A short manual of surgical operations.

  • Barker, Arthur E. J. (Arthur Edward James), 1850-1916.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: A short manual of surgical operations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    61/456 (page 49)
    net'dli- is bo be passed between the win and artery from within outwards, keeping close to the latter and thus avoiding the musculo-spiral nerw behind, and the median and externa] cutaneous externally. The point of ligatun- should be chosen as far as possible from the branches. Memoranda.—After the skin and fascia of the axilla have been divided, the dissection should be performed as far as possible with blunt instruments in order to avoid wounding any of the smaller glandular twigs of vessels, bleeding from which would tend to obscure the further steps of the operation. The incision may be made in a direction towards the trunk on the right side and away from it on the left. In every case it should be well towards the pectoral margin of the axilla rather than the posterior fold. LIGATURE OF THE BRACHIAL ARTERY IN THE MIDDLE OF THE ARM. Instruments as above. Position of Patient.—Supine, the arm being extended and abducted to a right angle with the body and somewhat everted (fig. 4). It is thus held by an assistant. Position of Operator and Assistants.—The operator may stand or sit beside the patient's body on the affected side. One assistant holds the arm as above, standing at the elbow, the other stands at the shoulder. Landmarks for Incision and Operation.—The first guide is the inner border of the biceps muscle. If for any reason this be not easily made out, a line running from the head of the humerus in the middle of the axilla to the middle of the bend of the elbow will give the direction of the vessel. A three-inch incision (fig. 4, /) in the middle of the arm is carried along the above line. This should be E