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.

    73/1274 (page 41)
    or sal-alembrotb vessel covered with a lid to keep out the dust. Before bein^- used they should be agaia soaked for some hours in carbolic lotion. After an operation the meshes of a s]jonge are more or less filled with co.agulated blood, which mere washing in water will hardly remove. In order to clean it thoroughly, it may be soaked in a strong solution of sulphurous acid ; or, after maceration for forty-eight houi-s in a dilute solution of hydrochloric acid (about ten drops of the strong acid to the ounce of water), and for twenty-four hours in a strong solution of carbonate of soda, it may be well washed in common water, and kept ready for use in a bath of 1 in 20 carbohc acid lotion. A simpler plan, and one which experience has shown to be very efficient, is to wash the sponges for ten minutes in very hot water with a large amount of soft soap. The soap must be well washed out by repeated rinsing in fresh hot water, after which the sponges may be placed in the carbolic lotion. In many cases sponges are advantageously replaced by pieces of salicylic wool moistened with some antiseptic solution and squeezed as dry as possible. Before commencing an operation, the Surgeon must look over his instruments, comparing them, if the opera- tion be compKcated, with a list previously made out ; he must see that they are arranged in the order in which they are wanted. They should be. placed in a flat dish filled with an antiseptic solution. For this purpose nothing is better than a 1 in 20 solution of carbolic acid, which has no injurious efiFect on the instruments. This method of sterihzing the instruments seems practi- cally efficient, but some Surgeons prefer to expose them to super-heated steam in a specially constructed chamber, and use knives with metal handles which will not be injured by the heat. Much of the successful perform- ance of an operation depends on the attention and steadiness of the assistants. Of these there should be enough, but not too many. In all capital operations three orfourwiU be required ; one for the administration of the anaesthetic, another to command the artery, a third immediately to assist the Surgeon, and the fourth to hand sponges, instruments, &c. The duties of the assistants should be performed in silence, and each man must carefully attend to his own business, and not neglect this, as is too often done, in his anxiety to see what the Surgeon is about. There should be no unnecessary talking when once the patient is on the table ; the Surgeon's directions ought to be conveyed by a brief word or two, or by a sign with the hand. The incisions for the operation should be carefully and properly planned, so as to give sufficient space with as little mutilation as possible ; but it must always be borne in mind, that although a needlessly long incision may lead to unnecessary disfigurement, it does not add materially to the danger of the patient, while too small an incision hampers the Surgeon and greatly increases his difficulties, especially in the arrest of haemorrhage. Incisions may be made by cutting from without inwards, or from within outwards, or subcutaneously. The most convenient instrument for all ordinary -Bistoury held per- pendicularly.