Part 61

Abscess of liver, consequent to injuries of the head, 356. in abdominal parietes, caused by neglected injuries, 489.

Acids, mineral, use of, in sloughing wounds, 70, 168. in hospital gangrene, 70, 168.

_Addenda_, commentaries on the cases in, 586.

Alexander, Deputy Inspector-General, on amputations, while under the influence of chloroform, 563.

Amaurosis from balls passing behind the eyes, 478.

Amputation, primary, not required in gunshot wounds of the upper extremity, 120. aphorisms on, 73. at the ankle-joint, Mr. Syme’s operation for, 105. of the arm below the tuberosities, 126. by the circular incision, 134. by Mr. Luke’s operation by two flaps, 135. primary, of the arm, 120. at the elbow-joint, 137. place of election for, in local mortification of a limb, 46. of the fingers, 139. of the foot, 114. by Roux’s plan, 108. of the forearm, 137. by the flap operation, 137. by the circular incision, 138. for gunshot wounds of the femur, 145. at the hip-joint, 77, 92, 562, 563, 586. Mr. Guthrie’s mode of operating in, 79, 83. Professor Langenbeck’s, 80. Mr. Brownrigg’s, 82. under chloroform, 564. immediate, question as to, 51. cases for, 150. of the leg, 99. by the circular incision, 99. by Mr. Luke’s flap operation, 101. immediately below the tuberosity of the tibia, 102. of the metacarpal bones, 139. of a metatarsal bone, 118. in cases of mortification from wounded arteries, 228. necessity for, 51. of the phalanges, 140. primary and secondary, 59. secondary, 59, 141. at the shoulder-joint, 122. by two flaps, 124. by one flap, 125. by Lisfranc’s operation, 125. at the tarsus, 112. of the thigh, by the circular incision, 83. by Mr. Luke’s flap operation, 86. at the wrist, 138. under the influence of chloroform, in the Crimea, 561. case of death from, 561. Deputy Inspector-General Taylor on, 562. Deputy Inspector-General Alexander on, 563.

Ankle-joint, excision of, 103. Mr. Syme’s amputation at, 105.

Aneurism of the arch of the aorta, 276. formation of, after wound of artery, 212. Hunterian theory respecting, 188. popliteal, operation for, 263. traumatic, formation of, 214.

Aneurismal swelling after deep wound of an artery, 212.

Anus, artificial, 525. operation for the formation of, in the loins, 558. Desault’s operation for, 527. Dupuytren’s forceps for, 527. Mr. Trant’s forceps for, 528.

Aorta, ligature of, 250, 252, 256. aneurism of the arch of, 276.

Arachnoid and dura mater, wounds of, 345.

Arm, amputation of, below the tuberosities, 126. primary, 120. by the circular incision, 134. by Mr. Luke’s double flap operation, 135. gunshot fracture of, 121, 156. wounds of the arteries of, 238. thigh and abdomen, extensive injury to, 576.

Arsenic, local use of, in hospital gangrene, 169.

Arteries, wounded, the Hunterian theory inapplicable in the treatment of, 189. Mr. Guthrie’s theory respecting, 189. principles of surgery relative to, 191. punctured wounds of, 210. formation of aneurism after, 211. transverse wound of, 212. complete division of, 212. large, mode of arresting hemorrhage from, 234. of arm and forearm, wounds of, 238.

Artery, structure of, 176. deep wound of, forming aneurismal swelling, 213. effects of a ligature on, 203. wounded, not to be operated on, unless it bleed, 215, 241. to be tied at the seat of injury, 191, 219. main, of the lower extremity, mortification caused by a wound of, 45, 226.

Artificial anus, 525. formation of, in the loins, 558. Desault’s operation for, 527. Dupuytren’s forceps for, 527. Mr. Trant’s forceps for, 528. foot, M. de Beaufoy’s, 119.

Astragalus and calcis, Mr. T. Wakley’s operation for the removal of, 115. ball lodged in the, 109, 590. removal of, 109.

Auscultation, value of, in injuries of the chest, 367.

Axillary artery, gunshot wounds of, rarely cause mortification of the hand or fingers, 46, 235. ligature of, 278. wounds of, 235.

Ball, lodging in the abdominal parietes, 489. in the astragalus, 109, 590. in the bladder, 553. calculus formed on, 553. operation for removal of, 554. in bone, 36, 149. in the brain, 283. behind the eye, 478. or other foreign bodies loose in the cavity of the pleura, 448. inclosed in a cyst, 451. lodged in the head of the humerus, 128. in the liver, 532. orifices of entrance and exit, 27, 489. passing behind the eyes, causing amaurosis, 478. lodging in the pelvis, 545. penetrating the brain, 347. rolling on the diaphragm, 451. operation for extraction of, 455. separating the sutures of the skull, 349.

Balls, relative size of those used by the Allies and by the Russians, 588. on cysts inclosing foreign bodies, in gunshot wounds of the chest, 451. operation for empyema, 452. operation for gunshot fracture of the lower jaw, 480.

Baudens, M., on excision of the head of the humerus, 133.

Bayonet, wounds by, 37. wounds, delusion as to, 38.

Bearers for the wounded, 156.

Beaufoy’s, M. de, artificial foot, 119.

Bedsteads for gunshot fractures of the femur, 152.

Bell, Mr. J., on emphysema in gunshot wounds of the chest, 412.

Bennet, Dr. Hughes, on phlebitis, 71.

Blackadder, Mr., on hospital gangrene, 164, 169.

Bladder, wounds of, 546. ball in the, 553. calculus formed on, 553. operation for extraction of, 554.

Blood, effusion of, into the abdomen, 505, 510.

Boggie, Dr., on hospital gangrene, 168, 169.

Bone, lodgment of a ball in, 36, 149. protrusion of, after amputation, 89. exfoliation of, after amputation, 89.

Bones of the face, penetrating wounds of, 479.

Brachial artery, ligature of, 279.

Brain, balls lodging in, 283. balls penetrating into, 347. M. Burdach’s statistics of lesions of, 306. compression of, 302. paralysis caused by, 305. injuries of the head affecting the, 283. concussion of, 287. causing mania, 299. laceration of, by contre-coup, 340. motions of, 303. suppuration of the surface of, 342. wounds of, 347. causing abscess of the liver, 356.

Bronchophony, 372, 376.

Brow and eyelids, wounds of, 477.

Brownrigg’s mode of amputating at the hip-joint, 82.

Brunner, glands of, 486.

Buck, Dr. Gurdon, operation for excision of the knee-joint, 97.

Burdach’s statistics of lesion of the brain, 306.

Calcis and astragalus, operation for the removal of, 115. removal of, 104.

Calculus formed on a ball in the bladder, 553. operation for extraction of, 554.

Cannon-shot, hemorrhage after the carrying away a limb by, 25. wind of, 43. causes mortification of a limb, by destroying its internal textures, 43.

Carotid, common, ligature of, 270. statistics of ligature of, 241. external, ligature of, 272. the common carotid not to be tied for wounds of, 242. internal, ligature of, 272. wounds of, through the mouth, 245. operation for securing, 245, 248, 272. the primitive carotid not to be tied for wounds of, 246. primitive, not to be tied for wounds of external carotid, 541. nor for wounds of the internal carotid, 246.

Cartilages, costal, fracture of, in gunshot wounds of the chest, 429.

Cerebrum, fungus of, (hernia cerebri,) 352.

Chain saw, utility of, 588.

Chelius on suture of incised wounds of abdominal parietes, 493.

Chest, wounds of, 364, 590. effusion into, 371, 378, 420. purulent effusion, etc. into, 378, 390, 420, 435. operation for, 394. non-penetrating wounds of, 364. value of auscultation in wounds of, 367. incised wounds of, 364, 414. wounds of both sides of, 417. large penetrating wounds of, the lung injured, 418. with hemorrhage into the cavity, 421. ecchymosis a sign of internal hemorrhage in penetrating wounds of, 424. conclusions respecting wounds of, 424. gunshot wounds of, 426. statistics of, 426. enlargement of, 427. fracture of the ribs in, 428. of the costal cartilages in, 429. involving the lungs, 429. removal of splinters, etc., 445. the ball loose in the cavity of the pleura, 448. rolling on the diaphragm, 451. inclosed in a cyst, 451. involving the lungs, effusion caused by, 435. formation of a dependent opening, 452. operation for the evacuation of the fluid, 455. anatomy of the parts concerned, 453.

Chloroform, use of, 55. Dr. Snow on, 55. Mr. Syme on the treatment of approaching death from, 58. amputation under the influence of, in the Crimea, 561. case of death from, 561. Deputy Inspector-General Taylor on, 54, 562. Deputy Inspector-General Alexander on, 563.

Circulation, collateral, 184.

Colon, Hilton’s operation for opening into, 558.

Commentaries on the cases in the _Addenda_, 586.

Compound fractures, 145. splints for, 153.

Compression of the brain, 302. convulsions caused by, 307. paralysis caused by, 305. in hemorrhage from wounds of the hand, 238.

Conclusions respecting wounds of the chest, 424. abdomen and pelvis, 555. hospital gangrene, 173.

Concussion of the brain, 287. causing mania, 299.

Contre-coup, fracture of the skull by, 316. laceration of the brain by, 340.

Contusions, severe, of abdomen, followed by rupture of the hollow or solid viscera, 490.

Convulsions caused by compression of the brain, 307.

Cooper, Sir A., mode of tying the external iliac, 258.

Cranium, fracture of the base of, 317.

Crepitating râle, or rhonchus, 375.

Delpech on hospital gangrene, 165, 166, 167.

Deposits, purulent, 61, 68.

Depression of the skull, 329. of the back of the skull, with fracture, 338.

Desault’s operation for artificial anus, 527.

Diaphragm, ball rolling on the, 451. operation for the extraction of, 455. wounds of, 458. may cause internal hernia, 463.

Dupuytren’s forceps for artificial anus, 527.

Dura mater, incision of, 343. removal of blood from the surface of, 360. suppuration on the surface of, 342. wounds of, 345.

Ecchymosis, a sign of hemorrhage into the chest, 424.

Effusion, purulent, in penetrating wounds of the chest, 420, 435.

Elbow-joint, amputation at, 137. excision of, 135, 580.

Emphysema, 410. Mr. J. Bell on, in gunshot wounds of the chest, 412.

Empyema, 390, 436. operation for, 394, 455. M. Baudens on, 452. necessity for depending opening in, 452. Mr. Quekett’s experiments on the anatomy of the parts engaged in, 452. operation for, by incision, 455.

Endocardial sound of the heart, 466.

Epigastric artery, ligature of, 510.

Erysipelas phlegmonodes, 40. improvement in the treatment of, 41. of the scrotum, 42. of the scalp, 359, 363.

Excision of the ankle-joint, 103. calcis, 104. calcis and astragalus, 115. elbow-joint, 135, 580. with injury to left hip, 581. head of the femur, 90, 150, 564, 587. in gunshot wounds of, 150. of the head, neck, and great trochanter of the femur, 564. of the head of the humerus, 126, 571, 590. Langenbeck’s operation for, 130. M. Baudens on, 133. of the knee-joint, 97. Mr. Jones’s mode of operating, 97, 98. Dr. Gurdon Buck’s operation for, 97. metacarpal bone of thumb, 140. phalangeal joints, Langenbeck’s operation for, 140.

Excito-motory system of Dr. Marshall Hall, 286.

Exfoliation of bone after amputation, 89.

Exocardial sound of the heart, 466.

Expiration, 369.

Extraction of the ball in gunshot wounds, 32.

Extremities, upper, gunshot wounds of, 20.

Eye, ball lodged behind, 478. wounds of, 477.

Eyelids and brow, wounds of, 477.

Face, wounds of, 476. penetrating wounds of the bones of, 479.

Femoral artery, gunshot wound of, a cause of local mortification, 45, 226. laceration of, 208. ligature of, 260. superficial ligature of, 262. and vein, injuries of, may cause gangrene, 45.

Femur, removal of the head of, 90, 150, 564, 587. gunshot wounds of, 145, 579, 587. secondary amputation in, 145. of the head and neck of, 150. bedsteads for, 152.

Fingers, amputation of, 139. mortification of, rarely caused by wound of axillary artery, 46.

Fissure of the skull, 311.

Foot, gunshot wounds of, 107, 112. amputation of, 114. amputation of, by Roux’s plan, 108. at the ankle-joint, Mr. Syme’s operation for, 105. artificial, M. de Beaufoy’s, 119.

Forearm, gunshot wounds of, 137. amputation of, 137. by flap operation, 137. by circular incision, 138. wounds of arteries of, 238.

Forehead, gunshot wounds of, causing loss of sight, 350.

Foreign body, lodgment of in a nerve, 47.

Fowler’s solution of arsenic, in hospital gangrene, 169.

Fractures, compound, 145. splints for, 153.

Fracture, gunshot, of the leg, 154, 588. Mr. Luke’s apparatus for, 154. of the head of the femur, 150. of the upper extremities, 120. of the shoulder-joint, 120. of the elbow-joint, 136. of the arm, 121, 156. of the skull, 311. of the skull by contre-coup, 316. of the base of the cranium, 317. of the inner table of the skull, 321, 324, 328. with depression at the back part of the skull, 338. of the superior maxillary bone, 582. of the ribs in gunshot wounds of the chest, 429. of costal cartilages, ditto, 429.

Frontal sinuses, gunshot wound of, 350.

Fungus, or hernia cerebri, 352.

Gall-bladder, gunshot wounds of, 530.

Gangrene, hospital, 163. Fowler’s solution of arsenic in, 169. mineral acids in the treatment of, 70, 168. sloughing or pulpous form of, 166. conclusions respecting, 173. local and dry, from wound of the main artery of the lower extremity, 44, 226. traumatic, 42.

Glands of Brunner, Grew, and Peyer, 486. solitary, 487.

Gluteal artery, ligature of, 259.

Goyraud’s operation for ligature of the internal mammary, 473.

Grew, glands of, 486.

Gross’s experiments on intestine, 506.

Gunshot fractures of the upper extremities, 120. lower ditto, 154. wounds of axillary artery, rarely cause mortification of hand or fingers, 46, 285. extraction of the ball in, 32. of the foot, 107, 112. knee-joint, 94, 574. shoulder-joint, 120. arm, 121, 156. elbow-joint, 136. forearm, 137. hand, 139. femur, 145, 579, 587. head and neck of, 150. face, 479. leg, 154, 588. lower jaw, 480. skull, 346, 584. frontal sinuses, 350. forehead, causing loss of sight, 353. orbit, 350, 583. superior maxillary bone, etc., 582. chest, 426. statistics of, 426. fracture of the ribs in, 428. costal cartilages in, 429. involving the lungs, 429. heart, 468. abdominal parietes, 489. intestine, 515. liver, 528. gall-bladder, 530. stomach, 535. spleen, 536. kidney, 538. spermatic cord and testicle, 539. penis, 540. pelvis, 541. bladder, 546. rectum, 555. inflammation consequent on, 30.

Guthrie, Mr., mode of amputating at the hip-joint, 79, 83. theory respecting wounded arteries, 189.

Hall, Dr. Marshall, excito-motory system of, 286.

Hand, gunshot wounds of, 139. mortification of, rarely caused by wound of the axillary artery, 46, 235. compression in wounds of, 238.

Head, injuries of, 283. affecting the brain, 283. causing abscess of the liver, 356. mania, 299.

Heart, sounds of, 465. relative position of, 464. wounds of, 464. recovery after, 464, 468. insensibility of, 471. laceration and rupture of, 472.

Hernia cerebri, 352. of the lung, 456. of the stomach or bowels into the chest, after wounds of the diaphragm, 463.

Hevin on the swallowing of knives, 535.

Hilton’s operation for opening into the colon, 558.

Hip-joint, amputation at, 77, 92, 562, 563, 586. Mr. Guthrie’s operation for, 79, 83. Langenbeck’s, 80. Mr. Brownrigg’s, 82. injury to, with excision of elbow-joint, 581.

Hemorrhage after a gunshot wound, 25. secondary, 208. from the intercostal artery, 474. after the carrying away a limb by cannon-shot, 25. from sloughing stumps, 71. means used by nature for the suppression of, 187, 191. from large arteries, mode of arresting, 234. from wounds in the hand, compression in, 288. in penetrating wounds of the chest, 421. in wounds of the heart, 468. in penetrating wounds of the abdomen, 510.

Hospital gangrene, 163. Deputy Inspector-General Taylor on, 171. Dr. Tice on, 165. M. Delpech on, 165, 166, 167. Mr. Blackadder on, 164, 169. Dr. Boggie on, 168, 169. Dr. Walker on, 170. mineral acids in the treatment of, 70, 168. use of Fowler’s solution of arsenic in, 169. sloughing or pulpous form of, 166. conclusions respecting, 173. hospital returns respecting, 175.

Hospital, statistics of operations, 158.

Hughes, Dr., on pneumothorax, 396.

Humerus, amputation of, below the tuberosities, 127. excision of the head of, 126, 571. by Langenbeck’s operation, 130. M. Baudens on, 133. ball lodged in the head of, 128. amputation of, by the circular incision, 134. Mr. Luke’s, by two flaps, 135. gunshot fracture of, 156.

Hunter, John, on inflammation of the veins, 70.

Hunterian theory of aneurism, 188. inapplicable to the treatment of wounded arteries, 189.

Iliac, external, ligature of, 257. internal, ligature of, 256.

Iliacs, common, relative situation of, 251. ligature of, 252.

Immediate amputation, question as to, 51. cases for, 150. tumors of the scalp, 340.

Incisions, use of, in erysipelas phlegmonodes, 40.

Inflammation consequent on gunshot wound, 30. acute idiopathic, of the pleura, 370, 376. of the lungs, 373, 380. typhoid, of the lungs, 388. of the pleura, 390.

Innominata, ligature of, 273.

Inspiration, 368.

Intercostal artery, wounds of, 474.

Internal carotid, wounds of, through the mouth, 245. operation for, 245, 248, 272. mammary artery, wounds of, 473. strangulated hernia, after a wound of the diaphragm, 463.

Intestine, structure of, 482. rupture of, 491. protrusion of, in penetrating wounds of abdomen, 501, 509. wounds of, 504, 508. punctured, 504, 509. Travers and Gross’s experiments on, 506. divided, treatment of, 507. Ramdohr on, 507. wounded, application of continuous suture to, 508. gunshot wounds of, 515.

Jaw, lower, wounds of, 480. Baudens’s operation for, 480. upper, wounds of, 479.

Jones’s mode of excising the knee-joint, 97, 98.

Knee-joint, gunshot wounds of, with fracture of the bones, 94. excision of, 97. Jones’s operation for, 97, 98. Dr. Gurdon Buck’s operation for, 97. loss of, by a round shot, 574.

Kidney, wounds of, 537.

Knives, etc. in the stomach, 535. operation for their removal, 536.

Laceration of the femoral artery, 208. brain by contre-coup, 340. and rupture of the heart, 472.

Langenbeck’s mode of amputating at the hip-joint, 80. excision of the head of the humerus, 130. phalangeal joints, 140. metacarpal bone of thumb, 141.

Larrey’s operation for opening the pericardium, 469. ligature of the femoral artery, prior to amputation at the hip-joint, 79.

Lateral sinus, wounds of, 351.

Larynx, wound of, 571.

Lee, Mr. Henry, on phlebitis, 70.

Leg, gunshot fractures of, 154, 588. amputation of, 99. by the circular incision, 99. by Luke’s flap operation, 101. immediately below the tuberosity of the tibia, 102. apparatus for compound fracture of, 154. for slinging, when broken, 589.

Ligature on an artery, effects of, 203. size of, etc., 207. one, utterly insufficient to control hemorrhage from a wounded artery, 245.

Lisfranc’s amputation at the shoulder-joint, 125.

Liver, abscess of, consequent to injuries of the head, 356. wounds and injuries of, 528. removal of portions of, 533. lodgment of balls in, 532.

Longitudinal sinus, wounds of, 351.

Luke’s flap amputation of the thigh, 86. leg, 101. arm, 135. apparatus for compound fracture of the leg, 154.

Lung, hernia of, 456.

Lungs, acute inflammation of, 373, 380. morbid changes caused by, 380. typhoid inflammation of, 388. gunshot wounds of, 413. removal of splinters from, 445.

Machine for raising wounded soldiers in bed, 589.

Mammary, internal, wounds of, 473. Goyraud’s operation for ligature of, 473.

Mania caused by concussion of the brain, 299.

Maxillary bone, superior, gunshot fracture of, 582.

Membrane, mucous, of the stomach, 485.

Meningeal artery, middle, injury of, 314.

Metacarpal bone of thumb, excision of, 140. bones, amputation of, 139.

Metatarsal bone, amputation of, 118.

Mineral acids, use of, in hospital gangrene, etc., 70, 168.

Mortification, 42. from wind of cannon-shot, not admitted, 43. from extensive injuries from large shot, etc., 44. from gunshot wound of main artery of a limb, 45, 226. of hand and fingers, rarely caused by wound of the axillary artery, 46, 235. from cold, 46.

Motions of the brain, 303.

Mouth, wound of the internal carotid through, 245. operation for, 245, 248, 272.

Mucous membrane of the stomach, 485.

Musket-ball wounds. See _gunshot wounds_.

Neck, wounds of, 242, 475. Velpeau on wounded arteries of, 246.

Nerve, consequences of the section of, 47. lodgment of a foreign body in, 47. enlargement, of extremity of, after amputation, 89. consequences of incomplete section of, 47.

Nose, wounds of, 477.

Occiput, depression and fracture of, 338.

Œgophony, 373.

Ollivier on lacerations and ruptures of the heart, 472.

Omentum, protrusion of, in penetrating wounds of abdomen, 498.

Operations, hospital statistics of, 158.

Orbit, wounds of, 350, 583.

Os calcis, removal of, 104.

Patella, compound gunshot fractures of, 95.

Paracentesis thoracis, 394, 455.

Paralysis, the result of compression of the brain, 305.

Parotid gland, wounds of, 479. and duct, wounds of, 479.

Pelvis, wounds of, 541. balls lodging in, 545. and abdomen, conclusions respecting wounds of, 555.

Penis, wounds of, 540.

Pericardium, Larrey’s operation for opening, 469. Skielderup’s ditto, 469.

Peroneal artery, ligature of, 266.

Peyer, glands of, 486.

Phagedena gangrenosa, 163.

Phalangeal joints, excision of, 140.

Phalanges, amputation of, 140.

Phlebitis, 60, 62, 63. Mr. Hunter on, 70. Mr. Henry Lee on, 70. Dr. Hughes Bennett on, 71.

Plantar artery, external, ligature of, 267.

Pleura, acute idiopathic inflammation of, 370, 376. typhoid ditto, 390. effusion into the cavity of, 371, 378, 420. purulent ditto, 379, 390. operation for, 393. balls or other foreign bodies loose in the cavity of, 418.

Pneumonia, 373, 379. morbid changes caused by, 380. typhoid, 388.

Pneumothorax, 396, 402. Dr. Hughes on, 396.

Popliteal aneurism, operation for, 263. artery, not to be tied, unless wounded and bleeding, 265. wound of, 573.

Pourriture d’hôpital, 163.