A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart.

  • Caird, Francis Mitchell, 1853-1926
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Ironi base In a])cx. If necessary, all ihc organs of Ihe neck and chest may be removed en masse. This is ilone by dis seeling back the skin of the neck, and then thrusting the knife Ihrbiigh the floor of the mouth, so as to divide the mucous membrane close to the jaw all round. When this is done, the tongue may be pulled downwards and outwards, and as the larynx, trachea, <esoi)hagiis, and great vessels, are pulled forwards, they may be stripped from off the prevertebral muscles and cervical vertebra-. The vessels passing over the first rib are next divided, the contents of the [losterior mediastinum, as far as may be, detached from the vertebne, and the structures piercing the dia])hragm cut ; whereujjon we may lift out everything- and examine the ])arts in detail. The larynx, trachea, bronchi, and oesophagus should be slit up. The Abdomen.—-An inspection having been made jirior to re- moval of the thoracic viscera, the abdominal organs may be now- more carefully examined, and, if necessary, removed. For this pur|)ose, double ligatures .should be ajiplied to the cardiac and pyloric extremities of the stomach, the beginning of the jejunum and the sigmoid flexure. The bowel may be removed for complete examination by cutting between the ligatures and dividing the omentum and mesenteries. The stomach, liver, duodenum, and pancreas may now be removed together. The duodenum should be laid ojicn, and the |)atency of the bile-pas.sages ascertained by jiressing upon the gall-bladder, and by introducing a prol)e-]iointed knife and slitting them up. Sections may be made of the liver and ])ancreas, and the stomach opened. The kidneys, ureter, and l)Iadder, together with the rectum and ovaries in the female, may now be removed. 'J'he size and consistence of the kidney should be noted, and also the thickness and adhesion of the cajisule. It should then be laid in halves with a knife, the jielvis opened, the ureters followed u]i, and the l)ladder incised. The Spinal Cord is reached by laying the body prone, and making a mesial incision from the ligamentum nucliiv to the sacrum. The arches of the vertebra; should now l)e ex]50sed, divided with saw and chisel, and removed as in the dissecting-room. At the conclusion of the autopsy the organs may be carefully replaced, and the incisions closed with a continuous suture. The body should be left exactly as found, the grave-clothes re])lnced, and the most scrupulous care exercised to avoid leaving even the trace oi a stain. The operator's hands should be held from time to lime in running water from a tap, if possible, or washed with turpentine and carbolic lotion.