Book Description

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1855 edition. Excerpt: ...the surgeon lifts up the other and divides it either fr"n without inwards, or from within outwards, which last incision 3 effected by plunging the bistoury, with its edge looking upwards, through the base of the fold. This first incision is only carried through the skin, and should extend about half an inch above and below the tumour. It is sometimes necessary to make a crucial, or T shaped incision. After the incision of the skin some hemorrhage takes place from the divided superficial arteries; this is usually trifling in amount, and rarely requires the employment of a ligature. 2d Stage.--Incision of the sub-cutaneous envelopes of the sac.--In this stage great caution and delicacy of hand is required. Some surgeons make the incision directly from without inwards, by holding the scalpel like a pen, and carrying its edge directly over the tumour. The safest way is to raise up with the forceps each layer which covers the hernia and incise it to a limited extent horizontally and obliquely; then introducing a director through the small opening thus made, insinuate it beneath the layer to the extremity of the tumour, and sliding the bistoury with its edge upward along the groove, divide it surely and safely. Divide in the same manner, one by one, all of the several layers of the hernia, down to the sac. Blunt scissors may also be employed for the same purpose. The number of the envelopes varies. We have enumerated and described them in our account of the surgical anatomy of the inguinal and femoral regions. But the long standing of a hernia, the duration of its strangulation, etc., so modify the naturo and relations of these envelopes, that their anatomy in the healthy state will no longer serve as a guide to the surgeon, and he will...