Chapter I: Front Matter

[Transcriber's Notes]

Thanks to Carol Presher of Timeless Antiques, Valley, Alabama, for lending the original book for this production. The 140 year old binding had disintegrated, but the paper and printing was in amazingly good condition, particularly the multicolor images.

Thanks also to the Mayo Clinic. This book has increased my appreciation of their skilled care of my case by showing the many ways that things could go wrong.

Footnotes are indicated by "[Footnote]" where they appear in the text. The body of the footnote appears immediately following the complete paragraph. If more than one footnote appears in the same paragraph, they are numbered.

A few obvious misspellings have been corrected. Several cases of alternate spelling of the same(?) word have not been modified.

Pages have been reorganized to avoid splitting sentences and paragraphs. Each image is inserted immediately following its description.

Some of the plates did not fit on the scanner and were captured as two separate images. The merged images show some artifacts of the merge process due to slightly different lighting of the page. The contrast and gamma values have been adjusted to restore the images.

Here are the definitions of some words used in the text. Medical terms are defined only relating to humans. Words are omitted that have ambiguous or technical meanings not expressible in lay language.

acromial (acromion)
Outward end of the spine of the scapula or shoulder blade.

adipose
Consisting of, resembling, or relating to fat.

anasarca
Pronounced, generalized edema; accumulation of serous fluid in various
tissues and cavities of the body.

anastomosing (anastomoses, anastomosis)
Communication between blood vessels by means of collateral channels,
when usual routes are obstructed. Opening between two organs or spaces
that normally are not connected.

aneurism
Localized blood-filled dilatation of a blood vessel caused by disease
or weakening of the vessel's wall.

anthropotomist (anthropotomy)
One versed in human anatomy.

aorta (aortic)
Main trunk of the arterial system, conveying blood from the left
ventricle of the heart to all of the body except the lungs.

apices (plural of apex)
Pointed end of an object; the tip.

aponeurosis
Sheet-like fibrous membrane, resembling a flattened tendon, that
serves as a fascia to bind muscles together or as a means of
connecting muscle to bone.

armamentaria
Complete equipment of a physician or medical institution, including
books, supplies, and instruments.

auscultation
Listening, either directly or through a stethoscope or other
instrument, to sounds within the body as a method of diagnosis.

axilla (axillary)
Armpit.

azygos
Occurring singly; not one of a pair.

bifid
Separated or cleft into two equal parts or lobes.

biliary
Relating to bile, the bile ducts, or the gallbladder; transporting
bile.

bistoury
Long, narrow surgical knife for minor incisions.

bougie
Slender, flexible instrument introduced into body passages, to dilate,
examine, or medicate.

brachial (brachio)
Belonging to the arm.

bubonocele
Inguinal hernia, in which the protrusion of the intestine is limited
to the region of the groin.

cannula
Metal tube for insertion into the body to draw off fluid or to
introduce medication.

carotid
Two large arteries, one on each side of the head.

cephalic
Relating to the head.

cervical
Pertaining to the neck.

chlorotic
Benign iron-deficiency anemia in adolescent girls, marked by a pale
yellow-green complexion.

clavicle
Either of two slender bones extending from the upper part of the
sternum (breastbone) to the shoulder.

coaptation
Joining together of two surfaces, such as the edges of a wound or the
ends of a broken bone.

condyle
Smooth surface area at the end of a bone, forming part of a joint.

costal
Pertaining to the ribs or the upper sides of the body.

cremaster
Suspensory muscle of the testis.

crural
Relating to the leg or thigh.

director
A smoothly grooved instrument used with a knife to limit the incision
of tissues.

distal
Situated away from the point of origin or attachment.

dropsy (dropsical) (edema)
Swelling from excessive accumulation of watery fluid in cells,
tissues, or serous cavities

emphysema
Chronic, irreversible disease of the lungs; abnormal enlargement of
air spaces in the lungs accompanied by destruction of the tissue
lining the walls of the air spaces.

emunctory
Organ or duct that removes or carries waste from the body.

epigastric (epigastrium)
Upper middle region of the abdomen.

episternal
See sternum.

esophagus
See oesophagus.

euphoneously (euphoniously)
Pleasant in sound; agreeable to the ear;

exigence
Urgency, need, demand, or requirement intrinsic to a circumstance.

extravasation
Exuding or passing out of a vessel into surrounding tissues; said of
blood, lymph or urine

fascia
A band of connective tissue supporting, or binding together internal
organs or parts of the body.

femoral
Pertaining to, or situated at, in, or near the thigh or femur.

fistula
Abnormal duct or passage resulting from injury, disease, or a
congenital disorder that connects an abscess, cavity, or hollow organ
to the body surface or to another hollow organ.

foramen (foramina)
Opening, orifice, or short passage, as in a bone.

fossa (fossae)
Small cavity or depression, as in a bone.

hepatic
Pertaining to the liver.

herniae (hernia)
Protrusion of an organ or tissue through an opening in its surrounding
walls, especially in the abdomen.

humerus
Bone in the arm of humans extending from the shoulder to the elbow.

hydragogue
Cathartics that aid in the removal of edematous fluids and thus
promote the discharge of watery fluid from the bowels.

hydrocele
An accumulation of serous fluid, usually about the testis.

hydrops
See dropsy. Edema.

iliac artery
Common iliac artery--either of two large arteries that conduct blood
to the pelvis and the legs. External iliac artery--the outer branch of
an iliac artery that becomes the femoral artery. Hypogastric
artery--internal iliac artery; the inner branch of an iliac artery
that conducts blood to the gluteal region.

infundibuliform
Shaped like a funnel.

inguinal
Relating to, or located in the groin.

innominate
Designated parts otherwise unnamed; as, the innominate artery, a great
branch of the arch of the aorta; the innominate vein, a great branch
of the superior vena cava.

inosculate
Unite by openings; connect or join so as to become or make continuous,
as fibers; blend, unite intimately

integument
Natural covering, coating, enclosure, etc., as a skin, shell, or rind.

laryngotomy
Cutting into the larynx, from the outside of the neck, to assist
respiration, or to remove foreign bodies.

ligature
Thread or wire for constriction of blood vessels or for removing
tumors by strangulation.

lithotomy
Surgery to remove one or more stones from an organ or duct.

meatus
Body opening such as the opening of the ear or the urethral canal.

metamorphosis
Profound change in form from one stage to the next, as from the
caterpillar to the pupa and from the pupa to the adult butterfly.

micturition
Passing urine; urination.

nares (naris)
Nostrils or the nasal passages.

nisus
Effort or endeavor to realize an aim.

occiput
Back part of the head or skull.

oesophagus (esophagus)
Muscular membranous tube for the passage of food from the pharynx to
the stomach.

osseous
Bone, bony;

palmar
Pertaining to, or located in the palm of the hand.

paracentesis
Puncture of the wall of a cavity to drain off fluid.

parietes
Wall of a body part, organ, or cavity.

parotid
Salivary gland situated at the base of each ear; near the ear.

percussion
Striking or tapping the surface the body for diagnostic or therapeutic
purposes.

pericardii (pericardium)
A double membranous sac protecting the heart. The layer in contact
with the heart is referred to as the visceral layer, the outer layer
in contact with surrounding organs is the parietal pericardium.

peritoneum (peritonaeum)
Serous membrane that lines the walls of the abdominal cavity and folds
inward to enclose the viscera.

pharynx (pharyngeal)
The cavity, with its surrounding membrane and muscles, that connects
the mouth and nasal passages with the esophagus.

physiology (physiologist)
Biological study of the functions of living organisms and their parts.

platysma
Broad, thin muscle on each side of the neck, from the upper part of
the shoulder to the corner of the mouth. They wrinkle the skin of the
neck and depresses the corner of the mouth.

pleura
Thin serous membrane in mammals that envelops each lung and folds back
to make a lining for the chest cavity.

pleuritic (pleurisy)
Inflammation of the pleura, often as a complication of a disease such
as pneumonia, accompanied by accumulation of fluid in the pleural
cavity, chills, fever, and painful breathing and coughing.

plexus
Network, as of nerves or blood vessels.

pneumothorax Air or gas in the pleural cavity.

popliteal
Relating to the hollow part of the leg behind the knee joint.

probang
Long, slender, elastic rod with a sponge at the end. It is introduced
into the esophagus or larynx to remove foreign bodies or introduce
medication.

pudic
Pertaining to the external organs of generation.

pyriform
Shaped like a pear.

radius
Bone of the forearm on the thumb side. (See ulnar)

ramus
A branch, as of a nerve, or blood vessel.

raphe
Seamlike union between two parts or halves of an organ.

ratiocination
Logical reasoning.

sacculated
Formed with or having saclike expansions.

scirrhus
Hard dense cancerous growth usually arising from connective tissue.

septa
Thin partition dividing two cavities or soft masses of tissue.

sternum
Bones extending along the middle line of the ventral portion of the
body of most vertebrates, consisting in humans of a flat, narrow bone
connected with the clavicles and the true ribs; breastbone.

stricture
Abnormal narrowing of a duct or passage.

subclavian
Beneath the clavicle.

submaxillary
Pertaining to the lower jaw.

sui generis
The only example of its kind; a class of its own; unique

superficies
Outward appearance.

sutural
Junction of two bones.

symphysis
Growing together, or the fixed or nearly fixed union, of bones.

taxis
Replacing of a displaced part, or the reducing of a hernia, by
manipulation without cutting.

tegument (tegumentary, integument)
Natural outer covering.

thorax (thoracic)
Trunk between the neck and the abdomen, containing the cavity enclosed
by the ribs, sternum, and certain vertebrae, containing the heart,
lungs, etc.; chest.

trachea (tracheal)
Tube descending from the larynx to the bronchi and carrying air to the
lungs. Windpipe.

trephine (trephining)
Small circular saw with a center pin mounted on a strong hollow metal
shaft, used to remove circular disks of bone from the skull.

trocar
Sharp-pointed instrument enclosed in a cannula, used for withdrawing
fluid from a cavity, as the abdominal cavity.

tunica vaginalis
Pouch of serous membrane covering the testis and derived from the
peritoneum.

venesection (venisection, phlebotomy)
Opening a vein by incision or puncture to remove blood as a
therapeutic treatment.

viz.
Contraction of the Latin "videre licet" meaning "it is permissible to
see," The -z- is not a letter, but originally a twirl, representing
the symbol for the ending -et. Usually read as "namely."

ulnar
Bone of the forearm on the side opposite to the thumb. (See radius)

[End Transcriber's Notes]

SURGICAL ANATOMY

BY JOSEPH MACLISE

FELLOW OF THE ROYAL COLLEGE OF SURGEONS.

WITH SIXTY-EIGHT COLOURED PLATES.

PHILADELPHIA: BLANCHARD AND LEA. 1859.

I INSCRIBE THIS WORK TO THE GENTLEMEN WITH WHOM AS A FELLOW-STUDENT I WAS ASSOCIATED AT THE London University College:

AND IN AN ESPECIAL MANNER, IN THEIR NAME AS WELL AS MY OWN, I AVAIL MYSELF OF THE OPPORTUNITY TO RECORD, ON THIS PAGE, ALBEIT IN CHARACTERS LESS IMPRESSIVE THAN THOSE WHICH ARE WRITTEN ON THE LIVING TABLET OF MEMORY, THE DEBT OF GRATITUDE WHICH WE OWE TO THE LATE

SAMUEL COOPER, F.R.S., AND ROBERT LISTON, F.R.S.,

TWO AMONG THE MANY DISTINGUISHED PROFESSORS OF THAT INSTITUTION, WHOSE PUPILS WE HAVE BEEN, AND FROM WHOM WE INHERIT THAT BETTER POSSESSION THAN LIFE ITSELF, AN ASPIRATION FOR THE LIGHT OF SCIENCE.

JOSEPH MACLISE.