RESECTION OF ENTIRE BONES AND JOINTS. Resection of Joints and entire Bones.-Phalanges of the Fingers.- Pha- langeal Joints: (1) by lateral Incisions, (2) by a dorsal Flap.- Meta- carpal Bone of the Thumb.- Metacarpal Bone of little Finger. —Wrist Joint: (1) by lateral Incisions, (2) a semilunar Flap, (3) Mr. Butcher's Method. - Elbow Joint: (1) Liston's Method, (2) H-shaped Incision, (3) Langenbeck's Operation.—Shoulder-Joint: (1) By a semilunar Flap, (2) By a longitudinal Incision, (3) Stromeyer's Method.- Excision of the Lower Jaw. -Excision of the Upper Jaw.-Resections of the Lower Extremity.-Phalanges and Phalangeal Joints of the Toes.-Metatarsal 4. Manner of using the Knife and Director in conjunction 5. Position of the Knife in the larger Amputations . 6. Eustachian Catheter 7. Section of the Nasal Cavities 8. Catheter for the Lachrymal Duct. 9. View of the Lachrymal Canals, Sac, and Duct 40 58 59 Position and Outline of its various Articulations 10. Course of the Lingual Artery 11. Speculum used in Mr. Lloyd's Operation for Lithotomy. 12. Forceps used in the same Operation 13. Diagrammatic View of the Skeleton of the Hand, showing the 14. Amputation of the last Phalanx of a Finger 64 66 15. Side View of the Hand, showing the Outline of the Bones about 73 16. Manner of forming a Flap in Amputation of the Hand at the 17. Formation of a Palmar Flap in amputating at the Wrist-Joint 19. Manner of forming the Posterior Flap in Amputation at the Shoulder-Joint. FIG. 20. Division of the external Rotator Muscles of the Humerus in the same Operation 21. Formation of the Anterior Flap in Amputation at the ShoulderJoint. 22. Diagrammatic View of the Foot, with an Outline tracing of its Bones, the Direction of the Incisions in the Amputations about the Parts being also shown 23. Method of tracing a Plantar Flap. 24. Manner of dividing the Interosseous Ligaments, &c., in Lisfranc's 25. Manner of completing Lisfranc's and Chopart's Operation 26. Roux's Amputation 27. Appearance of the Foot after this Operation 28. Dr. E. Watson's Method of performing Pirogoff 's Operation 29. Manner of completing the same 30. Appearance of the Wound after the Performance of Mr. Teale's Amputation on the Leg 31. Appearance of the Stump, when the Flaps have been brought together, after Mr. Teale's Amputation 32. Director used in the Practice of Resections PAGE 86 87 91 94 95 96 99 . 99 . 101 . 102 106 · 107 . 116 The Selection of a Subject. - Instruments. Assistant. A Table of Operations. Ir rarely happens that the student of operative surgery in this country has a choice of bodies for his purpose; to those who have such an opportunity, we would recommend the selection of a male subject with a moderate amount of fat about it. An emaciated body gives too low an idea of the difficulties of ligaturing arteries on the living; while its deficiency of subcutaneous tissue renders it difficult to provide sufficient material for the formation of stumps in the practice of amputations. The subject should be placed on a high and narrow table, such as dissectingrooms are generally furnished with. To save subsequent trouble, the operator should at once provide himself with those instruments which will suffice for the performance of all the ordinary operations: these instruments, with others, are contained in the regulation B |