The principles and practice of modern surgery

An ultimate analysis of the primary causes of disease, excluding traumatisms, will permit their reduction to one or the other of the following categories: _nutritional_ (functio...

The reactionary results of injury to various tissues and the first local appearances due to the surgical infectious diseases are indicated by certain appearances, which, for a f...

The part played by the constituent elements of the blood in inflammation, suppuration, and other still more disastrous conditions is so great and so important that, before proce...

After having duly considered hyperemia as a phenomenon having an identity and termination of its own, we are prepared to study the more complex processes included under the term...

=Signs and Symptoms of Abscesses.=--The appearances by which pus may be suspected or detected are those of congestion and hyperemia, more or less abruptly circumscribed and mark...

While an ulcer may be the result of ulceration, it is not necessarily so, the term _ulceration_ being one of very loose significance and applied to many different processes. The...

particularly after injury to or division of nerve trunks in the arm or forearm. Perforating ulcer of the foot is a circumscribed circular ulcer with thickened edges, often nearl...

Gangrene is known also as _necrosis_, although this term is usually limited to gangrene of bone. It is known also as _mortification_, and to the older writers, especially when s...

One of the greatest advances made in pathology has been the establishment of the fact that a great many of the morbid conditions from which the human race suffer are those due t...

Formerly the surgical fevers were all grouped together, and a certain amount of febrile disturbance was looked for after any injury. But with the introduction of antiseptic meth...

Tetanus is an _acute infectious disease_, of relatively infrequent occurrence, _invariably of microbic origin, characterized by more or less tonic muscle spasm with clonic exace...

character. It is characterized by rapidity of spread and the specific nature of the exudate, as well as by the speedy destruction of the tissue involved, and by more or less gas...

The most important and frequent of the infectious diseases common to animals and man is _tuberculosis_. This appears usually as a subacute or chronic affection, although in a sm...

The younger generation, when studying the subject of syphilis, should be referred back one hundred years or more to the time when the opinions held by John Hunter generally prev...

Since the time of John Hunter and his pupils, who confused the three totally different and so-called venereal diseases, pathologists have drawn a distinct line between _chancre_...

Gonorrhea is an acute infectious process, involving especially the mucous membranes of the genito-urinary organs, but met with elsewhere about the body, in both superficial and...

Scurvy is placed among the so-called surgical diseases, since it manifests many distinctly surgical features and is possibly of parasitic character, although this feature of its...

Under the term _status lymphaticus_ has been described a condition which is of interest to the surgeon, as it includes not only minor complications, and even those which are ser...

As a result of the conditions which two centuries ago and more so distinctly separated the barber surgeon from the practitioner of medicine, there has been evolved an artificial...

Certain poisons or deleterious substances are introduced in various ways into the human system from without, some of which produce only symptoms of moderate intensity, while oth...

Delirium tremens as an expression of acute or subacute alcoholic poisoning is in no essential degree a surgical condition. This form of toxic delirium may occur while the indivi...

The maintenance of the normal pressure of the blood is a material factor in the welfare of surgical cases. Deviations in the direction of lowered pressure constitute the most im...

Abstraction of blood, usually of venous blood, known as venesection, was a practice frequently indulged in years ago. At one time in the history of medicine it seemed to be the...

To Oliver Wendell Holmes we owe the term _anesthesia_, as generally employed and made to mean insensibility to pain, no matter how produced. A more strict definition would limit...

The old classification of wounds divides them into _contused_, _lacerated_, _punctured_, and _incised_. For descriptive purposes these adjectives are self-sufficient; they can b...

Gunshot wounds are usually considered with the special subject of military surgery. Military surgery as such, however, consists in the application of general surgical principles...

The first requisite after the infliction of a wound is to arrest and control the hemorrhage. In many operations upon the extremities precautions are taken to avoid its occurrenc...

The medical student of the present generation has no conception of the contrast between the results of today and those of a generation ago, or before the introduction of antisep...

At the risk of some repetition it is proposed to epitomize here a few directions on a subject of great importance, to which, as well in theory as in practice, too little attenti...

By the above definition it is intended to separate the new-growths from a distinctive class of neoplasms which are of inflammatory (_i. e._, of infectious) origin, to which the...

origin involving the spinal meninges. One form of spina bifida is constituted by cystic dilatation of the central canal of the spinal cord, and produces _syringomyelocele_. Thes...

_Dermatitis_ may be produced by chemicals, caustics, and various irritants; the former, for instance, by the use of strong antiseptics upon sensitive skins, and the latter as wh...

Fasciæ and aponeuroses are such non-vascular and indifferent tissues that they have practically no primary diseases, except such fibrous and malignant tumors as have their origi...

A generation ago a chapter on the surgery of the heart would have been regarded as a surgical fantasy. Today the subject is not only a live one, but experience is constantly acc...

An appreciation of the pathology of the lymphatic system requires a brief allusion here to the latest investigations and conclusions regarding the purpose of the lymph as a flui...

The joints, by virtue of their function and anatomical relations, are liable to a variety of injuries and affections, most of which are essentially surgical. The joints most sub...

At the outset of a study of surgical diseases of the osseous system it is necessary to emphasize a fact which students and young practitioners are liable to forget, namely, that...

In previous chapters have been considered the various morbid conditions of bones, joints, muscles, and tissues which help to form the locomotor apparatus of the body. It would s...

The term _fracture_ is, in surgery, applied to such injury of bone and cartilage as effects break in continuity. This injury is effected instantly, and it is rarely that fractur...

A sprain has already been described as a momentary change of emplacement or disturbance of the normal relations between joint surfaces, which, so far as displacement is concerne...

Erysipelas and cellulitis of the scalp are the result of the same infections and conditions as when encountered in other regions, but are peculiarly prone to occur here because...

The condition of _shock (cerebral concussion)_, when of pure type, passes away with reasonable promptness, especially when aided by surgical treatment. _Anything which persists_...

_Intra-orbital hemorrhage_ is not uncommon after injuries to the head. It may result from rupture of orbital vessels proper or by escape of blood from within the cranium, either...

The term _syringomyelia_ implies irregular dilatation of the central canal of the spinal cord, having a congenital origin, tending to relative increase later in life, with corre...

Monsters are born with almost complete absence of the face, which is called _aprosopia_. They have also been observed with double faces. Again a condition of congenital hypertro...

Aside from anomalies due to incomplete closure or erratic development from the branchial clefts, the principal congenital defects of the regions included in this chapter are as...

Similar involvement of the lymphoid or adenoid tissue in the vault of the pharynx, and even at the base of the tongue, is quite common, the entire original lymphoid ring being m...

The _congenital malformations_ of the upper respiratory passages pertain mainly to the nasal septum and the interior of the complicated nasal cavities, which are rarely symmetri...

These consist largely of defects due to arrest of development along the lines of the branchial clefts. Necessarily of embryonic origin, they do not reveal this until varying per...

Congenital malformations of the thorax are not uncommon, yet but few of them permit of surgical remedy. One or more of the ribs may be absent or defective in formation and produ...

_Amastia_, or complete absence of one or both breasts, is a rare defect. _Polymastia_, or the occurrence of _supernumerary breasts_, is more frequent.[51] These may be found on...

That large portion of the human body which with its contents we term the abdomen was for a long time _terra incognita_ to the surgeon. Despite the sporadic success of such men a...

Were the peritoneum spread upon a flat surface it would be found to equal in area that of the skin which covers the body. In man it is a closed sac; in woman it is exposed to ex...

These malformations are quite rare, at least those raising the question of possible surgical remedy. _Transposition_ does not require relief, nor does a stomach abnormally small...

The entire intestinal canal is sometimes too short and sometimes fails to develop sufficiently in caliber, or sections of it may remain undeveloped. None of these changes have i...

[59] The laity, as well as part of the profession, having not yet ceased to wonder at the great importance attaching today to appendicitis, when twenty years ago it was practica...

The more common _congenital anomalies_ of the various divisions of the colon have to do mainly with the presence of _diverticula_ and _atresiæ_, or possibly total _absence_, due...

The term hernia of itself implies protrusion or escape of a contained organ or part through its containing walls, yet covered by some of them. Thus we may have hernia of the iri...

The congenital defects and displacements of the liver which interest the surgeon are few. More or less transposition, sometimes complete _situs transversus_, is encountered. The...

The omentum is something more than what it generally appears, _i. e._, a more or less thick and extensive apron of fat, hanging down in front of the small intestines, although i...

Recent embryological studies have established the fact, in regard to the kidneys, and given rise to the inference in regard to the other viscera, that the primary cause of conge...

Methods of recognition of surgical diseases of the bladder have been vastly improved, as well as complicated, within the past few years. The bladder has now been made accessible...

The most common _congenital defects of the penis_ are connected with elongation of the _prepuce_ or with abnormality in the construction of the _urethra_. Aside from these, howe...

Amputations are performed for (_a_) _the results of injury_, (_b_) _the results of disease_, and (_c_) _removal of deformity or mutilation_, or the possible results of congenita...

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