Transcriber’s notes:
Italic text is denoted by _underscores_ and bold text by =equal signs=.
An underscore is also used in conjunction with curly brackets to
indicate that the characters within the brackets are subscripted in the
original text, e.g. a_{1} (seen mainly in illustration captions).
The table of contents contains a mix of italicised and non-italicised
entries that generally correspond to different heading levels in the
body of the text, but the correspondence is inaccurate and not all
headings are listed. No attempt has been made to correct these
anomalies.
The text contains several archaic symbols representing measures of
weight that were used by apothecaries. In this text version the symbols
appear to display correctly with most of the common fonts, but Times New
Roman and Lucida Sans Unicode are the most reliable for displaying them
in the html version. The main symbols are ‘ʒ’ representing the drachm
unit of weight, and ‘℥’ representing the ounce unit of weight (8 drachms
= 1 ounce). The third symbol does not have an exact computer
equivalent and has been represented in this transcription by the
character ‘ɱ’, which can signify ‘minim’ (a measure of volume
equal to 1/60th of a fluid drachm), ‘drop’, or ‘part by volume’. Roman
numerals x, v, i and j (i and j both represent 1) indicate the
quantities associated with these symbols.
Various inconsistencies of spelling and hyphenation occur throughout the
text; some are simple typographical errors but most are probably
variations attributable to the book's multiple authorship. Words with
variable spellings that occur with similar frequency (e.g. _trocar_ /
_trochar_, _aneurism_ / _aneurysm_) have not been changed, but most
other spelling inconsistencies have been ‘corrected’ to the predominant
form (e.g. _Caesarian_ --> _Caesarean_, _turbinate_ --> _turbinal_).
Omitted letters have been corrected by inserting the missing letters in
square brackets (e.g. sella turc[ic]a). Simple typos such as _uretha_
(_urethra_) and _polpyus_ (_polypus_) have been corrected silently, and
likewise with missing punctuation such as commas omitted from the index
and the table of contents. An apostrophe is used inconsistently with the
proper noun _Bruening_ / _Bruenings_.
Inconsistencies of spacing and hyphenation have been treated similarly.
For example, spaces have been removed from the abbreviations _i.e._
_e.g._ and from percentage values. Compound nouns that occur equally
often with/without hyphens, have not been changed, e.g. _bone forceps_ /
_bone-forceps_, _attic wall_ / _attic-wall_, whereas those that are more
frequently either hyphenated or not hyphenated, have been standardised
accordingly, e.g. _punch forceps_ --> _punch-forceps_, _heart-failure_
--> _heart failure_.
[Illustration: Cover]
OXFORD MEDICAL PUBLICATIONS
A SYSTEM OF
OPERATIVE SURGERY
OXFORD: HORACE HART
PRINTER TO THE UNIVERSITY
OXFORD MEDICAL PUBLICATIONS
A
SYSTEM
OF
OPERATIVE SURGERY
BY VARIOUS AUTHORS
EDITED BY
F. F. BURGHARD, M.S. (Lond.), F.R.C.S. (Eng.)
TEACHER OF OPERATIVE SURGERY IN KING’S COLLEGE, LONDON
SURGEON TO KING’S COLLEGE HOSPITAL
SENIOR SURGEON TO THE CHILDREN’S HOSPITAL, PADDINGTON GREEN
IN FOUR VOLUMES
VOL. IV
OPERATIONS UPON THE FEMALE GENITAL ORGANS
OPHTHALMIC OPERATIONS
OPERATIONS UPON THE EAR
OPERATIONS UPON THE LARYNX AND TRACHEA
OPERATIONS UPON THE NOSE AND ITS ACCESSORY CAVITIES
LONDON
HENRY FROWDE HODDER & STOUGHTON
Oxford University Press Warwick Square, E.C.
1909
EDITOR’S PREFACE
Great as have been the advances made in Surgery during the last fifteen
years, there is no direction in which they have been more noticeable
than in the elaboration of those comparatively small but important
details of operative technique which do so much to ensure a low
mortality and a successful result.
These improvements have been developed simultaneously throughout the
whole of the vast field covered by modern Surgery, and it has become
increasingly difficult for any single writer to deal with such an
important subject as Operative Surgery in an authoritative and efficient
manner. The scope of the subject is so wide that it is difficult to
ensure that the work when published shall be thoroughly up to date,
while a second and even greater difficulty is for any one, however great
his ability and experience, to deal equally exhaustively and
authoritatively with all of the many branches of which he would have to
treat.
To avoid both of these difficulties and thus to make sure that the work
shall reflect faithfully the present position of British Operative
Surgery, the plan has been adopted of securing the co-operation of a
number of prominent British Surgeons. Each writer deals with a branch of
the subject in which he has had special experience, and upon which,
therefore, he is entitled to speak with authority.
Besides the two important points just referred to, a third equally
important one has been kept in view throughout. Particular care has been
taken to make the work of as much practical utility to the reader as
possible. Not only are the various operations described in the fullest
detail and with special reference to the difficulties and dangers and
the best methods of overcoming and avoiding them, but the indications
for the individual operations are described at length, and the
after-treatment and results receive adequate notice.
It is therefore hoped that the work will be useful alike to those who
are about to operate for the first time, and to those surgeons of
experience who desire to keep themselves informed as to the progress
that has been made in the various branches of Operative Surgery.
The division of the work into a number of sections each written by a
different author, necessarily involves some overlapping of subjects and
some diversity of opinion upon points of technique. Efforts have been
made to prevent overlapping of subjects as far as possible by care in
their distribution and by conference between the authors concerned, but
no attempt has been made to harmonize conflicting views. Each author
supports his individual opinions by the weight of his authority, and any
discrepancies may be taken to represent the absence of unanimity on
various minor points that is well known to exist among surgeons of all
countries.
The task of editing a work contributed to by so many writers might well
appear to be an onerous one, but, owing to the promptitude, courtesy,
and forbearance of all concerned, it has been a source of great
pleasure, and the Editor’s most cordial thanks are tendered to all those
who have devoted so much time and trouble to the work.
PREFACE TO VOLUME IV
Every effort has been made to keep this volume strictly within the
definition of a work upon Operative Surgery--a somewhat difficult task
in the case of certain of the special subjects with which it deals. In
some cases methods of examination or manipulation have been described
that are not strictly operative in nature, but their inclusion has been
justified upon the ground that many of them are essential in operations
upon the regions concerned, and all require special manipulative skill
and dexterity.
The Index to this volume has been arranged in five parts, one part for
each Section comprised in it. In this way it has been possible to
economize space and, it is hoped, to render the task of reference
easier.
In the Section on Vaginal Gynæcological Operations, instrument blocks
have been kindly supplied by Messrs. Montague, Down Bros., and Griffin.
The remaining illustrations are from original sketches by the author.
In the Section on Ophthalmic Operations, Messrs. Weiss have kindly
supplied the instrument blocks. The remainder of the illustrations are
original. Mr. Mayou desires to thank Mr. W. H. McMullen for valuable
help in reading the proof sheets.
In the Section on Operations upon the Ear, all the illustrations, with
the exception of the instrument blocks kindly supplied by Messrs. Mayer
and Meltzer and a few illustrations from Tod’s _Manual of Diseases of
the Ear_, are original.
In the Section on Operations upon the Nose, the instrument blocks have
been supplied by Messrs. Mayer and Meltzer, who have also furnished them
in the Section on Operations upon the Throat. Mr. F. A. Rose has kindly
read the proof sheets of the latter Section, for which Mr. Harmer
desires to thank him.
CONTRIBUTORS TO THIS VOLUME
JOHN BLAND-SUTTON, F.R.C.S. (Eng.)
_Surgeon to the Middlesex Hospital, and Senior Surgeon to the Chelsea
Hospital for Women, London_
Abdominal Gynæcological Operations
JOHN PHILLIPS, M.A., M.D. (Cantab.), F.R.C.P.
_Professor of Obstetric Medicine, King’s College, London; Obstetric
Physician and Gynæcologist to King’s College Hospital_
Vaginal Gynæcological Operations
M. S. MAYOU, F.R.C.S. (Eng.)
_Assistant Surgeon to the Central London Ophthalmic Hospital; Ophthalmic
Surgeon to the Children’s Hospital, Paddington Green_
Ophthalmic Operations
HUNTER F. TOD, M.A., M.D. (Cantab.), F.R.C.S. (Eng.)
_Aural Surgeon to the London Hospital_
Operations upon the Ear
W. DOUGLAS HARMER, M.C. (Cantab.), F.R.C.S. (Eng.)
_Surgeon to the Throat and Nose Department, St. Bartholomew’s Hospital_
Operations upon the Larynx and Trachea
StCLAIR THOMSON, M.D., F.R.C.P. (Lond.), F.R.C.S. (Eng.)
_Professor of Laryngology and Physician for Diseases of the Throat,
King’s College Hospital, London_
Operations upon the Nose and its Accessory Cavities
CONTENTS
SECTION I
OPERATIONS UPON THE FEMALE GENITAL ORGANS
PART I
ABDOMINAL GYNÆCOLOGICAL OPERATIONS
By JOHN BLAND-SUTTON, F.R.C.S. (Eng.)
Surgeon to the Middlesex Hospital and Senior Surgeon to the Chelsea
Hospital for Women, London.
PAGES
CHAPTER I
CŒLIOTOMY
Preparation of Patient, 3. Basins, Dishes, and Instruments, 4.
Suture and Ligature Material, 5. Dabs, 5. Gloves, Operating
Table, Anæsthesia, 6. The Incision, 7. Misplaced Viscera, 8.
Closure of Wound, 8 3-9