Volume 1

The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.

  • John Eric Erichsen
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. 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.

    173/1274 (page 141)
    is maiuly dependent. Assistant No. 2 holds the limb; flexing it slightly on the abdomen in the first stage of the operation, whilst the anterior fla]i is being made ; forcibly abdncting, extending,and rotating it outwai'ds during the second stage, when the Surgeon is opening the capsule of the joint ; and extending and rotating inwards during the time the posterior flap is being cut. On the way in which he performs these duties the facility with which the Surgeon performs the operation is mainly dependent. To Assistant No. 3 is consigned the care of the instrument used for controlling the circulation. After the removal of the limb. Assistant No. 2 aids the Surgeon in ligaturing the arteries. These preliminaries having been arranged, and the duty of each assistant assigned to him, the operation is to be performed in the following way : The Surgeon, standing on the left side of the limb to be removed, feels for the bony points which guide his knife, viz. the tuber ischii and the anterior Fig. SO.—Amputation at the Hip-.joint: Formation of Anterior Flap in Left Limb. superior spine of the ilium. The knife, which must have a blade twelve inches long, is entered, and the flap made, in different ways, according to the side of the body on which the operation/is performed. If it be on the left side, the knife should be entered about two finger's breadths below the anterior superior spine of the ilium, and carried deeply in; the limb behind the vessels, directly across the joint, its point being made to issue near the tuberosity of the ischium well behind the prominent ridge formed by the tendon of the ad- ductor longus (Fig. 80). In transfixing on this side, care must be taken not to wound the scrotum or the opposite thigh ; the back of the knife must run parallel to Poupart's ligament, and the point must not be directed too much upwards, lest it enter the abdominal cavity. As soon as the point of the knife passes the head of the bone, the handle must be raised so as to direct the point beneath the femoral vessels, lest tlT,cy5be wounded. The aortic compressor does not control the iliac vein, and should the femoral vein be punctured above its