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Title: Manual of Surgery
       Volume First: General Surgery. Sixth Edition.

Author: Alexis Thomson and Alexander Miles

Release Date: March 4, 2006 [EBook #17921]

Language: English


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OXFORD MEDICAL PUBLICATIONS MANUAL OF SURGERY BY

ALEXIS THOMSON, F.R.C.S.Ed.
PROFESSOR OF SURGERY, UNIVERSITY OF EDINBURGH
SURGEON EDINBURGH ROYAL INFIRMARY

AND

ALEXANDER MILES, F.R.C.S.Ed.
SURGEON EDINBURGH ROYAL INFIRMARY

VOLUME FIRST
GENERAL SURGERY

SIXTH EDITION REVISED
WITH 169 ILLUSTRATIONS

LONDON
HENRY FROWDE and HODDER & STOUGHTON
THE LANCET BUILDING
1 & 2 BEDFORD STREET, STRAND, W.C.2

First Edition 1904 Second Edition 1907 Third Edition 1909 Fourth Edition 1911 ""Second Impression 1913 Fifth Edition 1915 ""Second Impression 1919 Sixth Edition 1921

Printed in Great Britain by
Morrison and Gibb Ltd., Edinburgh

PREFACE TO SIXTH EDITION

Much has happened since this Manual was last revised, and many surgical lessons have been learned in the hard school of war. Some may yet have to be unlearned, and others have but little bearing on the problems presented to the civilian surgeon. Save in its broadest principles, the surgery of warfare is a thing apart from the general surgery of civil life, and the exhaustive literature now available on every aspect of it makes it unnecessary that it should receive detailed consideration in a manual for students. In preparing this new edition, therefore, we have endeavoured to incorporate only such additions to our knowledge and resources as our experience leads us to believe will prove of permanent value in civil practice.

For the rest, the text has been revised, condensed, and in places rearranged; a number of old illustrations have been discarded, and a greater number of new ones added. Descriptions of operative procedures have been omitted from the Manual, as they are to be found in the companion volume on Operative Surgery, the third edition of which appeared some months ago.

We have retained the Basle anatomical nomenclature, as extended experience has confirmed our preference for it. For the convenience of readers who still employ the old terms, these are given in brackets after the new.

This edition of the Manual appears in three volumes; the first being devoted to General Surgery, the other two to Regional Surgery. This arrangement has enabled us to deal in a more consecutive manner than hitherto with the surgery of the Extremities, including Fractures and Dislocations.

We have once more to express our thanks to colleagues in the Edinburgh School and to other friends for aiding us in providing new illustrations, and for other valuable help, as well as to our publishers for their generosity in the matter of illustrations.

Edinburgh,
March 1921.

CONTENTS page CHAPTER I Repair 1 CHAPTER II Conditions which interfere with Repair 17 CHAPTER III Inflammation 31 CHAPTER IV Suppuration 45 CHAPTER V Ulceration and Ulcers 68 CHAPTER VI Gangrene 86 CHAPTER VII Bacterial and other Wound Infections 107 CHAPTER VIII Tuberculosis 133 CHAPTER IX Syphilis 146 CHAPTER X Tumours 181 CHAPTER XI Injuries 218 CHAPTER XII Methods of Wound Treatment 241 CHAPTER XIII Constitutional Effects of Injuries 249 CHAPTER XIV The Blood Vessels 258 CHAPTER XV The Lymph Vessels and Glands 321 CHAPTER XVI The Nerves 342 CHAPTER XVII Skin and Subcutaneous Tissues 376 CHAPTER XVIII The Muscles, Tendons, and Tendon Sheaths 405 CHAPTER XIX The Bursæ 426 CHAPTER XX Diseases of Bone 434 CHAPTER XXI Diseases of Joints 501 INDEX 547 LIST OF ILLUSTRATIONS fig. page 1. Ulcer of Back of Hand grafted from Abdominal Wall 15 2. Staphylococcus aureus in Pus from case of Osteomyelitis 25 3. Streptococci in Pus from case of Diffuse Cellulitis 26 4. Bacillus coli communis in Pus from Abdominal Abscess 27 5. Fraenkel's Pneumococci in Pus from Empyema following Pneumonia 28 6. Passive Hyperæmia of Hand and Forearm induced by Bier's Bandage 37 7. Passive Hyperæmia of Finger induced by Klapp's Suction Bell 38 8. Passive Hyperæmia induced by Klapp's Suction Bell for Inflammation of Inguinal Gland 39 9. Diagram of various forms of Whitlow 56 10. Charts of Acute Sapræmia 61 11. Chart of Hectic Fever 62 12. Chart of Septicæmia followed by Pyæmia 63 13. Chart of Pyæmia following on Acute Osteomyelitis 65 14. Leg Ulcers associated with Varicose Veins 71 15. Perforating Ulcers of Sole of Foot 74 16. Bazin's Disease in a girl æt. 16 75 17. Syphilitic Ulcers in region of Knee 76 18. Callous Ulcer showing thickened edges 78 19. Tibia and Fibula, showing changes due to Chronic Ulcer of Leg 80 20. Senile Gangrene of the Foot 89 21. Embolic Gangrene of Hand and Arm 92 22. Gangrene of Terminal Phalanx of Index-Finger 100 23. Cancrum Oris 103 24. Acute Bed Sores over right Buttock 104 25. Chart of Erysipelas occurring in a wound 108 26. Bacillus of Tetanus 113 27. Bacillus of Anthrax 120 28. Malignant Pustule third day after infection 122 29. Malignant Pustule fourteen days after infection 122 30. Colony of Actinomyces 126 31. Actinomycosis of Maxilla 128 32. Mycetoma, or Madura Foot 130 33. Tubercle bacilli 134 34. Tuberculous Abscess in Lumbar Region 141 35. Tuberculous Sinus injected through its opening in the Forearm with Bismuth Paste 144 36. Spirochæte pallida 147 37. Spirochæta refrigerans from scraping of Vagina 148 38. Primary Lesion on Thumb, with Secondary Eruption on Forearm 154 39. Syphilitic Rupia 159 40. Ulcerating Gumma of Lips 169 41. Ulceration in inherited Syphilis 170 42. Tertiary Syphilitic Ulceration in region of Knee and on both Thumbs 171 43. Facies of Inherited Syphilis 174 44. Facies of Inherited Syphilis 175 45. Subcutaneous Lipoma 185 46. Pedunculated Lipoma of Buttock 186 47. Diffuse Lipomatosis of Neck 187 48. Zanthoma of Hands 188 49. Zanthoma of Buttock 189 50. Chondroma growing from Infra-Spinous Fossa of Scapula 190 51. Chondroma of Metacarpal Bone of Thumb 190 52. Cancellous Osteoma of Lower End of Femur 192 53. Myeloma of Shaft of Humerus 195 54. Fibro-myoma of Uterus 196 55. Recurrent Sarcoma of Sciatic Nerve 198 56. Sarcoma of Arm fungating 199 57. Carcinoma of Breast 206 58. Epithelioma of Lip 209 59. Dermoid Cyst of Ovary 213 60. Carpal Ganglion in a woman æt. 25 215 61. Ganglion on lateral aspect of Knee 216 62. Radiogram showing pellets embedded in Arm 228 63. Cicatricial Contraction following Severe Burn 236 64. Genealogical Tree of Hæmophilic Family 278 65. Radiogram showing calcareous degeneration of Arteries 284 66. Varicose Vein with Thrombosis 289 67. Extensive Varix of Internal Saphena System on Left Leg 291 68. Mixed Nævus of Nose 296 69. Cirsoid Aneurysm of Forehead 299 70. Cirsoid Aneurysm of Orbit and Face 300 71. Radiogram of Aneurysm of Aorta 303 72. Sacculated Aneurysm of Abdominal Aorta 304 73. Radiogram of Innominate Aneurysm after Treatment by Moore-Corradi method 309 74. Thoracic Aneurysm threatening to rupture 313 75. Innominate Aneurysm in a woman 315 76. Congenital Cystic Tumour or Hygroma of Axilla 328 77. Tuberculous Cervical Gland with Abscess formation 331 78. Mass of Tuberculous Glands removed from Axilla 333 79. Tuberculous Axillary Glands 335 80. Chronic Hodgkin's Disease in boy æt. 11 337 81. Lymphadenoma in a woman æt. 44 338 82. Lympho Sarcoma removed from Groin 339 83. Cancerous Glands in Neck, secondary to Epithelioma of Lip 341 84. Stump Neuromas of Sciatic Nerve 345 85. Stump Neuromas, showing changes at ends of divided Nerves 354 86. Diffuse Enlargement of Nerves in generalised Neuro-Fibromatosis 356 87. Plexiform Neuroma of small Sciatic Nerve 357 88. Multiple Neuro-Fibromas of Skin (Molluscum fibrosum) 358 89. Elephantiasis Neuromatosa in a woman æt. 28 359 90. Drop-Wrist following Fracture of Shaft of Humerus 365 91. To illustrate the Loss of Sensation produced by Division of the Median Nerve 367 92. To illustrate Loss of Sensation produced by Complete Division of Ulnar Nerve 368 93. Callosities and Corns on Sole of Foot 377 94. Ulcerated Chilblains on Fingers 378 95. Carbuncle on Back of Neck 381 96. Tuberculous Elephantiasis 383 97. Elephantiasis in a woman æt. 45 387 98. Elephantiasis of Penis and Scrotum 388 99. Multiple Sebaceous Cysts or Wens 390 100. Sebaceous Horn growing from Auricle 392 101. Paraffin Epithelioma 394 102. Rodent Cancer of Inner Canthus 395 103. Rodent Cancer with destruction of contents of Orbit 396 104. Diffuse Melanotic Cancer of Lymphatics of Skin 398 105. Melanotic Cancer of Forehead with Metastasis in Lymph Glands 399 106. Recurrent Keloid 401 107. Subungual Exostosis 403 108. Avulsion of Tendon 410 109. Volkmann's Ischæmic Contracture 414 110. Ossification in Tendon of Ilio-psoas Muscle 417 111. Radiogram of Calcification and Ossification in Biceps and Triceps 418 112. Ossification in Muscles of Trunk in generalised Ossifying Myositis 419 113. Hydrops of Prepatellar Bursa 427 114. Section through Gouty Bursa 428 115. Tuberculous Disease of Sub-Deltoid Bursa