenious author favour us with his own opinion, but seems to prefer this to the common reading. Ep. vii. p. 189.
Now it should seem almost certain, that the lunated incision was meant to be concave towards the rectum; because when made in that direction, it would probably render the rectum much more loose and supple, than it is in its natural state, and thereby greatly facilitate the operation, by allowing the surgeon a much freer use of the two fingers, which are introduced into the rectum, and consequently admitting him to bring the stone more easily forwards into the neck of the bladder. One would suppose, however, that the benefit here suggested to arise from this lunated incision, was not extremely evident, or it would not have been dropped so early by succeeding surgeons: Ægineta makes not the least mention of this process, nor do we know when it was first discontinued. Perhaps, even in Celsus’s time, there were different methods of performing this operation; for does not he himself, when describing Meges’s manner of cutting upon a rough stone, omit the lunated incision? And does he not imply that there were different methods by saying, Quocunque autem modo cervix ea parte secta est, &c.?