Chapter I: Preface: To the First Edition

Having been asked, year after year, by the members of my Class for Operative Surgery, to recommend to them some Manual of Surgical Operations which might at once guide them in their choice of operations, and give minute details as to the mode of performance, I have been gradually led to undertake the production of this little work.

My aim has been to describe as simply as possible those operations which are most likely to prove useful, and especially those which, from their nature, admit of being practised on the dead body.

In accordance with this plan, neither historical completeness of detail, nor much variety in the methods of performing any given operation, is to be expected. Hence, also, many omissions which would be unpardonable in the briefest system of Surgery are unavoidable. For example, excision of tumours and operations for necrosis are hardly mentioned, because for these no special instructions can well be given; for, while general principles may guide us to _what_ should be done, the special circumstances of each case must dictate _how_ it is to be done.

In such a work as this, to attempt originality would be undesirable and intrusive; a judicious selection, a faithful compilation, are all that can be expected.

That the selection of operations may sometimes show "Northern Proclivities" is possible; and this is perhaps not unnatural to a scholar and teacher in the Edinburgh School.

An earnest endeavour has been used to make the references correct and copious: for any mistakes or omissions the author would crave indulgence.

The four plates which precede the letterpress were drawn on wood (from original photographs) by Mr. D.W. Williamson, Melbourne Place, and the lines of incision for the various operations were added by the author.

The rough woodcuts scattered through the work were drawn on wood by the author, and for their roughness he, not his engraver, is responsible. He also hopes that the references in the letterpress will be accepted as sufficient acknowledgment of the true ownership, in those few instances in which the idea of the diagram has been borrowed.

It has been thought unnecessary to introduce woodcuts of surgical instruments, as the illustrated catalogues lately published by Weiss, Maw, and others, are sufficiently accurate.

In excuse of the frequent baldness and brevity of the style, the author must point to the size and price of the work. Its composition would have been easier had its dimensions been greater.

Though intended chiefly to guide the studies, on the dead subject, of students and junior practitioners, the author ventures to hope that the Manual may be useful to those who, in the public services, in the colonies, or in lonely country districts, find themselves constrained to attempt the performance of operations which, in the towns, usually fall to the lot of a few Hospital Surgeons.

JOSEPH BELL.

5 CASTLE TERRACE, EDINBURGH,
_July 1866._

CONTENTS.

CHAPTER I.

LIGATURE OF ARTERIES.

PAGE

Ligature of Arteries--General Maxims--Ligature of Aorta--Iliacs--Gluteal--Femoral--Popliteal--Innominate--Carotids-- Lingual--Subclavian--Brachial, etc., 1-45

CHAPTER II.

AMPUTATIONS.

Eras of Amputation--Flap and Circular compared--Special Amputation of Arm and Leg, 46-107

CHAPTER III.

EXCISION OF JOINTS.

Brief Historical Sketch--Comparison of Excisions with Amputations--Special Excisions of the six larger Joints--Excisions of smaller Joints and Bones, 108-146

CHAPTER IV.

OPERATIONS ON CRANIUM AND SCALP.

Trephining--Excision of Wens, 147-150

CHAPTER V.

OPERATIONS ON THE EYE AND ITS APPENDAGES.

Entropium and Ectropium--Trichiasis--Tarsal Tumours--On Lachrymal Organs--Mr. Bowman's Operation--Pterygium--Strabismus, convergent and divergent--Paracentesis of the Anterior Chamber--Operations for Cataract by Displacement, Solution, and Extraction--Various methods of Extraction--Operations for Artificial Pupil--Iridesis--Corelysis--Iridectomy--Excision of Staphyloma--Excision of Eyeball, 151-174

CHAPTER VI.

OPERATIONS ON THE NOSE AND LIPS.

Rhinoplastic Operations from Cheek, Forehead, and elsewhere--Removal of Nasal Polypi--Excision of Cancers of Lips--Cheiloplastic Operations--Operations for Harelip, 175-187

CHAPTER VII.

OPERATIONS ON THE JAWS.

Excision of Upper Jaw--Of Lower Jaw, 188-195

CHAPTER VIII.

OPERATIONS ON MOUTH AND THROAT.

For Salivary Fistula--Excision of Tongue, complete and partial--Fissures of the Palate, soft and hard--Excision of Tonsils, 196-205

CHAPTER IX.

OPERATIONS ON AIR PASSAGES.

Larynx and Trachea--Tracheotomy--Tubes--Laryngotomy--OEsophagotomy--[see Addendum, p. 302], 206-217

CHAPTER X.

OPERATIONS ON THORAX. PAGE Excision of Mamma--Paracentesis Thoracis, 218-221

CHAPTER XI.

OPERATIONS ON ABDOMEN.

Paracentesis Abdominis--Gastrotomy--Ovariotomy--Operation for Strangulated Hernia--Inguinal--Femoral--Umbilical--Operations for the Radical Cure of Hernia, 222-255

CHAPTER XII.

OPERATIONS ON PELVIS.

Lithotomy--Varieties--Lithotrity--Operations for Stricture--Puncture of the Bladder--Phymosis--Amputation of Penis--Hydrocele--Hæmatocele--Castration--Operation for Fistula--Fissure--Polypi of Rectum--Piles, 256-295

CHAPTER XIII.

TENOTOMY.

On Tenotomy for Wry Neck and Club Foot, 296-298