A System of Operative Surgery, Volume 4 (of 4)

There is evidence to show that this operation was known to the ancients, and that it has been practised during at least two thousand years chiefly for the treatment of foreign b...

The performance of ovariotomy, hysterectomy, and allied procedures is attended by several risks, immediate and remote, which may spoil the best-planned and most carefully execut...

It is advisable to follow Krishaber in the separation of all forms of laryngeal cancer into two classes, the _Intrinsic_ and the _Extrinsic_. The term ‘intrinsic’ implies a grow...

The normal membrane is inclined obliquely downwards and forwards so that it forms an obtuse angle of 140 degrees with the roof and an acute angle of 27 degrees with the floor of...

=Indications.= It is chiefly employed as a diagnostic test. As a curative measure it is seldom successful except in comparatively recent infection. If the case be uncomplicated...

Before considering the question of the radical operation, it is assumed that conservative treatment has been attempted and has failed, and that the middle-ear suppuration has ex...

=Indications.= This operation is indicated for the ordinary mucous polypus of the nose when presenting in the post-nasal space. Polypoid masses of the ethmoid may project throug...

When possible, it is always preferable to operate under a general anæsthetic, such as gas and oxygen. If, however, the patient objects to a general anæsthetic, it should be expl...

=Surgical anatomy.= The lens consists of fibres which are developed from cells originating in an inclusion of the fœtal epiblast. A normal lens is surrounded by a capsule, the a...

The object of such operations is to arrest or eradicate the disease which, by further extension through the bony walls of the temporal bone, might eventually cause death by givi...

Pregnancy is apt to be complicated with tumours growing in the walls of the uterus, _e.g._ fibroids, cancer of the neck of the uterus, or cysts and tumours of one or both ovarie...

The sigmoid portion of the lateral sinus is the part usually infected. Thrombosis, however, may occur primarily in the region of the jugular bulb from direct extension of the py...

An intracranial abscess, the result of disease of the temporal bone, is usually situated close to the surface of the brain, and is in close relationship with the diseased area o...

The external injuries of the nose belong to general surgery. It might be well to recollect that the fleshy end of the nose may be completely detached, and yet, if carefully and...

=Indications.= Iridotomy is an operation which is performed when the iris has become drawn up after a cataract extraction, so that there is no pupil, or the pupillary area is co...

This is an operation which is much less frequently resorted to than formerly, owing partly to the risks of sepsis attending its performance and partly to the greater perfection...

=Indications.= Hysterectomy is mainly required in the radical treatment of fibroids and malignant disease (carcinoma, sarcoma, and chorion-epithelioma). It is occasionally requi...

=Indications.= A spur or ledge, uncomplicated with deviation of the septum, occasionally requires removal. It will generally be found in the lower meatus, at the junction of the...

Labyrinthine suppuration usually occurs in the course of a chronic middle-ear suppuration; more rarely, as the result of tuberculous disease of the temporal bone, or in conseque...

=Operation.= A platinum electrolysis needle (negative pole) is passed alongside each lash into the follicle, and a constant current of about 5 milliampères allowed to pass for a...

An intimate knowledge of the surgical anatomy of the nose is an important factor in successful treatment. It is sufficient to recall the close relations of the nasal chambers an...

Along the lid margin, between the eyelashes and the posterior border of the eyelid, is a white line (intermarginal line) formed by the edge of the tarsal plate. In the many oper...

The majority of operations are undertaken for the relief of obstruction to some portion of the canal which leads from the conjunctival sac to the nose, obstruction to which caus...

Intubation, or ‘tubage’, was first recommended by Loiseau and Bouchut in France; in 1880 attention was drawn to the subject by Sir W. Macewen in England, and soon afterwards O’D...

=Indications.= Operation with the snare is indicated in cases of simple mucous polypi, if only a few polypi are present, and no sinus suppuration is suspected. It is a suitable...

The history of this operation is of great interest to surgeons because it was the forerunner, so to speak, of all abdominal gynæcological operations; they followed as a natural...

=Indications.= (i) _Tumours._ Tumours of the larynx are more often innocent than malignant. Sir F. Semon[5] collected 12,297 cases seen between 1862 and 1888 by 107 laryngologis...

The great success which followed the use of the short ligature in ovariotomy induced several surgeons to apply the same principle to the cervical pedicle when removing the uteru...

A few surgeons prefer the operation to iridectomy, especially in cases of bup[h]thalmos. When practised after an iridectomy which has been done upwards, the sclerotomy is someti...

As the intracranial complications of otitic origin are due to direct extension of the pyogenic infection through the temporal bone to the cranial cavity, it follows that they wi...

Under this heading may be considered manipulations requiring special technical knowledge and skill: (1) Catheterization; (2) passing of bougies; and (3) washing out the tympanic...

When the abdomen is opened for the purpose of removing a diseased viscus, the operation receives a specific name, such as nephrectomy, gastrectomy, splenectomy, and so forth. In...

Operations upon the eye differ so widely from general surgical operations that it is necessary to say something of the preparations for them before passing on to their actual pe...

In order to perform successfully the various operations upon the ear, it is essential that the surgeon should be familiar with the technique of its examination, which, for the s...

=Gynæcological injuries.= The simplest and certainly the commonest accident is perforation of the uterus with a sound, dilator, or forceps in the operation of curetting. Many ca...

The systematic surgical treatment of extra-uterine gestation we owe to the genius of Lawson Tait. His first operation for this condition was performed in 1883. Tait wrote that h...

In _malignant tumours_ enucleation should only be performed when there are no signs of extra-ocular extension. If extra-ocular extension be present, evisceration of the orbit sh...

The evolution of this operation is of great interest to surgeons. The removal of ovaries as a surgical operation was introduced independently by Hégar in Germany and Battey in G...

Uterine growths include primary malignant disease and fibro-myomata; the former should be treated by exploration and subsequent vaginal hysterectomy (see p. 168), while the latt...

When the operation is performed for the latter reason the adjustment will naturally have to be much more accurate than for the former, so as to bring about the superimposition o...

The glands of Bartholin, or the vulvo-vaginal glands, are two racemose structures about the size of a pea, lodged between the layers of the triangular ligament, one on each side...

In operations upon the perineum and vagina, the same scrupulous precautions against sepsis should be taken as in abdominal section. Before proceeding to practical details, it wi...

This may be performed either by following the sinus downwards or through the floor of the auditory canal and tympanic cavity. The former method was first described by Grunert (_...

The symptoms requiring interference are pain on micturition, dyspareunia, bleeding and discomfort on movement, and, occasionally, retention of urine which is probably due to app...

Removal of a foreign body from the cornea requires a good light (focal illumination). The use of a binocular lens is also of service. Foreign bodies lodged on the surface of the...

Any of the above may become impacted in the trachea or fall into one of the bronchi: the right bronchus is affected nearly twice as often as the left owing to its larger size, i...

The modern operation of hysterectomy as a radical measure for the relief of cancer of the uterus has a somewhat curious history. In 1878 Freund extirpated the uterus for carcino...

The operation when employed for severe retroflexion of the uterus is now known as ventro-suspension of the uterus; when carried out for prolapse it is termed ventro-fixation of...

between the blades. In this way as much of the conjunctiva is gone over as is necessary. The lower fornix is best expressed by picking up the loose fold of the fornix with ordin...

For the Relief of Lachrymal Obstruction, 290--_Dilatation of the Canaliculus_, 290; _Slitting the Canaliculus_, 291; _Syringing the Lachrymal Duct_, 292; _Probing the Lachrymal...

Electrolysis, 275. Skin and Muscle Operation, 275. Rectification of a Faulty Curvature of the Tarsus--_Burow’s Operation_, 276; _Streatfield’s Operation_, 277. Transplantation o...

Operations upon the Maxillary Sinus--_Catheterizing the Maxillary Sinus_, 626; _Puncturing from the Nose_, 626; _from the Alveolar Margin_, 628. _Operation through the Canine Fo...

Operations for Injuries to the Nose--Fractures of the Nasal Bones and Septum, 581. For Congenital Occlusion of the Nostrils, 582. Removal of Foreign Bodies, 584; of Rhinoliths,...

Surgical Anatomy, 263. Suture of Wounds of the Eyelids, 263. Operations for Ankyloblepharon, 264; for Symblepharon, 264. Upon the Palpebral Aperture, 265--_Canthoplasty_, 265; _...

=Indications.= (i) _Foreign bodies._ Accidental inhalation of foreign bodies is more common in children than in adults in the proportion of about two to one. The character of th...

After-treatment of Abdominal Operations, 93. Complications of Abdominal Gynæcological Operations--_Metrostaxis_, 95; _Bed-sores_, 95; _Post-anæsthetic Paralysis_, 95; _Giving wa...

Surgical Anatomy of the Tympanum, 335. Paracentesis, 336. Artificial Perforation of the Tympanic Membrane, 340. Division of the Anterior Ligament, 341. Division of the Posterior...

Cæsarean Section, 69; _Immediately after the Death of the Mother_, 72. Ovariotomy and Hysterectomy during Pregnancy and in Labour, 73. Ovariotomy during the Puerperium, 76. Fibr...

Removal by the Snare, 613. Removal by Forceps and Curettes, 615. Lateral Rhinotomy (Moure’s Operation), 618. Rouge’s Operation, 622. Combination of Moure’s and Rouge’s Operation...

Sources of Illumination, 569. Local Anæsthesia, 572. Local Ischæmia, 573. Bleeding and its Control, 574. The Protection of the Lower Air-passages from the Descent of Blood, 576....

Removal of a Foreign Body from the Cornea, 240. Cauterization of the Cornea, 240. Operations for Conical Cornea, 241. Removal of Tumours involving the Cornea, 243. Tattooing the...

Methods of Operation, 392; _Küster-Bergmann (Schwartze-Stacke) Operation_, 393; _Wolf’s Operation_, 396; _Stacke’s Operation_, 397; _Preservation of the Ossicles and Tympanic Me...

The Operation, 10. Cysts of the Broad Ligaments, 14. Spurious Capsules, 15. For Carcinoma of Ovary, 15. Incomplete Ovariotomy, 16. Anomalous Ovariotomy, 16. Ovariotomy followed...

Operations for Furunculosis, 314. Removal of Exostoses from the External Meatus, 316. Removal of Foreign Bodies--_by Syringing_, 322; _by Instruments_, 323; _by Post-aural Incis...

For Deformities--_Removal of Spurs_, 597; _Perforating the Septum_, 598. For Simple Deviation, 598; _Gleason-Watson Operation_, 599; _Asch’s Operation_, 599; _Moure’s Operation_...

Surgical Anatomy, 187. Discission or Needling, 189--_for Cataract_, 189; _for High Myopia_, 190. Capsulotomy, 192. Evacuation, 194. Evulsion of the Capsule, 195. Extraction of t...

Cancer of the Body of the Uterus and Fibroids, 52. Sarcoma, 53. Cancer of the Uterus after Bilateral Ovariotomy, 55. Adenomyoma of the Uterus, 56. Fate and Value of Belated Ovar...

Gynæcological, 86. Obstetric, 87; to the Pregnant Uterus, 89; to the Gravid Uterus in the course of an Abdominal Operation, 89. Bullet Wounds of the Pregnant Uterus, 90. Stab-wo...

Passage of the Uterine Sound, 149. Reposition of a Chronic Uterine Inversion, 151. Curetting the Uterus, 152. Dilatation of the Cervix, 156--_Rapid Dilatation_, 157; _Gradual Di...

Iridotomy, 211. Alternative Methods--_Kuhnt’s Operation_, 212; _Ziegler’s_, 213. Iridectomy--Optical Iridectomy, 214; Glaucoma Iridectomy, 217--for small Growths of the Iris, 22...

Examination of the Ear, 305--_Sources of Illumination_, 305; _Technique of Examination_, 306; _Method of cleansing the Ear_, 307. General Considerations with regard to Operation...

General Preliminaries to an Operation, 177. Local Preparation of the Patient, 80. Making and Healing of Wounds in the Globe, 182--_Purification of Hands_, 182; _of Instruments_,...

Enucleation, 255. Evisceration, 257. Mules’s Operation, 259. Frost’s Operation, 259. Operations upon the Socket after Removal of the Eye--_Paraffin Injection_, 260. Operations f...

Anterior Sclerotomy, 228. Cyclo-dialysis, 229. Sclerectomy, 231. Posterior Sclerotomy, 232. Paracentesis of the Anterior Chamber, 233. For Penetrating Wounds of the Globe, 234....

Preparation of Patient, 3. Basins, Dishes, and Instruments, 4. Suture and Ligature Material, 5. Dabs, 5. Gloves, Operating Table, Anæsthesia, 6. The Incision, 7. Misplaced Visce...