A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    43/878 (page 19)
    Fig. 30. °f the. di.sefe* T1;e cut edges in such cases when placed Wn ht^f a Sing!e hne’ ?rdfss f ye*y lar»e portion of skin has been taken away, when probably they cannot be brought into apposition. . There are various modifications of these in- cisions which are had recourse to in different operations, as will be afterwards shown; and, from time to time, the surgeon meets with diseases requiring operation, where it is neces- sary to set aside all general rules, and to shape his incisions in such a way as he judges best fitted to the peculiarities of each case. As a preliminary step to dissection, the arteries should be filled with a coarse injection of tallow and vermilion, to which has been added a small proportion of carbonate of magnesia. This composition runs sufficiently minute to fill all the vessels of much surgical import- ance, and keeps well in a dried preparation, should it be thought desirable to preserve any of the parts in this manner after the vessels have been dissected: but if the dissector be already a little familiar with the parts, they will appear more as they are met with in the living body, if the arteries are not thus distended, and the veins being usually filled with dark blood, there never can be much difficulty in detecting them. The body should be placed on a firm table, of a convenient height, and m a good light. Before using the knife, the contour of each | kf carefully studied : the prominences of bone and muscle should be looked at and fingered, and each joint should be examined, and put through its movements. These matters are too generally neg ecte in the dissecting-rooms, but I know of no exercise, or minor part of education, if it may be so called, which will be more useful to the young surgeon, in enabling him to detect distortion, whether from disease or accident. Both eyes and fingers may be advan- ageous y exercised on these occasions : with the former we can detect the most conspicuous deviations from nature; but, to make assurance doubly sure, we in general use the latter also; indeed, in all in- stances, where accurate examination is requisite, we must use the fingers, and by the touch we can often acquire a knowledge of im- portant circumstances, of which we might otherwise be ignorant: we should so use both m the practice of surgery, as to be able to make out the cause of ophthalmia to be an eyelash in contact with the con- junctiva, or the symptoms of ileus to be occasioned by the presence of a small hernial tumour,—too minute to be discerned by the eye, but sufficiently large to be detected with the fingers. Mistakes occa- sionally happen on these points, and I have known them under both circumstances. It is notorious that a common dislocation of the shoulder-jomt has often been detected by a glance or touch by one individual, when it had not been discovered by another who had previously examined the case, but who has been devoid of the tactus