The first lines of the practice of surgery: designed as an introduction for students and a concise book of reference for practitioners (Volume 2).

  • Samuel Cooper
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: The first lines of the practice of surgery: designed as an introduction for students and a concise book of reference for practitioners (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    43/480
    muscle. In short, it pulls the mastoid process downwards and forwards towards the sternum, counteracts the opposite muscle of the same name, and rectifies the position of the head. The apparatus is to be constantly worn. When, by perseverance in the use of this simple invention and other means, the position of the neck has been improved, the head is generally found to have a disposition to incline too much forwards; an effect, which the contracted sterno-cleido- mastoideus, and its antagonist, the band, both tend to promote. In order to hinder this, Professor Jorg removes the end of the band from the breast, carries it under the arm, and through a ring at the side of the leather corsets, or stays, and thence to the fillet on the head, where it is fastened close to the mastoid process. The ring hinders the band from chafing the axilla, and following the motions of the shoulder.* It is when the disease originates from a contraction of the muscles on one side of the neck, quite unattended with the smallest perceptible induration, that an operation is advised for dividing the contracted muscular fibres. This, however, must only be performed when the wry-neck depends entirely, or principally, on a contraction of the sterno-cleido-mastoideus. When the defect is situated in the other muscles, or the cervi- cal vertebrae are altered, the operation is not advisable. When the above muscle is alone, or chiefly concerned, the face is always turned from that side to which the head is inclined; and in endeavouring to put the head in a straight position, the fibres of the muscle are rendered exceedingly tense. Should Sharp's operation of dividing the sterno-cleido-mas- toideus be determined upon, it will generally be prudent at first only to cut through the clavicular portion of it. If the surgeon should determine to cut out a part of the fibres, the incision must be made through the skin, exactly in the direction of this portion of the sterno-cleido-mastoideus.t If he means simply to divide it, a transverse wound will suffice. On this part of * Plate 5. Fig. 4. Professor Jorg's apparatus applied. Fig. 5. Back View of the leather stays. Fig. 6. Key for turning the pulley. | {I assisted Dr. G. M'Clellan in an operation of this kind, which he performed on a lady, 27 years old. The distortion was excessive, and had existed from infancy. He cut down perpendicularly over the outer head of the sterno-mastoideus, dissected the skin up from the muscle, until he had exposed both edges, ran a grooved director under the muscle, and slit it entirely across with a bistoury. The patient was greatly benefited by the operation, and can now perform her domestic duties with ease. Mr. Kirby has published an excellent tract upon this subject, and argues forci- bly in favour of the operation.]
    digitised image 1
    digitised image 2
    digitised image 3