A Manual of the Operations of Surgery by Joseph Bell (best e reader for epub txt) 📕
Operation.--The ligature may be applied in one of two ways, the choice being influenced by the nature of the disease for which it is done.
1. A straight incision (Plate I. fig. 1) in the linea alba, just avoiding the umbilicus by a curve, and dividing the peritoneum, allows the intestines to be pushed aside, and the aorta exposed still covered by the peritoneum, as it lies in front of the lumbar vertebræ. The peritoneum must again be divided very cautiously at the point selected, and the aortic plexus of nerves carefully dissected off, in order that they may not be interfered with by the ligature. The ligature should then be passed round, tied, cut short, and the wound accurately sewed up.
2. Without wounding the peritoneum.
A curved incision (Plate I. fig. 2), with its convexity backwards, from the projecting end o
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[1] This line is placed too low down; it should be in the middle third of the thigh.
[2] Erichsen, Surgery. Sixth edition, vol. ii. p. 121.
[3] The line 3 in Plate I. shows the direction required. It will not be necessary to carry the incision so far up for the external as for the common iliac.
[4] On the Arteries and Veins, p. 421.
[5] Cyclopædia of Practical Surgery, vol. i. p. 277.
[6] John Bell's Prin. of Surg., vol. i. 421; Dublin Jour., vol. iv. 321.
[7] Observations in Clinical Surgery, Syme, pp. 171-3.
[8] Brit. Med. Jour. 1867, Oct. 5.
[9] International Encyclopædia of Surgery, vol. iii. p. 466.
[10] Poland, Guy's Hosp. Report, ser. iii. vol. vi.
[11] Mr. W. Thomson's most interesting paper on this subject is full of information down to the latest date.
[12] Lancet, Jan. 5, 1867.
[13] Lancet, May 1879.
[14] Dublin Quarterly Journal, Nov. 1867.
[15] W. Zehender—Monatsbl. für Augenheilkunde. 1868.
[16] Butcher, Op. and Cons. Surgery, p. 861.
[17] Leçons Orales, iv. 530.
[18] Ed. Med. and Surg. Journ. vol. xlv.
[19] Observations in Clinical Surgery, pp. 148, 149.
[20] Edin. Med. Journal, March 1879.
[21] See case of recurrence, Fergusson's Practical Surgery 1st ed. p. 222.
[22] Operative Surgery, p. 279.
[23] Surgical Operations, p. 50.
[24] For details see article "Amputation" in Cooper's Surgical Dictionary, and the short sketch of the history in Mr. Lister's paper in the third volume of Holmes's System of Surgery.
[25] See a most interesting foot-note to Professor Lister's paper on "Amputation," in Holmes's System of Surgery, vol. iii. pp. 52, 53.
[26] Manuel d'Opérations chirurgicales.
[27] Fig. iv. shows dorsal view of incision. Fig. iii. showsface of completed stump; R, radial; U, ulnar.
[28] As the surgeon will find it most convenient to stand on his own right side of the limb to be removed, the knife will be entered on the palmar side of the radius of the right arm, of the ulna of the left.
[29] Teale, On Amputation by Rectangular Flaps, pp. 46-48.
[30] Johnson's folio ed., p. 342.
[31] Gross's Surgery, 6th ed. vol. ii. p. 1103.
[32] International Encyclopædia of Surgery, vol. i. p. 641.
[33] Spence's Surgery, pp. 800, 801.
[34] Gross's Surgery, 8vo., 6th ed., vol. ii., p. 1106.
[35] Excision of Scapula, p. 33.
[36] Hey's Observations, 3d ed. pp. 552, 556.
[37] Roux's Parallel between English and French Surgery. Translation abridged from Cooper's Surgical Dictionary, p. 106.
[38] Syme's Principles, 4th edit. p. 145.
[39] International Encyclopædia, vol. 1. p. 655.
[40] Observations in Clin. Surgery, p. 48.
[41] Monthly Journal of Medical Science for 1849, vol. ix. p. 951.
[42] Med. Times and Gazette, June 3, 1865.
[43] Operative Surgery, p. 170.
[44] Annali Universali de Medicina, Milano, 1857.
[45] Med. Chir. Transactions of London, vol. liii., p. 175.
[46] Carden's (of Worcester) Pamphlet, pp. 5, 6; and British Medical Journal, 1864.
[47] B. Bell's Surgery, 6th ed. vol. vii. pp. 336-339.
[48] In diagram the amputation is drawn as if for middle third of thigh.
[49] Teale, op. cit., pp. 34, 39.
[50] Edin. Med. Journal, for April 1863.
[51] Edin. Medical Journal, March 1879.
[52] On Diseases and Injuries of Joints, p. 121.
[53] For a very large amount of most interesting and valuable information on the whole subject of excisions of joints, I would refer to Dr. Hodge's most excellent work on this subject—On Excisions of Joints. By Richard M. Hodge, M.D., Boston, Massachusetts.
[54] See Syme's Observations on Clinical Surgery, pp. 55, 57; Hodge on Excision of Joints, p. 63.
[55] Maunder's Operative Surgery, 2d ed. p. 123.
[56] Edin. Med. Journal, May 1873.
[57] Quoted by Mr. Porter. Dublin Quarterly Journal for May 1867, p. 264.
[58] A-A. Deep palmar arch; B. Trapezium; C. Articular surface of ulna; Dotted lines include the amount removed in Lister's earlier operations; Unshaded portions are those removed by Lister in cases where the disease is limited to the carpus. (Reduced from Lister's diagram in Lancet, 1865.)
[59] Skey, Op. Surg., 2d ed. p. 438.
[60] Abridged from Butcher, Op. and Con. Surgery, p. 208.
[61] Science and Art of Surgery, 3d ed. p. 745.
[62] On the Surgical Treatment of Children's Diseases, pp. 454-6.
[63] Clinical Society's Transactions, vol. xiii. p. 71.
[64] Billroth of Vienna and Pelikan of St. Petersburg, quoted from Heyfelder by Hodge on Excision of Joints, p. 161.
[65] Operative and Conservative Surgery, pp. 28, 138.
[66] On Excision of Knee-Joint, pp. 18, 20.
[67] Operative and Conservative Surgery, p. 169.
[68] Mr. Jones of Jersey, Med. Chir. Trans., vol. xxxvii. p. 68.
[69] Lancet, Oct. 1, 1859.
[70] Barwell On Diseased Joints, p. 464.
[71] Syme On Excision of the Scapula, pp. 13-26, 1864.
[72] Butcher's Operative and Conservative Surgery, p. 225.
[73] For an excellent case, see Annandale on Diseases of the Finger and Toes, p. 261.
[74] Holmes's Surgery, 3d edition, vol. iii. p. 771.
[75] Brit. and Foreign Med. Chir. Review for July 1853.
[76] Mr. Holmes in Lancet for February 18, 1856.
[77] Ibid. for May 1865.
[78] Butcher, Operative and Conservative Surgery, p. 354.
[79] See Butcher, Operative and Conservative Surgery, p. 356.
[80] See case by the author in the Edin. Med. Jour. for June 1868.
[81] a. Elliptical incision for entropium; b. wedge-shaped incision for ectropium.
[82] Fig. viii. illustrates Streatfeild's operation for entropium.—a. section of skin; b. section of levator palpebrae; c. section of cartilage of lid; d. section of conjunctiva; e. wedge-shaped portion excised.
[83] Ophthalmic Hospital Reports, vol. i. p. 121.
[84] Rough diagram of Bowman's operation, showing the grooved director in the punctum, and the knife in the groove just before it slits up the canaliculus.
[85] Diagram of operations for convergent squint—A A, line of sub-conjunctival incision; B B, line of Dieffenbach's operation; c, wire speculum.
[86] The Radical Cure of Extreme Divergent Strabismus. J. Vose Solomon, F.R.C.S., 1864.
[87] Ophthalmic Hospital Reports, vol. iv. part ii. p. 197.
[88] Biennial Retrospect for 1865-66. Syd. Soc. pp. 363-4. For a thorough discussion of the merits of this operation, see papers by Von Graefe in Brit. Med. Jour. for 1867, vol. i. pp. 379, 446, 499, 657, 765.
[89] Ophthalmic Hospital Reports, vol. i. p. 224.
[90] Streatfeild on Corelysis. Ophthalmic Hospital Reports, vol. ii. p. 309.
[91] a iris; b lens; c cornea. The hook is seen applied to the adhesion between lens and iris.
[92] The staphyloma with the needles inserted, the lids held asunder by a spring speculum. The elliptical dotted line shows the amount to be removed; the vertical one, the position of the preliminary incision with the Beer's knife.
[93] Resulting stump after the stitches are inserted.
[94] Ophthalmic Hospital Reports, vol. iv. part 1.
[95] Operation for formation of a new nose from the cheeks; a a, flaps approximated in middle line; B B, outer part of bed of flaps stitched up; C C, triangle at each side left to granulate.
[96] The Restoration of a Lost Nose by Operation, p. 57; an excellent monograph on the subject.
[97] Operation for formation of a new nose from the forehead:—a, prominence of flap which is to be used as septum; b, left-hand corner of flap, which is twisted and fastened at c; d, one of the tubes or quills over which the nose is moulded.—(Modified from Bernard and Huette.)
[98] Syme's Observations in Clinical Surgery, p. 132.
[99] Diagram of V-shaped incision; A B A, dots showing points for sutures.
[100] Diagram of incision for scooping out a shallow tumour by scissors.
[101] Diagram of incisions:—C A C, outline of incision for removal; C A D, outline of flap on each side; b, prominence of chin; C C, dotted lines, showing incisions to enlarge mouth, if required.
[102] Diagram of flaps in position:—A A, corners of flaps brought up and approximated by silver sutures; C C, new lip got by lateral incisions, skin and mucous membrane being united by silk threads; E E, gap left to granulate.
[103] Fig. xxiii. shows the incision bounding the cleft.
[104] Fig. xxiv. shows the diamond-shaped wound before the sutures are applied.
[105] Diagram of operation for double harelip:—a, stitch through both sides and wedge-shaped portion,
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