Operative Surgery

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John Churchill, 1801 - 709 pages
 

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Page 87 - For the purpose of retaining this admirable, because most efficient principle, I employ a well-padded iron knob, which may represent the heel, from which there extend, laterally, two strong straight branches of the same metal, each ending in a bulb or ring of about four inches in length, the office of which is designed to keep the margins of the axilla as free from pressure as possible.
Page 62 - ... has been displaced, than to the more important purpose of easing it from the surface, on which it has lodged. For example, the rim of the glenoid cavity in dislocation of the...
Page 63 - It is this power that succeeds in forcibly drawing backward the head of the femur into its cavity, when it has fairly reached the rim of the acetabulum, notwithstanding the force employed at that instant in extending it. In the examples of the larger dislocations, I place no reliance on any of the above-mentioned efforts of manipulation, but depend almost entirely on the act of simple extension, in the fullest confidence of the disposition of the joint to right itself if the obstacles be removed.
Page 17 - On the other hand, the records of St. Bartholomew's Hospital point to its successful administration in upwards of nine thousand cases ; in not one of which, including the aged and the young, the healthy, the infirm and the asthmatic, has its employment left a stain on its character, as an innocuous agent of good. Under all circumstances, its careful employment may be unhesitatingly resorted to in all cases, excepting only such as are marked by determination to the brain of an apoplectic type ; secondly,...
Page 17 - ... cases; in not one of which, including the aged and the young, the healthy, the infirm, and the asthmatic, has its employment left a stain on its character, as an innocuous agent of good. Under all circumstances, its careful employment may be unhesitatingly resorted to in all cases, excepting only such as are marked by determination to the brain of an apoplectic type ; secondly, under circumstances of great and serious exhaustion from loss of blood ; and, thirdly, in diseases of the heart. In...
Page ix - Probably every reader will recollect cases where a leg or arm has been amputated, and after a time it was found that the frightful sacrifice might have been spared.* These are the men who, as Tennyson says, are Happier in using the knife than in trying to save the limb. When we think of the cruelty...
Page 263 - A line drawn from a point midway between the anterior superior spine of the ilium and the symphysis pubis...
Page 62 - So, also, in dislocations of the femur on the dorsum ilii, we do not attempt to draw the bone in a direct line with the acetabulum, but we carry it below, round its back and elevated margin, and no sooner does it reach the lower part of the rim, which is much less prominent than the upper and back part, than the muscles immediately restore it to its socket.
Page 61 - The answer has been invariably such as to justify me in adopting the principle I wish to urge on the attention of the reader, viz., that the immediate act of reduction is effected by the muscles, and by them alone. Remove the obstacle, bring the bone downwards, and the socket will receive it with avidity, by the agency of its own muscles, which it would appear are more powerful in a good, than in a bad cause, and which now contend more successfully against the extending force employed, even at its...
Page 62 - ... line with the acetabulum, but we carry it below, round its back and elevated margin, and no sooner does it reach the lower part of the rim, which is much less prominent than the upper and back part, than the muscles immediately restore it to its socket. The same rule holds in dislocation of the ulna and radius backwards, at the elbow-joint. I believe the exact line of extension, to be much more readily determined, and in truth a less important subject of consideration, than it is generally deemed.

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