(seq. 3)

Notes from Esse’s Lectures

Venereal nodes arise in the bone & affect the
Periostium & not first in the periostium & from there
infect the bone as Astruc taught

Never Salivate immediatly after opening a boubo
or after any churgical operation in the Venereal
Disease not even circumcision but reathe wait 8 or 9
days before we give ☿ [mercury] otherwise the wound will not
heal kindly

Never extend the Limb in order to reduce a fracture
but bend it so that the least number of muscles are
upon Action — the Weight of the Cubit when bent is
(Esse says) sufficient to bring the Ends of the Bone of a
fractured Humerus in contact & that extension is commonly
unessesary. If there are splinters of a bone & are
not so troublesome as to bring on convulsions they are
reather to be let alone & suffered to work out thro the
suppurated part than to be extracted thro' an incision
for the putrid air of an Hospital coming in contact
with the bones does more harm than (in this case) can
do service. Be careful to examine (in
Compound fractures) not only the Anterior part of the
bone but the posterior for frequently the splinters
are shattered from behind i.e the opposite side of the
bone from that which received the immediate blow