complete operation. The preliminary use of adrenalin and cocaine, the
administration of lactate of calcium, and the other methods recommended
for the prevention of bleeding (see p. 574) should be carefully attended
to. But in every case preparation should be made beforehand for ligature
of the external carotids and for saline infusion.
OPERATION FOR RETROPHARYNGEAL ABSCESS
=Indications.= The disease is serious, and when not diagnosed almost
inevitably ends in death. Before the abscess bursts death may result
from spasm of the glottis, laryngeal œdema, or asphyxia. The affection
runs its course in 5 to 10 days, and if the abscess opens spontaneously
death almost inevitably results--either from suffocation, or septic
pneumonia, or cardiac failure.
=Operation.= When the diagnosis is settled intervention should be
prompt. It is not necessary to wait for distinct fluctuation. The pus
focus may be so difficult of manipulation in an infant, and the
pharyngeal muscle may be so thick and indurated, that it is practically
impossible, even in the later stages of retropharyngeal abscess, to
detect the presence of pus by palpation.[88]
[88] M. A. Goldstein, ibid., xviii, January, 1908, p. 46.
_The evacuation of the abscess through the mouth_ was formerly looked
upon as dangerous, owing to the difficulty of drainage, the fear of pus
burrowing behind the œsophagus, and the risk of flooding the larynx with
pus. The more difficult plan of opening it from the neck was generally
recommended. The majority of cases can be opened through the mouth with
perfect safety.
No general or local anæsthetic is administered, but everything necessary
for an immediate tracheotomy should be ready at hand. No gag should be
employed, a tongue depressor or the operator’s left forefinger being
sufficient both to keep the mouth open and act as a guide. The infant is
swaddled in a shawl so as to completely control the movements of the
extremities and is then laid on its side on a low pillow, and held by a
trustworthy assistant. The sinus-forceps used for opening a
peritonsillar abscess are thrust into the most prominent part of the
swelling, and the opening enlarged by separating the blades as they are
withdrawn. A slender sharp-pointed bistoury, guarded and guided by the
index-finger, may be used instead of the forceps. The pus will pour out
through the nose and mouth. The incision of the pharynx should be free,
deep and long, and directed against the posterior wall of the pharynx
and as close to the median line as possible, so as to avoid any chance
of wounding the internal carotid.
The surgeon may feel more security if, with the same precautions and
with the patient in the same position, he first aspirates the pus
cavity.
If more accustomed to it, he may also prefer to have the child flat on
its back, with the head overhanging the edge of the table.
Suffocation may be so imminent when the patient is first seen that a
preliminary tracheotomy is required.
_The external operation_, which leaves a certain scar, is reserved for
some rare cases--as when the abscess is too low to be easily reached
through the mouth, when the spasm of the masseters cannot be overcome,
when a large pulsating vessel is noticed in front of the abscess, and
when the abscess points towards the neck. It is also the suitable one
for the chronic and generally tubercular form of abscess more commonly
met with in older patients.[89]
[89] George E. Waugh, _The Lancet_, September 29, 1906.
The external operation is made through an incision along the posterior
border of the sterno-mastoid muscle, and the dissection is carried
behind the large vessels of the neck and in front of the prevertebral
muscles.
=After-treatment.= The after-care of the patient will require
consideration, since the disease is generally met with in the feeble and
ill nourished.
If the abscess be opened in good time the patient is at once relieved
and begins to recover rapidly.
REMOVAL OF NASO-PHARYNGEAL ADENOIDS
=Indications.= The removal of naso-pharyngeal adenoids is not called for
simply because they are accidentally discovered to be present, nor does
the need of operation depend solely on the size of the growths or the
nasal obstruction they produce. Adenoids require removal whenever the
symptoms attributable to them call for relief. These symptoms may be
arranged in three groups, according as they are those (i) of nasal
stenosis, (ii) of secondary septic infection, or (iii) of reflex
effects.
(i) Amongst the first are mouth-breathing and all the numerous sequelæ,
including facial, buccal, dental, and thoracic deformities. It must not
be forgotten that mouth-breathing may never be present, and yet
deformities of the chest or septic or reflex results can be produced by
a small amount of growth in the post-nasal space.
(ii) Amongst secondary septic infections are catarrhal conditions of the
Eustachian tube and otitis media, and catarrhal infection of any part of
the air-passages. Cervical glands and so-called ‘glandular fever’ occur
in this group, as do septic gastritis and other conditions caused by the
conveyance of sepsis to more distant parts.
(iii) Various reflex effects are sometimes attributable to
naso-pharyngeal adenoids. Laryngismus stridulus, reflex cough, chorea,
convulsions, night-terrors, enuresis nocturna, and aprosexia are some of
the ailments which may justify operation on Luschka’s tonsil.
As it is chiefly in children that this operation is required it is
important to see that they are free from indication of infectious
fevers. The operation should be postponed until any acute catarrh has
subsided. If there be otorrhœa the ears should receive suitable
cleansing treatment for a week or two beforehand. The condition of the
teeth requires attention.
The operation is so frequently carried out in private houses that it is
well to make inquiries into the health of the members of the household,
recent illness, and sanitation. When possible, a large, airy room with a
south aspect should be chosen.
=Operation.= In adults it is possible to carry out the operation under
cocaine. On the Continent, particularly in hospital practice, it is
often done without any anæsthetic at all. In this country general
anæsthesia is almost the universal custom. Opinion is divided as to
which is the safest and most suitable anæsthetic to employ.
When the removal of tonsils or other operation is not carried out at the
same time, an anæsthesia of less than a minute is sufficient. In adults,
and in children over 10 years of age, nitrous oxide does excellently.
Younger children are apt to be alarmed by the face-piece and apparatus
necessary for nitrous oxide, and this gas does not seem so suitable for
them as for adults. In younger children chloride of ethyl is extensively
employed on the Continent, but has not met with general favour here.
When the tonsils require removal, or any other operation on the upper
air-passages is carried out at the same time, and in young children
generally, an anæsthesia allowing of more deliberation is desirable.
For this, some operators employ ether,--preceded or not by nitrous
oxide. But the well-known objections to pure ether in the surgery of the
air-passages have caused the preference to be given to chloroform, or to
one of the mixtures of chloroform and ether.
The patient should lie quite flat on the operating table, with only a
low pillow or folded towel under the head. The anæsthetist, who takes
charge of the gag and flexes or rotates the head as directed, stands at
the end of the table. At the patient’s right hand stands the surgeon,
and within easy reach are his instruments, sponges, and iced water.
Standing on the same side and behind him is the nurse. Her duty is to
soothe the patient while passing into unconsciousness, and later on to
roll him well over on to his right side as the operation finishes.
The operation can be carried out more correctly, rapidly, safely, and
comfortably if the surgeon be armed with an electric forehead
search-light (see p. 571). Failing this, the table should be brought
close up and parallel to a window, with the patient’s right hand next
the light.
Surgeons differ as to the degree of anæsthesia desirable. Some like it
to be quite light, so that the patient is all the time in the struggling
stage and requires his hands to be controlled by the nurse. I think this
is quite as dangerous as when the anæsthesia is pushed until the patient
is relaxed, with the corneal reflex just abolished, and the swallowing
and coughing reflexes still present.
When the anæsthetic is administered steadily, with plenty of air, a
degree of unconsciousness is generally secured which will allow of an
operation lasting two or three minutes without any further
adminis[t]ration. Should the patient show signs of recovering
consciousness more chloroform can be given from a Junker’s apparatus.
The anæsthetist then opens the mouth with a suitable gag, such as
Doyen’s or Mason’s, and maintains the patient’s head exactly in the
middle line of the body. Directing the electric search-light into the
pharynx, the surgeon depresses the tongue with a spatula in the left
hand, while with the right he holds the adenoid curette--some
modification of the original Gottstein model (Fig. 349). This is best
seized firmly dagger-wise (Fig. 351). It is then introduced along the
tongue and slipped up into the post-nasal space. Once safely behind the
soft palate and kept straight in the middle line, no harm can be done.
Dropping the tongue depressor, the surgeon depresses the handle of his
instrument until the beak of it is felt in contact with the posterior
free margin of the septum. Pressing the cutting blade firmly and
steadily along this it is swept upwards, backwards, and downwards along
the vault of the naso-pharynx, while the curette revolves around an
imaginary centre in its shaft (Fig. 350). As the instrument is withdrawn
from the pharynx, its cage will be found to contain the adenoid growth,
removed _en bloc_ and generally complete (Fig. 351). Should the growth
slip from the cage, or remain semi-detached from the posterior
pharyngeal wall, it can be seized and lifted from the throat with a pair
of post-nasal forceps (Fig. 287).
[Illustration: FIG. 349. ADENOID CURETTE. StClair Thomson’s
modification.]
The rush of blood which now takes place is met by rolling the patient
well over to his right side, with his face over the edge of the table,
so that the blood can run into the right cheek and so out through the
mouth. With the patient on his side there is no anxiety of asphyxia from
descent of blood or fragments of growth into the trachea, and the
surgeon can more deliberately explore the post-nasal space and, with a
simple adenoid curette, remove any lateral remains of growth which may
have escaped the caged curette.
[Illustration: FIG. 350. THE REMOVAL OF NASO-PHARYNGEAL ADENOIDS.
Semi-diagrammatic illustration to show how the curette revolves around
an axis which moves from _a_, through _b_ and _c_, to _d_. The growth is
pressed into the fenestra of the instrument in the _a'_ position, and
when the sweeping movement has brought it to _d'_, it is detached and
caught in the cage.]
Sponges are merely used to cleanse the mouth and pharynx in order to
make sure that no semi-detached fragments are left behind. If present,
tonsils can be conveniently removed at this stage.
Bleeding, which may be very free for a minute or two without any cause
for anxiety, is promptly arrested by freely sluicing the patient’s face
and neck with ice-cold water.
=After-treatment.= The patient is put back to bed, lying well over to
one side. He should not be allowed to lie on his back, or left
unattended, until consciousness has returned. Collapse may occur at this
time, generally as a precursor of vomiting, or blood may be vomited and
then, owing to the patient’s semi-conscious condition, may be drawn into
the trachea.
[Illustration: FIG. 351. REMOVAL OF NASO-PHARYNGEAL ADENOIDS. The growth
is shown as partially removed from its attachment, and bulging into the
cage of the instrument which opens to receive it.]
Ice may be sucked. After a few hours, if there be no vomiting, barley
water, lemonade, tea, thin beef-tea, or beef jelly can be given. Milk
and milky food should be avoided. An aperient should be given the same
evening, as any foul breath or feverish condition is more likely to be
due to blood and mucus in the stomach than to local sepsis. The mouth is
kept cleansed with the tooth-brush and an alkaline wash.
It is best to avoid local treatment for the nose. At the end of a few
hours the patient is encouraged to clean the nose, and if he be
supplied with abundance of fresh air through freely opened windows, the
wound in the post-nasal space will heal promptly without any local or
general reaction. Occasionally an alkaline nose lotion is required if
there has been much secondary rhinitis, or if the child be kept in
vitiated air.
One day in bed is generally sufficient, and a child may be allowed out
in two or three days, though fatigue should be avoided for a week.
Suitable after-treatment in the way of breathing exercises, gymnastics,
speech correction, and tonics is often needed. Relief of nasal stenosis
may require completion by attention to the condition of the turbinals
and septum.
The operation in adults is performed under nitrous oxide. This can be
carried out in exactly the same way as that already described, but some
surgeons prefer to have the patient sitting up in a dentist’s chair. In
that case, after the removal of the mass of growth, the patient’s head
is thrown forward between his knees.
=Difficulties and dangers.= It may be said that the operation itself,
carried out with usual care and in a patient who is not a hæmophilic, is
free from danger. The chief anxiety is from the anæsthetic, and no
inconsiderable number of deaths from this cause have been reported. When
possible, it is well to secure the services of an expert anæsthetist who
is well used to laryngological work, and accustomed to the operator’s
particular methods.
_Hæmorrhage_ may be brisk, even profuse, for a few minutes, but as a
rule it promptly ceases if the operation be completed, the patient well
rolled to one side, the air thoroughfare left clear so as to allow free
breathing and avoid congestion, and the gag removed to permit swallowing
and diminish pharyngeal reflexes. The more rapidly and completely the
operation is executed, the less will be the bleeding. It not
infrequently originates from semi-detached fragments of growth. Even
when the hæmorrhage is profuse it is better to push on and complete the
removal of growth before attempting to check it. The value of free
applications of ice-cold water cannot be exaggerated (see p. 574). In
many cases bleeding is maintained by the surgeon’s anxious efforts to
stop it with sponging, pressure, or the application of styptics. The
greatest danger arises in the case of hæmophilics. If this diathesis be
undoubtedly present, the operation should be avoided. If only suspected,
more care than usual should be taken in preparing the patient for
operation, and lactate of calcium in 15 to 30 grain doses twice a day
might be given for two or three days beforehand.
When bleeding persists it is met by keeping the patient very quiet and
free from alarm, in a cool and well-ventilated room, and only lightly
covered with clothes. Ice is given to suck and applied on each side of
the neck, while iced cloths are applied to the face and forehead. Clots
are blown out of the nose so as to permit the access of fresh cold air
to the post-nasal space. With a pipette, or a pledget of cotton-wool, a
few drops of adrenalin can be trickled into the nostril and allowed to
run backward. If these measures fail--as they rarely do--the post-nasal
space must be plugged (see p. 575). When hæmorrhage takes place after
the removal of adenoids and tonsils, it will generally be found that the
source of it is in the tonsillar area.
_The uvula_ may retract strongly at the moment of introducing the
curette and then get crushed against the posterior pharyngeal wall: or
it may be seized by mistake with the post-nasal forceps and be torn
away. The same instrument has sometimes been responsible for fracturing
the posterior margin of the septum, injuring the Eustachian cushion, and
tearing off strips of mucosa from the pharynx. These complications are
avoided by using a frontal search-light, operating deliberately, and
abandoning the forceps in favour of the curette. This latter instrument
can be manipulated without these risks if it be first guided safely
behind the uvula and then used more like a carpenter’s adze than a
curette. The stroke with the caged curette should be carried through in
one movement and exactly in the middle line of the body, but always on
the posterior wall. There is no need to attempt removal of adenoid
tissue on the lateral walls. This atrophies if the main mass is removed,
and the fossa of Rosenmüller can be cleared out with the forefinger.
_Local sepsis_ rarely follows if the precautions described be observed,
and local douching is avoided. Any local fœtor--if not arising from the
stomach--is generally traceable to some semi-detached fragment which can
be removed from the posterior wall with a wire snare (Fig. 312) or a
pair of forceps (Fig. 287).
_Deafness_, _earache_, and _otitis media_ will sometimes follow the
operation, even when the use of a nasal douche has been carefully
avoided. They are best met by warm applications, disinfection of the ear
with carbolic lotion (5%), and early incision of the drum under nitrous
oxide gas.
=Other methods of operation.= Removal through the nasal chambers--the
route originally used by Meyer for his ring-knife--is not to be
recommended.
Treatment of the growth with the galvano-cautery, introduced through the
mouth, is difficult, risky, and unsatisfactory.
The use of Loewenberg’s forceps, or some modification (Fig. 287), is
generally abandoned by any one who has become accustomed to the
Gottstein’s curette. A small pair of forceps is, however, very
serviceable in quite young children in whom the post-nasal space may be
so small as to prevent the manœuvring of any form of curette.
The position with the extended head over the end of the table--Rose’s
position--increases the congestion and hæmorrhage, and by throwing
forward the cervical vertebræ makes the approach to the roof of the
naso-pharynx more difficult.
INDEX
OPERATIONS UPON THE FEMALE GENITAL ORGANS
ABDOMINAL
gynæcological operations, 1
after-treatment of, 93
complications following, 95
hysterectomy, 36
risks of, 45
myomectomy, 46
ABSCESS OF BARTHOLIN’S GLANDS
incision of, 142
ADENOMYOMA OF UTERUS, 56
ADHESIONS IN OVARIOTOMY, 12
ANÆSTHETIC FOR CŒLIOTOMY, 6
ANTERIOR COLPOTOMY, 145
ATRESIA OF HYMEN AND VAGINA
operations for, 143
AUVARD’S SPECULUM, 136
AVELING’S SIGMOID REPOSITOR, 151
BARTHOLIN’S GLANDS
operations upon, 142
BED-SORES AFTER CŒLIOTOMY, 95
BELATED OVARIES
fate of, 56
BLADDER
injuries during hysterectomy, 111
operations upon, 134
BROAD-LIGAMENT CYSTS
removal of, 14
CÆSAREAN SECTION, 69
CANCER
of body of uterus, abdominal hysterectomy for, 63
vaginal hysterectomy for, 168
and fibroids, 52
cervix with pregnancy, 82
cicatrix after cœliotomy, 121
Fallopian tube, operation for, 26
ovary, ovariotomy for, 15
uterus after bilateral ovariotomy, 55
CAPSULES
spurious, in ovariotomy, 15
CARCINOMA (_see_ Cancer)
CARUNCLE, URETHRAL
extirpation of, 134
CERVIX
cancer of, in pregnancy, 82
dilatation of, rapid, 156
gradual, 159
fibroids, hysterectomy for, 42
hypertrophy of, operations for, 160
CHRONIC UTERINE INVERSION
reposition of, 151
CICATRIX
after cœliotomy, 120
cancer of, 121
CŒLIOTOMY, 3
COLPOTOMY, 144
anterior, 145
posterior, 147
COMPLETE LACERATION OF PERINEUM, 127
COMPOUND PREGNANCY, 33
CURETTAGE, 152
CYST
of Bartholin’s glands, removal of, 142
broad ligament, 14
CYSTOCELE
operations for, 140
DABS FOR CŒLIOTOMY, 5
DÉDOUBLEMENT
Walcher’s, 137
DILATATION
of cervix, 156
vulval orifice, 143
DILATORS, HEGAR’S, 153
DUDLEY
operation upon perineum, 134
DÜHRSSEN
trachelorrhaphy, 163
EMBOLISM, PULMONARY
after abdominal section, 101
EMMETT’S
hook, 136
scissors, 162
trachelorrhaphy, 161
ENUCLEATION OF FIBROIDS, 46
EXTIRPATION OF URETHRAL CARUNCLE, 134
EXTRA-UTERINE GESTATION
operation for, 29
results of operation, 34
FALLOPIAN TUBE
operation for cancer of, 26
FIBROIDS
abdominal hysterectomy for, 61
cancer of uterus and, 52
cervix, hysterectomy for, 42
enucleation of, 46
hysterectomy for, 61, 173
interstitial, vaginal removal of, 167
pedunculated, vaginal removal of, 165
and pregnancy, 77
red degeneration of, 78
sessile, vaginal removal of, 166
vaginal hysterectomy for, 173
FISTULA
juxta-cervical, operation for, 139
recto-vaginal, operation for, 139
vesico-utero-vaginal, operation for, 139
FOREIGN BODIES LEFT IN ABDOMEN, 105
GALABIN’S
broad-ligament needle, 169
GASTRIC ULCER
perforating after cœliotomy, 111
GESTATION, EXTRA-UTERINE
operations for, 29
GLANDS, BARTHOLIN’S
operations upon, 142
GYNÆCOLOGICAL
operations, abdominal, 1
vaginal, 125
uterine injuries, operations for, 86
HÆMORRHAGE AFTER CŒLIOTOMY, 97
HEGAR’S
dilators, 153
operation for hypertrophy of cervix, 160
HYMEN
operation for atresia of, 143
HYPERTROPHY OF CERVIX
operations for, 160
HYSTERECTOMY, ABDOMINAL, 46
subtotal, 36
total, 40
in bifid uterus, 44
after bilateral ovariotomy, 17
for adenomyoma, 56
for cancer of body of uterus, 63
cervix, 61
for fibroids, 61
Wertheim’s operation, 62
HYSTERECTOMY, VAGINAL
for cancer, 168
fibroids, 173
HYSTEROPEXY
abdominal, 66
vaginal, 164
HYSTEROTOMY, 46
INCISION OF ABSCESS OF BARTHOLIN’S GLANDS, 142
INCONTINENCE OF URINE FOLLOWING LABOUR
operations for, 134
INJURIES OF UTERUS
operations for, 86
INJURY
to bladder during pelvic operations, 111
gravid uterus during abdominal operations, 89
intestines during gynæcological operations, 109
ureter during pelvic operations, 112
INTERSTITIAL UTERINE FIBROIDS
vaginal removal of, 167
INTESTINAL OBSTRUCTION
after pelvic operations, 110
INTESTINES
injuries to during gynæcological operations, 109
INTRAPELVIC HÆMORRHAGE
after cœliotomy, 98
JESSETT’S
broad-ligament needle, 169
JUXTA-CERVICAL FISTULA
operations for, 139
KRAUROSIS, POST-OPERATIVE, 120
LACERATIONS
of pelvic floor, repair of, 132
perineum, repair of, 127
LATERAL COLPOTOMY, 148
LIGAMENT, BROAD (_see_ Broad ligament)
LIGATURES
fate of, in pelvic operations, 117
MACKENRODT
vesico-vaginal fistula operation, 138
MARCKWALDT
operation for hypertrophy of cervix, 160
MARTIN’S
trochar, 147
vesico-vaginal fistula operation, 137
MENSTRUATION AND PELVIC OPERATIONS, 4
METROSTAXIS
after gynæcological operations, 95
MYOMECTOMY
abdominal, 46
vaginal, 167
OBSTETRIC UTERINE INJURIES
operations for, 87
OÖPHORECTOMY, 21
hysterectomy after bilateral, 25
OPERATING TABLES, 6
OVARIAN TUMOURS
and pregnancy, 74
removal of (_see_ Ovariotomy)
OVARIES, BELATED
fate and value of, 56
OVARIOTOMY, 10
adhesions in, 12
anomalous, 16
for cancer of ovary, 15
at extremes of life, 18
incomplete, 16
in infants, 18
during labour, 75
mortality of, 19
pregnancy after, 17
during puerperium, 76
repeated, 17
spurious capsules in, 15
OVARY, REMOVAL OF (_see_ Oöphorectomy)
PARALYSIS, POST-ANÆSTHETIC, 95
PARAVAGINAL SECTION, 148
PAROTITIS
following abdominal operations, 99
PASSAGE OF UTERINE SOUND, 149
PÉAN’S RETRACTOR, 145
PEDICLE IN OVARIOTOMY
treatment of, 12
PELVIC FLOOR
repair of laceration of, 132
PELVIC OPERATIONS
complications during, 111
PELVIC TUMOURS
during pregnancy, 83
PERINEUM
repair of lacerations of, 127
PNEUMONIA
after abdominal operations, 99
POST-ANÆSTHETIC PARALYSIS, 95
POSTERIOR COLPOTOMY, 147
POZZI’S RETRACTOR, 145
PREGNANCY
after bilateral ovariotomy, 17
bullet wounds of uterus during, 90
with cancer of cervix, 82
compound, operations for, 82
and fibroids, 79
injury to uterus during, 89
operations upon uterus during, 69
and ovarian tumours, 74
and pelvic tumours, 83
PREPARATIONS FOR VAGINAL OPERATIONS, 125
PUERPERAL SEPSIS
operations for, 83
PUERPERIUM
ovariotomy during, 76
PULMONARY EMBOLISM
after abdominal operations, 101
RECTO-VAGINAL FISTULA
repair of, 139
RED DEGENERATION IN FIBROIDS, 78
REPOSITION OF CHRONIC UTERINE INVERSION, 151
RETRACTOR
Péan’s, 145
Pozzi’s, 145
RICARD
uretero-neo-cystostomy, 114
SARCOMA OF UTERUS
hysterectomy for, 53
SEPSIS, PUERPERAL
operations for, 83
SIGMOID REPOSITOR, AVELING’S, 151
SIMS’S
speculum, 136
vaginal rest, 144
SOUND, UTERINE
passage of, 149
SPECULUM
Auvard’s, 136
Sims’s, 136
SPURIOUS CAPSULES IN OVARIOTOMY, 15
STABS OF PREGNANT UTERUS, 91
STERILIZATION
after Cæsarean section, 71
STOLTZ
cystocele operation, 140
SUBTOTAL HYSTERECTOMY, 36
relative value of, 50
SUTURES FOR CŒLIOTOMY, 5
SWAFFIELD
closure of wounds, 9
TAIT, LAWSON
oöphorectomy, 21
operation for extra-uterine gestation, 29
TENTS
dilatation of cervix by, 160
TETANUS
after gynæcological operations, 107
THROMBOSIS
after abdominal section, 101
TOTAL HYSTERECTOMY, 40
relative value of, 50
TRACHELORRAPHY
Emmett’s, 161
Dührrsen’s, 163
TUMOURS
ovarian, during pregnancy, 74
pelvic, during pregnancy, 83
ULCER
gastric perforating, after cœliotomy, 111
URETER
injury to during pelvic operations, 112
URETERO-NEO-CYSTOSTOMY, 114
URETHRA, FEMALE
operations upon, 134
URETHRAL CARUNCLE
extirpation of, 134
UTERINE SOUND
passage of, 149
UTERUS
operations upon (_see_ individual operations)
adenomyoma of, 86
bullet wounds of pregnant, 90
cancer of body with fibroids, 52
after ovariotomy, 55
chronic inversion of, reposition of, 151
compound pregnancy, 82
fibroids and pregnancy, 77
fibro-myomata, operations for, 46, 165
gynæcological injuries to, 86
pregnant, injuries to, 91
wounds of, 89, 91
VAGINA
atresia of, operations for, 143
operations upon, 142
VAGINAL
cœliotomy, 144
gynæcological operations, 125
hysterectomy, for cancer, 168
fibroids, 173
hysteropexy, 164
myomectomy, 167
rest, Sims’s, 136
VENTRO-FIXATION OF UTERUS, 67
VENTRO-SUSPENSION OF UTERUS, 66
VESICO-UTERO-VAGINAL FISTULA
repair of, 139
VESICO-VAGINAL FISTULA
repair of, 135
VISCERA, MISPLACED
in cœliotomy, 8
VULVA
operations upon, 142
dilatation of, 143
WALCHER
dédoublement, 137
WERTHEIM
hysterectomy, 62
WOUNDS OF PREGNANT UTERUS, 90
OPHTHALMIC OPERATIONS
ABSCESS
lachrymal, incision of, 297
orbital, 301
ACTIVE (CICATRICIAL) ECTROPION
operations for, 284
ADRENALIN
in ophthalmic operations, 178
ADVANCEMENT
of levator palpebræ, 272
ocular muscles, 251
AFTER-TREATMENT OF OPERATIONS IN GENERAL, 180
ANÆSTHETICS, 177
ANKYLOBLEPHARON
operations for, 264
ANTERIOR
chamber, evacuation of, 194
paracentesis of, 233
sclerotomy, 228
synechiæ, division of, 227
APERTURE, PALPEBRAL
operations upon, 265
ARGYLL ROBERTSON
ectropion operation, 282
ARLT
entropion operation, 278
ATTACHMENT
of lid to occipito-frontalis, 268
BANDAGES, EYE, 186
BRUDENELL CARTER
iridectomy, 217
BUROW
entropion operation, 276
CALCAREOUS FILMS
scraping, 243
CANAL, LACHRYMAL
operations upon, 290
CANALICULI
dilatation of, 290
incision of, 291
obliteration of, 294
CANTHOPLASTY, 265
CANTHORRHAPHY, 265
CAPSULE OF LENS
evulsion of, 195
CAPSULOTOMY, 192
CATARACT
needling of, 189
secondary, operations for, 192
CAUTERIZATION OF CORNEA, 240
CHAMBER, ANTERIOR (_see_ Anterior chamber)
CICATRICIAL ECTROPION
operations for, 284
COCAINE
sterilization of, 182
CONGENITAL GLAUCOMA
iridectomy for, 219
CONICAL CORNEA
operations for, 241
CONJUNCTIVA
expression of, 245
removal of foreign bodies from, 244
CONJUNCTIVOPLASTY, 245
CONTRACTED SOCKET
operations for, 260
CORNEA
cauterization of, 240
conical, operations for, 241
operations upon, 240
removal of foreign bodies from, 240
tattooing the, 243
tumours, removal of, 243
CORNEAL TUMOURS
removal of, 243
COUCHING, 209
CYCLO-DIALYSIS, 229
CYSTOID SCAR
after iridectomy, 184
CYSTS, TARSAL
removal of, 246
DE VINCENTIIS’ OPERATION, 287
DENONVILLIERS
ectropion operation, 285
DIEFFENBACH’S OPERATION, 288
DILATATION OF CANALICULI, 290
DISCISSION OF THE LENS, 189
DIVISION
of anterior synechiæ, 227
tarsal cartilage for entropion, 276
DUCT, LACHRYMAL
probing and syringing, 292
ECTROPION OPERATIONS, 279
ELECTRO-CAUTERY OPERATION FOR CONICAL CORNEA, 242
ELECTROLYSIS FOR TRICHIASIS, 275
ELECTRO-MAGNET OPERATIONS, 237
ENTROPION OPERATIONS, 275
ENUCLEATION
of the globe, 255
EVACUATION
of the anterior chamber, 194
EVISCERATION
of the globe, 257
orbit, 301
EVULSION
of the lens capsule, 195
EXCISION
of apex of conical cornea, 241
lachrymal sac, 294
EXPLORATION
of the orbit (Krönlein’s), 299
EXPRESSION
of the conjunctiva, 245
EXTRACTION
of foreign bodies from conjunctiva, 244
from cornea, 240
globe, 237
lens, 195
EXTRA-OCULAR MUSCLES
operations upon, 247
EYELIDS
operations upon, 263
EYE-SOCKET
contracted, operations upon, 261
paraffin injections into, 260
FERGUS
ectropion operation, 281
plastic operation upon eyelid, 267
FILMS
calcareous, scraping, 243
FIXATION FORCEPS, 190
FLAPS
transplantation of for ectropion, 284
FOREIGN BODIES
in conjunctiva, 244
cornea, 240
globe, 237
FRICKE
plastic eyelid operation, 285
FROST’S OPERATION, 259
GIANT ELECTRO-MAGNET OPERATIONS, 238
GLAND, LACHRYMAL
excision of, 298
GLAUCOMA
iridectomy for, 217
GLOBE
direction of incisions in, 183
enucleation of, 255
evisceration of, 257
Frost’s operation upon, 259
Mules’s operation upon, 259
operations for penetrating wounds of, 234
wounds in, 182
GRAFTING SUPERIOR RECTUS INTO LID, 273
HANDS
sterilization of, 182
HARMAN
ptosis operation, 269
HEINE
cyclo-dialysis, 229
HESS
ptosis operation, 268
INCISION
of the canaliculi, 291
into the globe, 183
INJECTION
of paraffin into eye-socket, 260
INSERTION OF STYLES, 293
INSTRUMENTS
sterilization of, 183
IRIDECTOMY, 214
for glaucoma, 217
growths of iris, 225
optical, 214
Brudenell Carter’s, 217
for prolapse of iris, 225
IRIDOTOMY, 211
Kuhnt’s, 212
Ziegler’s, 213
IRIS
iridectomy for growths of, 225
operations upon, 211
prolapse of, iridectomy for, 225
transfixion of, 226
IRRIGATION
delivery of lens by, 203
KRÖNLEIN
exploration of orbit, 299
KUHNT
ectropion operation, 281
iridotomy, 299
LACHRYMAL
abscess, opening of, 297
canals, obliteration of, 294
operations upon, 290
duct, probing, 292
syringing, 292
gland, operations upon, 298
sac, excision of, 294
LANG’S SPECULUM, 181
LASH-BEARING AREA
transplantation of, 278
LENS
capsule, evulsion of, 195
delivery of, by irrigation, 203
discission of, 189
extraction of, 195
operations upon, 187
surgical anatomy of, 187
LEVATOR PALPEBRÆ
advancement of, 272
LID MARGIN
suture of wounds of, 264
LIDS
operations upon, 263
LOCAL PREPARATION OF PATIENT FOR OPERATION, 180
MCKEOWN
removal of lens, 203
MAGNET, ELECTRO-, OPERATIONS, 237
MAXWELL
contracted socket operation, 261
MOTAIS
ptosis operation, 273
MULES’S OPERATION, 259
MUSCLES, EXTRA-OCULAR
operations upon, 247
MYOPIA
discission of lens in, 190
NEEDLING OF THE LENS, 189
OBLITERATION
of the canaliculi, 294
lachrymal canals, 294
OCULAR MUSCLES
advancement of, 251
tenotomy of, 248
OPERATING
tables, 180
theatres, 179
OPERATIONS
general preliminaries, 177
OPTICAL IRIDECTOMY, 214
ORBIT
abscess of, 301
evisceration of, 301
exploration of, 299
operations upon, 299
plastic operations upon, 260
ORBITAL
abscess, opening, 301
portion of lachrymal gland, removal of, 299
PAGENSTECHER’S SPOON, 196
PALPEBRAL
aperture, operations, upon, 265
portion of lachrymal gland, removal of, 298
PANAS
ptosis operation, 271
PARACENTESIS
of anterior chamber, 233
PARAFFIN INJECTIONS
into eye-socket, 260
PASSIVE ECTROPION
operations for, 280
PENETRATING WOUNDS
of the globe, 234
PLASTIC OPERATIONS
upon the eyelids, 287
orbit, 260
POSTERIOR SCLEROTOMY, 232
PREPARATIONS FOR EYE OPERATIONS, 177
PRIMARY GLAUCOMA
iridectomy for, 218
PROBING LACHRYMAL DUCT, 292
PROLAPSE OF IRIS
iridectomy for, 225
PTERYGIUM
operations for, 244
PTOSIS OPERATIONS, 267
PURIFICATION OF EYE, 181
RECTIFICATION
of faulty curve of tarsus, 276
REMOVAL
of eye, operations upon socket after, 260
foreign bodies from conjunctiva, 244
from cornea, 240
globe, 236
SAC, LACHRYMAL
excision of, 294
SCLERECTOMY, 231
SCLEROTOMY
anterior, 228
posterior, 232
SCRAPING CALCAREOUS FILMS, 243
SECONDARY
cataract, operations for, 192
glaucoma, iridectomy for, 219
SEPSIS
after intra-ocular operations, 181
SKIN-GRAFTING
for contracted socket, 261
ectropion, 287
SKIN AND MUSCLE ENTROPION OPERATION, 275
SNELLEN’S SUTURES, 280
SOCKET, CONTRACTED
operation for, 261
operations upon after removal of eye, 260
SPECULUM, LANG’S, 181
SQUINT OPERATIONS, 247
STREATFIELD’S OPERATION, 277
STERILIZATION
of cocaine, 182
instruments, 183
STYLES
insertion of, 293
SURGICAL ANATOMY
of glaucoma, 217
lens, 187
SUTURE OF WOUNDS OF LIDS, 263
SUTURES, SNELLEN’S, 280
SYNECHIÆ, ANTERIOR
division of, 227
SYMBLEPHARON OPERATIONS, 264
SYRINGING
lachrymal duct, 292
TARSAL CARTILAGE
division of, for entropion, 276
TARSAL CYSTS
removal of, 246
TARSORRHAPHY, 266
TATTOOING THE CORNEA, 243
TENOTOMY
of ocular muscles, 248
THEATRES, OPHTHALMIC, 179
THIERSCH
skin-grafting for ectropion, 287
TRANSFIXION
of the iris, 226
TRANSPLANTATION
of the lash-bearing area, 278
TRICHIASIS
operations for, 275
TUMOURS
corneal, removal of, 243
UNDINE, 182
VECTIS, 196
VY OPERATION FOR ECTROPION, 284
WHARTON JONES
ectropion operation, 284
WOUNDS
of eyelids, suture of, 263
globe, 234
ZIEGLER
iridotomy, 213
OPERATIONS UPON THE EAR
ABSCESS
extra-dural, operations for, 431
Bezold’s mastoid, operations for, 389
cerebellar, opening of, 467
cerebral, opening of, 459
intracranial, operations for, 459
subperiosteal mastoid, operation for, 389
temporo-sphenoidal, opening of, 463
ADHESIONS, INTRATYMPANIC
division of, 342
ANÆSTHESIA
in aural operations, 310
ANÆSTHETIC SOLUTIONS
Neumann’s, 311
ANATOMY
of the labyrinth, 420
mastoid area, 373
ATRESIA
of the external auditory canal, operations for, 330
ATTIC
syringing out of the, 308
AUDITORY CANAL, EXTERNAL
operations upon, 314
for atresia, 330
stenosis, 328
removal of exostoses from, 316
foreign bodies from, 322
polypi from, 331
AURAL
instrument, Burkhardt-Merian’s, 315
mirror, 305
polypus, removal of, 333
specula, 306
BEZOLD’S MASTOID ABSCESS
operation for, 389
BOUGIE, EUSTACHIAN
passage of, 369
BULB
jugular, exposure of, 454
BURKHARDT-MERIAN’S AURAL INSTRUMENT, 315
CANAL, AUDITORY (_see_ Auditory canal)
CANULA
Hartmann’s, 308
Milligan’s, 308
CATH[ET]ERIZATION
of Eustachian tube, 364
CAUTERIZATION
of granulations in tympanum, 348
CEREBELLAR OTITIC ABSCESS
opening of, 467
CEREBRAL OTITIC ABSCESS
opening of, 459
CLAR’S LAMP, 305
CLEANSING OF EAR, 307
COCHLEA
removal of, 424
COMPLETE MASTOID OPERATION, 391
CURETTING
of aural polypi, 334
labyrinth, 421
tympanic granulations, 348
DILATATION
of external meatus, 328
DIVISION
of anterior tympanic ligament, 341
intratympanic adhesions, 342
posterior tympanic fold, 341
EAR
cleansing of, 307
EUSTACHIAN BOUGIE
passage of, 369
EUSTACHIAN TUBE
catheterization of, 364
lavage of tympanum through, 372
EXAMINATION OF EAR
methods of, 305
EXCISION
of stricture of external meatus, 329
EXOSTOSES
removal of from external meatus, 316
EXPOSURE
of the jugular bulb, 454
vein, 448
lateral sinus, 440
EXTERNAL AUDITORY CANAL (_see_ Auditory canal, external)
EXTERNAL MEATUS
operations for stenosis of, 328
removal of exostoses from, 316
EXTIRPATION OF LABYRINTH, 425
EXTRA-DURAL ABSCESS
operations for, 431
FOREIGN BODIES
in ear, removal of, 322
FURUNCULOSIS
of ear, operations for, 314
GALVANO-CAUTERY PERFORATION
of tympanic membrane, 340
GENERAL ANÆSTHESIA
in aural operations, 310
GRANULATIONS
in tympanum, removal of, 348
GRUNERT
operation on the jugular bulb, 454
HARTMANN’S CANULA, 308
ILLUMINATION
in aural examinations, 305
INCISION
of external auditory meatus, 328
Wilde’s mastoid, 377
INCUS
removal of, 351
INTRACRANIAL OTITIC ABSCESS
operations for, 459
after-treatment of, 469
complications of, 469
prognosis and results in, 470
recurrence of symptoms after, 471
INTRATYMPANIC OPERATIONS, 342
JUGULAR BULB
exposure of, 454
JUGULAR VEIN
ligature of, 446
KNIFE
paracentesis, 340
KÖRNER
post-meatal flaps, 402
KÜSTER-BERGMANN
mastoid operation, 393
LABYRINTH
operations upon, 417
curetting, 421
extirpation of, 425
surgical anatomy of, 420
LABYRINTHITIS
non-suppurative, operation for, 417
LAMP, CLAR’S, 305
LATERAL SINUS THROMBOSIS
operations for, 439
comparison of operations, 457
complications following, 458
difficulties and dangers in, 457
exposure of jugular bulb, 454
exposure of sinus, 440
Grunert’s operation for, 454
ligature of jugular vein for, 446
Piffl’s operation for, 455
opening of sinus, 442
prognosis in, 458
LAVAGE OF TYMPANUM, 372
LIGAMENT, ANTERIOR TYMPANIC
division of, 341
LIGATURE
of aural polypus, 333
jugular vein, 446
LOCAL ANÆSTHESIA, 310
MALLEUS
direct massage of, 349
and incus, removal of, 351
MASSAGE
direct, of malleus, 349
stapes, 350
MASTOID
abscess, Bezold’s, 389
subperiosteal, 389
area, anatomy of, 373
necrosis of, operation for, 390
operation, the complete, 391
closure of the wound after, 404
history of the, 375
in an infant, 389
Küster-Bergmann method, 393
post-meatal flaps, use of, 401
preservation of ossicles and tympanic membrane after, 399
for removal of foreign bodies from ear, 327
Schwartze’s method, 378
skin-grafting after, 405
Stacke’s method, 397
for stenosis of external auditory canal, 330
for subperiosteal abscess, 389
Wilde’s incision in, 377
Wolf’s method, 396
process, operations upon, 373
osteomyelitis of, 390
MEATUS, EXTERNAL (_see_ External meatus)
MEMBRANE, TYMPANIC (_see_ Tympanic membrane)
MENINGITIS, OTITIC
operations for, 433
after-treatment of, 436
prognosis and results, 438
MILLIGAN’S CANULA, 308
MIRROR, AURAL, 305
MOBILIZATION OF THE OSSICLES, 349
NECROSIS
of mastoid, operation for, 390
NEUMANN’S
anæsthetic solutions, 311
method of opening vestibule, 424
syringe, 311
OPENING OF LATERAL SINUS, 442
OSSICLES
operations upon the, 349
massage of the, 349, 356
mobilization of the, 349
preservation of the, after mastoid operation, 399
removal of the, 351, 361
OSTEOMYELITIS OF MASTOID
operation for, 390
PANSE
post-meatal flaps, 402
PARACENTESIS TYMPANI, 336
knife for, 340
PIFFL
operation upon the jugular bulb, 454
POLITZER
division of anterior tympanic ligament, 341
POLYPUS, AURAL
operations for, 331
POST-AURAL OPERATION (_see_ Mastoid operation)
POST-MEATAL FLAPS, 401
REMOVAL
of the cochlea, 424
ossicles, 351, 361
foreign bodies from the ear, 322
SCHWARTZE
mastoid operation, 378
SINUS, LATERAL (_see_ Lateral sinus)
SKIN FLAPS
post-meatal, 401
SKIN-GRAFTING
after mastoid operation, 405
SNARE, WILDE’S, 332
SPECULA, AURAL, 306
STACKE
mastoid operation, 397
post-meatal flaps, 402
STAPEDIUS
tenotomy of, 347
STAPES
massage of, 350
STENOSIS OF EXTERNAL MEATUS
operations for, 328
SUBPERIOSTEAL MASTOID ABSCESS
operations for, 389
SURFACE ANATOMY
of mastoid process, 375
SURGICAL
anatomy of labyrinth, 420
mastoid area, 373
tympanic cavity, 335
toilet of ear, 309
SYRINGING
out of attic, 308
ear, 308
for removal of foreign bodies, 322
TEMPORO-SPHENOIDAL ABSCESS
opening, 463
TENOTOMY
of tensor tympani, 346
stapedius, 347
TENSOR TYMPANI
tenotomy of, 346
THROMBOSIS OF LATERAL SINUS
operations for (_see_ Lateral sinus thrombosis)
TOD’S POST-MEATAL FLAPS, 401
TREPHINING
for otitic cranial abscess, 462
TUBE, EUSTACHIAN (_see_ Eustachian tube)
TYMPANIC CAVITY
lavage of, 372
operations within, 335
surgical anatomy of, 335
TYMPANIC FOLD
posterior, division of, 341
TYMPANIC GRANULATIONS
curetting of, 348
TYMPANIC MEMBRANE
artificial perforation of, 340
division of anterior ligament of, 341
post. tympanic fold, 341
paracentesis of, 336
preservation of after mastoid operation, 399
surgical anatomy of, 335
TYMPANUM (_see_ Tympanic cavity)
VEIN, JUGULAR (_see_ Jugular vein)
VESTIBULE
opening the, 422
WILDE
mastoid incision, 377
snare, 332
WOLF
complete mastoid operation, 396
OPERATIONS UPON THE THROAT
ANÆSTHESIA
for direct laryngoscopy, 482
laryngotomy, 512
thyrotomy, 489
tracheotomy, 544
ANATOMY
of laryngeal lymphatics, 496
the trachea, 523
BRONCHOSCOPY
lower, 562
upper, 562
BUTLIN
after-treatment in thyrotomy, 494
laryngectomy operations, 507
CHIARI
total laryngectomy, 502
CRICO-TRACHEOTOMY, 529
CUNEO
anatomy of laryngeal lymphatics, 496
CURES AFTER THYROTOMY, 505
DIPHTHERIA
tracheotomy for, 517, 526
DIRECT LARYNGOSCOPY
Killian’s method, 479
ENDOLARYNGEAL
operations, 475
removal of multiple papillomata, 485
EXTRA-LARYNGEAL OPERATIONS, 487
FEEDING AFTER THYROTOMY, 494
FÖDERL
total laryngectomy, 502
GLUCK
total laryngectomy, 500
HANDLEY
total laryngectomy, 502
HEMI-LARYNGECTOMY, 495
mortality after, 506
recurrence after, 506
HIGH TRACHEOTOMY, 530
INDIRECT LARYNGOSCOPY, 477
INFRATHYREOID LARYNGOTOMY, 510
INTUBATION, 549
of the larynx, 549
_v._ tracheotomy in diphtheria, 549
KILLIAN
direct laryngoscopy, 479
LAMP
for direct laryngoscopy, 480
LARYNGEAL LYMPHATICS
anatomy of, 496
LARYNGEAL STENOSIS
after tracheotomy, 538
LARYNGECTOMY, TOTAL, 498
Butlin’s cases, 507
Chiari’s cases, 502
Föderl’s cases, 502
Gluck’s operation, 500
Handley’s cases, 502
Le Bec’s cases, 502
mortality after, 506
recurrence after, 507
swallowing after, 509
voice after, 508
LARYNGO-FISSURE
for removal of multiple papillomata, 485
LARYNGOSCOPY
direct, 479
indirect, 477
LARYNGOTOMY
infrathyreoid, 510
LARYNX
intubation of, 549
LE BEC
total laryngectomy, 502
LOW TRACHEOTOMY, 532
LOWER BRONCHOSCOPY, 562
LYMPHATICS, LARYNGEAL
anatomy of, 496
MEDIAN TRACHEOTOMY, 532
MORTALITY
after hemi-laryngectomy, 506
total laryngectomy, 506
thyrotomy, 504
PAPILLOMATA, MULTIPLE
removal of, 484
PRELIMINARY TRACHEOTOMY, 523
RECURRENCE
after hemi-laryngectomy, 506
total laryngectomy, 507
thyrotomy, 505
REMOVAL OF TUBE AFTER TRACHEOTOMY, 535
RESECTION OF TRACHEA, 547
SKIAGRAPHY
in endolaryngeal operations, 476
STENOSIS
after tracheotomy, 538
SWALLOWING
after total laryngectomy, 509
THYROTOMY, 487
complications in, 494
cures after, 505
feeding after, 494
mortality after, 504
recurrence after, 505
TOTAL LARYNGECTOMY, 498
TRACHEA
anatomy of, 523
operations upon, 517
resection of, 547
TRACHEO-FISSURE, 547
TRACHEOSCOPY
indications for, 558
TRACHEOTOMY, 517
accidents during, 533
after-treatment of, 534
complications of, 536
for diphtheria, 517, 526
high, 530
intubation _v._, 549
local anæsthesia for, 544
low, 532
median, 532
preliminary, 523
for removal of multiple papillomata, 485
stenosis after, 538
TUBE SPATULÆ
for direct laryngoscopy, 480
TUBE, TRACHEOTOMY
removal of, 535
TUMOURS, ENDOLARYNGEAL, 475
UPPER BRONCHOSCOPY, 562
VOICE AFTER TOTAL LARYNGECTOMY, 508
OPERATIONS UPON THE NOSE AND NASO-PHARYNX
ABSCESS
retropharyngeal, 864
of septum, operation for, 612
ADENOIDS
removal of, 665
ADRENALIN
in nasal operations, 573
AFTER-RESULTS OF OPERATIONS, 580
AIR-PASSAGES, LOWER
protection of during operations, 576
AMPUTATION
of anterior end of inferior turbinal, 587
lower margin of inferior turbinal, 588
posterior end of inferior turbinal, 589
ANÆSTHESIA
for complete turbinotomy, 591
local, 572
for removal of posterior end of inferior turbinal, 589
ANTRUM, MAXILLARY (_see_ Maxillary sinus)
ASCH
operation upon the septum, 599
ASEPSIS, NASAL, 578
BLEEDING
control of, 574
BÖNNINGHAUS
operation upon the maxillary sinus, 637
BOND
preliminary laryngotomy in naso-pharyngeal operations, 663
BUTLIN
preliminary laryngotomy in naso-pharyngeal operations, 663
CALDWELL-LUC
operation upon the maxillary sinus, 631
CANINE FOSSA
operation through, 631
CATHETERIZING
frontal sinus, 638
maxillary sinus, 626
CHOANA, POSTERIOR
congenital occlusion of, 583
CLAR’S LAMP, 570
CLEANSING THE NOSE, 579
COCAINE
submucous injection of, 572
substitutes for, 573
COMPLETE TURBINOTOMY, 591
COMPLICATIONS FOLLOWING OPERATIONS, 577
CONGENITAL OCCLUSION
of nostrils, 582
posterior choana, 583
DEFORMITIES OF SEPTUM
operations for, 597
DENKER
operation upon the maxillary sinus, 625, 637
DESAULT
operation upon the maxillary sinus, 631
DEVIATION, SIMPLE, OF NASAL SEPTUM
operations for, 598
DIVISION OF THE SOFT PALATE
for removal of naso-pharyngeal growths, 663
ELEVATING OLD NASAL FRACTURES, 582
EUCAINE ANÆSTHESIA, 573
EXAMINATION OF NOSE
methods of, 569
FOREIGN BODIES
removal of, 584
FOSSA, CANINE (_see_ Canine fossa)
FRACTURES, NASAL
operations for, 582
FRONTAL SINUS
catheterizing and washing out, 638
Killian’s external operation, 642
Kuhnt’s external operation, 653
Ogston-Luc external operation, 651
operation for suppuration in, 638
GLEASON-WATSON
operation upon the septum, 599
GROWTHS, NASAL
removal of, 616
HÆMATOMA OF SEPTUM
operation for, 612
HÆMORRHAGE
control of in nasal operations, 574
ILLUMINATION
for nasal operations, 569
INJURIES, NASAL
operations for, 581
ISCHÆMIA, LOCAL, 573
KILLIAN
frontal sinus operation, 642
KUHNT
frontal sinus operation, 653
LAMP, CLAR’S, 570
LARYNGOTOMY, PRELIMINARY
in naso-pharyngeal operations, 663
LATERAL RHINOTOMY (_see_ Rhinotomy, lateral)
LOCAL
anæsthesia, 572
ischæmia, 573
MAXILLARY ANTRUM (_see_ Maxillary sinus)
MAXILLARY SINUS
operations upon, 626
Bönninghaus’s operation upon, 637
Caldwell-Luc operation upon, 637
canine fossa, operation through, 631
catheterizing, 626
Denker’s operation upon, 625, 637
Desault’s operation upon, 631
operation through nasal wall, 637
puncturing, 626
radical operation upon, 631
MIDDLE TURBINAL
operations upon, 592
MOURE
lateral rhinotomy, 618
operation upon the septum, 599
NARES, ANTERIOR
congenital occlusion of, 582
NASAL BONES
operations for fracture of, 582
NASAL GROWTHS
removal of, 613
NASAL SEPTUM
abscess of, 612
deformities of, 597
hæmatoma of, operation for, 612
operations upon, 597
Asch’s operation, 599
Gleason-Watson’s operation, 599
Moure’s operation, 599
perforating the, 598
perforation of, operation for, 611
removal of spurs from, 597
simple deviation, operations for, 598
submucous resection of, 601
NASAL SYPHILIS
operations for the results of, 594
NASO-PHARYNX
adenoids, removal of, 665
examination of, 569
operations for direct access to, 618, 661
post-syphilitic affections of, 595
sequestrotomy in, 594
NOSE
methods of examining, 569
NOSTRILS
congenital occlusion of, 582
NOVOCAINE ANÆSTHESIA, 573
OCCLUSION OF NOSTRILS
congenital, 582
OGSTON-LUC
frontal sinus operation, 651
OPENING SPHENOIDAL SINUS, 656
PALATE, SOFT (_see_ Soft palate)
PERFORATING THE SEPTUM, 598
PERFORATION OF THE SEPTUM
operation for, 611
POST-SYPHILITIC AFFECTIONS OF NOSE AND NASO-PHARYNX, 595
PROTECTION OF AIR-PASSAGES DURING OPERATIONS, 576
PUNCTURING
the maxillary sinus, 626
RADICAL OPERATION UPON THE MAXILLARY SINUS, 631
REMOVAL
of foreign bodies from nose, 584
nasal growths, 613
rhinoliths, 586
spurs from the nasal septum, 597
RESECTION OF THE SEPTUM
submucous, 601
RETROPHARYNGEAL ABSCESS, 664
RHINOLITHS
removal of, 586
RHINOTOMY
combined lateral and sublabial, 625
lateral, Moure’s, 618
sublabial, Rouge’s, 622
ROBINSON
operation for post-syphilitic affections of nose, 595
SEPSIS AFTER NASAL OPERATIONS, 577
SEPTUM (_see_ Nasal septum)
SEQUESTROTOMY IN NOSE AND NASO-PHARYNX, 594
SHOCK DURING OPERATIONS, 577
SINUS, FRONTAL (_see_ Frontal sinus)
SINUS, SPHENOIDAL (_see_ Sphenoidal sinus)
SOFT PALATE
division of, for removal of naso-pharyngeal growths, 663
SOUNDING SPHENOIDAL SINUS, 653
SPENCER
operation for post-syphilitic affections of nose, 595
SPHENOIDAL SINUS
opening, 656
sounding and washing out, 653
SPURS OF SEPTUM
operations for, 597
SUBLABIAL RHINOTOMY
Rouge’s, 622
SUBMUCOUS
injection of cocaine, 572
resection of the septum, 601
SUPPURATION IN FRONTAL SINUS
operation for, 638
SYPHILIS, NASAL
operations for results of, 594
TILLEY
operation for post-syphilitic affections of nose, 595
TUBERCULOSIS OF THE NOSE, 596
TURBINALS
operations upon, 586
inferior, amputation of inferior end, 587
lower margin, 588
removal of posterior end, 589
middle, operations upon, 592
TURBINOTOMY, COMPLETE, 591
OXFORD: HORACE HART
PRINTER TO THE UNIVERSITY