. A new manual of surgery, civil and military. per-formed frequently for the removal of diseased cartilages. It is simple andAvith reasonable care it is perfectly safe. An incision is made along one border of the sternum, from five to sevencm. from its center, and extending from the clavicle to the lower border ofthe ribs. The soft tissues are reflected inward and outward and each car-tilage is exposed successively. With a sharp, heavy cartilage knife thecartilages are cut off successively, then each cut end is elevated with a curvedperiostome and from one-half to three cm. of the cartilage is
. A new manual of surgery, civil and military. per-formed frequently for the removal of diseased cartilages. It is simple andAvith reasonable care it is perfectly safe. An incision is made along one border of the sternum, from five to sevencm. from its center, and extending from the clavicle to the lower border ofthe ribs. The soft tissues are reflected inward and outward and each car-tilage is exposed successively. With a sharp, heavy cartilage knife thecartilages are cut off successively, then each cut end is elevated with a curvedperiostome and from one-half to three cm. of the cartilage is removed, theshorter excision being made at the upper ribs. The wound is then closedand dressed and a circular bandage of wide rubber adhesive strips, extendingentirely around the chest, is applied the same as in the treatment of gunshotor stab wounds of the chest. The other side is treated in the same manner assoon as the patients condition warrants a second operation, which should,however, not be performed too soon. SURGERY OF THE CHEST 225. Choxdrectomy foe Relief of Broxchial Asthiia. (From Dr. E. WyHys Andrews, Jourml of A. If. A., Sept. 26, 1914.)The figure shows the curved incision over the middle of the costal cartilages of the second,third, fourth and fifth ribs. The wound is retracted in order to expose the entire cartilageand the sternal end of each rib. At least 1 cm. of the rib with 2 cm. of its periosteum isremoved, together with the entire cartilage of the four ribs, and also together with the peri-chondrium, in order that there may be no new bone or cartilage formed to fill in the space, butthat this space will be filled in with flexible sear tissue instead. If cartilage and perichondriumare left the chest will soon again become rigid, and with this the patient will again suffer fromhis former difficulty in breathing. Great care must be taken in removing the periosteum andperichondrium posteriorly in order to prevent injury to the pleura. FOREIGN BODIES LODGED I
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