Читать книгу The Compleat Surgeon or, the whole Art of Surgery explain'd in a most familiar Method - M. Le Clerc - Страница 20

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Why is Anatomy usually begun with the Demonstration of the Skeleton, or Contexture of Bones?

Because the Bones serve for the Foundation Connexion, and Support of all other Parts of the Body.

What is the Skeleton?

It is a gathering together, or Conjunction of all the Bones of the Body almost in their Natural Situation.

From whence are the principal differences of the Bones derived?

They are taken from their Substance, Figure, Articulation, and Use.

How is all this to be understood?

First then, with respect to their Substance, there are some Bones harder than others; as those of the Legs compared with those of the Back-Bone. Again, in regard of their Figure, some are long, as those of the Arm; and others short, as those of the Metacarpium. Some are also broad, as those of the Skull and Omoplatæ or Shoulder-Blades; and others narrow, as the Ribbs. But with respect to their Articulation, some are joined by thick Heads, which are received into large Cavities, as the Huckle-Bones with those of the Hips; and others are united by the means of a simple Line, as the Chin-Bones. Lastly, with relation to their Use; some serve to support and carry the whole Body, as the Leg-Bones, and others are appointed to grind the Meat, as the Teeth; or else to form some Cavity, as the Skull-Bone, and those of the Ribs.

What are the Parts to be distinguished in the Bones?

They are the Body, the Ends, the Heads, the Neck, the Apophyses, the Epiphyses, the Condyli or Productions, the Cavities, the Supercilia or Lips, and the Ridges.

The Body is the greatest Part, and the middle of the Bone; the Ends are the two Extremities; the Heads are the great Protuberances at the Extremities; the Neck is that Part which lies immediately under the Head; the Apophyses or Processes are certain Bunches or Knobs at the Ends of the Bones, which constitute a Part of them; the Epiphyses are Bones added to the Extremities of other Bones; the Condyli or Productions are the small Elevations or Extuberances of the Bones; the Cavities are certain Holes or hollow places; the Supercilia or Lips are the Extremities of the Sides of a Cavity, which is at the End of a Bone; the Ridges are the prominent and saliant Parts in the length of the Body of the Bone.

How are the Bones join'd together?

Two several ways, viz. by Articulation and Symphysis.

How many sorts of Articulations are there in the Bones?

There are generally two kinds, viz. Diarthrosis and Synarthrosis.

What is Diarthrosis?

Diarthrosis is a kind of Articulation which serves for sensible Motions.

How many kinds of Diarthroses, or great Motions are there?

There are Three, viz. Enarthrosis, Arthrodia, and Ginglymus.

Enarthrosis is a kind of Articulation which unites two Bones with a great Head on one side, and a large Cavity on the other; as the Head of the Thigh-Bone in the Cavity of the Ischion or Huckle-Bone.

Arthrodia is a sort of Articulation, by the means whereof two Bones are join'd together with a flat Head receiv'd into a Cavity of a small depth. Such is the Head of the Shoulder-Bone with the Cavity of the Omoplata or Shoulder-Blade; and that of the Twelfth Vertebra of the Back with the first of the Loins.

Ginglymus is a kind of Articulation which unites two Bones, each whereof hath at their Ends a Head and a Cavity, whereby they both receive and are received at the same time, such is the Articulation in the Bones of the Elbow and the Vertebræ.

What is Synarthrosis?

Synarthrosis being opposite to Diarthrosis, is a close or compacted Articulation, destitute of any sensible Motion.

How many sorts of Synarthroses, or close Articulations are there?

There are Three. viz. Sutura, Harmonia, and Gomphosis.

A Suture is that which joins together two Bones by a kind of Seam or Stitch, or by a Connexion of their Extremities dispos'd in form of a Saw, the Teeth whereof are reciprocally let one into another: Such are the Sutures of the Skull-Bones.

Harmonia is the uniting of two Bones by a simple Line; as the Bone of the Cheek with that of the Jaw.

Gomphosis is a kind of close Articulation, which unites two Bones after the manner of Nails or Wooden Pins fixt in the Holes made to receive them: Such is that of the Teeth in their Sockets.

What is Symphysis?

Symphysis is the uniting of two Bones by the interposition of a Medium, which ties them very streight together, being also threefold: Such is the Connexion of the Knee-Pan or Whirl-Bone of the Knee, and the Omoplata or Shoulder-Blade.

Are not these three kinds of Articulations or Symphyses distinguish'd one from another?

Yes; for tho' they are all made by the means of a third Body intervening, which joins them together; nevertheless every one of these various Bodies gives a different Denomination to its respective Articulation: Thus the Articulation which is caus'd by a Glutinous and Cartilaginous Substance, is properly call'd Synchondrosis; as that of the Nose, Chin, Os Pubis, &c. But an Articulation which is made by a Ligament is termed Synncurosis, as that of the Knee-Pan. Lastly, that which is wrought by the means of Flesh, bears the Name of Syssarcosis; as the Jaw-Bones, the Os Hyoides, and the Omoplata or Shoulder-Blade.

Have the Bones any sense of Feeling or Motion?

They have neither; for their sense of Pain proceeds from nothing else but their Periostium, or the Membrane with which they are cover'd, and their Motion is perform'd only by the Muscles that draw them.

Doth the Marrow afford any Nutriment to the Bones?

No, all the Bones are nourish'd by the Blood, as the other Parts; but the Marrow is to the Bones what the Fat is to the Flesh; that is to say, it is a kind of Oil or Unctuous Substance, which moistens, and renders them less brittle.

Are all the Bones of the same Colour?

No, they follow the Temperament and Constitution of the Persons.

How many in number are the Bones of the Humane Skeleton?

There are two hundred and fifty usually reckon'd, viz. 61 in the Head, 67 in the Trunk or Chest, 62 in the Arms and Hands, and 60 in the Legs and Feet; but the true Number cannot be exactly determin'd, by reason that some Persons have more, and others fewer; for some have more Ossa Sesamoidea, Teeth and Breast-Bones than others: Again, some have many indentings in the Lambdoidal Suture, and others have none at all.

Can you rehearse the Number of the Bones of the Head?

There are Fifteen in the Skull, and Forty six in the Face.

The Fifteen of the Skull are the Coronal for the fore-part of the Head; the Occipital for the hinder-part; the two Parietals for the upper-part and each side; the two Temporals for the Temples; the Os Sphenoides or Cuneiforme, which closeth the Basis or bottom of the Skull; the Os Ethmoides, or Cribriforme, situated at the Root of the Nose; and the four little Bones of the Ear on each side, viz. the Incus or Anvil; the Stapes or Stirrup; the Malleolus or Hammer; and the Orbiculare or Orbicular Bone.

Of the Forty six of the Face, Twenty seven are counted in the Upper-Jaw, viz. the two Zygomatick, or the two Bones of the Cheek-Knots; the two Lachrymal in the great Corners of the Eyes toward the Nose; the two Maxillar, that receive the Upper-Teeth, and which form part of the Palate of the Mouth, and the Orbits of the Eyes; the two Bones of the Nose; the two Palate-Bones which are at its end, and behind the Nostrils; the last being single is the Vomer, which makes the Division of the lower part of the Nostrils; and there are generally Sixteen Upper-Teeth. The Lower-Jaw contains Nineteen Bones, viz. sixteen Teeth; two Bones that receive them; and the Os Hyoides, which is single, and fix'd at the Root of the Tongue.

How are the Teeth usually divided with respect to their Qualities?

Into Incisive or Cutters, Canine or Dog-Teeth, and Molar or Grinders: There are eight Incisive, and four Canine, which have only one single Root; as also twenty Molar, every one whereof hath one, two, or three Roots.

Can you recite the Number of the Bones of the Trunk or Chest?

There are generally thirty and three in the Spine or Chine-Bone of the Back, viz. seven Vertebra's in the Neck, twelve in the Back, five in the Legs, five, six, and sometimes seven in the Os Sacrum, three or four in the Coccyx, and two Cartilages at its end.

There are twenty nine in the Breast, viz. twenty four Ribs, two Clavicles or Channel-Bones and commonly three Bones in the Sternum. The Hip-Bones are likewise divided into three, viz. Ilion, Ischion and Os Pubis.

Do you know the Number of the Bones of the Arms?

There are thirty and one Bones in each Arm, that is to say, the Omoplata or Shoulder-Blade; the Humerus or Shoulder-Bone; the two Bones of the Elbow call'd Ulna, and Radius; eight little Bones in the Carpus or Wrist; five in the Metacarpium or Back of the Hand; and fourteen in the Fingers, three to every one except the Thumb, which hath only two.

Can you give us a List of the Bones of the Leg in their Order?

There are thirty Bones in each Leg, viz. the Femur or great Thigh-Bone, the Knee-Pan or Whirl-Bone on the top of the Knee; the Tibia, greater Focile, or Shin-Bone; and the Perone or Fibula, or lesser Focile, which are the two associated Bones of the Leg; seven little Bones in the Tarsus; five in the Metatarsus; and fourteen in the Toes; that is to say, three to every one, except the great Toe, which hath only two.

Thus the Number of Bones of the Humane Skeleton amounts to two hundred and Fifty, without reckoning the Sesamoides, the Indentings of the Skull, and some others which are not always to be found.