. The principles and practice of surgery. brachialis anticus,etc., is made, otherwise the knife will strike against the coronoid pro-cess of the ulna. Nothing can exceed the facility and rapidity withwhich disarticulation at the elbow-joint can be made by this method. Results.—19 elbow-joint amputations had been returned to the officeof the Surgeon-General at the date of the publication of Circular , in 1865, and all of these had recovered. These returns, says , corroborate the conclusions of Dupuytren, Malgaigne, and Le-gouest, who combat the disfavor into which this operation has
. The principles and practice of surgery. brachialis anticus,etc., is made, otherwise the knife will strike against the coronoid pro-cess of the ulna. Nothing can exceed the facility and rapidity withwhich disarticulation at the elbow-joint can be made by this method. Results.—19 elbow-joint amputations had been returned to the officeof the Surgeon-General at the date of the publication of Circular , in 1865, and all of these had recovered. These returns, says , corroborate the conclusions of Dupuytren, Malgaigne, and Le-gouest, who combat the disfavor into which this operation has own experience confirms the justness of this observation. Amputations of the Arm. Amputation of the Arm in Continuity may be made by either thecircular or flap method. Most surgeons have preferred double lateralflaps. The operation by either method is so simple that no specialdescription is required. It is important, however, to direct attention tothe tendency in the muscles to retract and uncover the bone when the Fig. Amputation of the Arm in Continuity by the Double Flap Method. amputation is made above the middle; a circumstance which is due tothe great length of certain muscles embracing the humerus, and tothe fact that some of them have little or no attachments to the bone in AMPUTATION AT THE SHOULDER-JOINT. 3oO this portion of the limb. In making a flap amputation this mustespecially be borne in mind, and the length of the flaps must havereference to their probable retraction after the operation is completed. Amputation at the Scapula-humeral Articulation—Shoulder-joint.—In amputation at the shoulder-joint, the method which I havefound to be the most easily executed and most economical in the ex-penditure of blood is as follows:— First Step of the Process.—An assistant seizes the forearm at theelbow and wrist, and, in order that he may control its motion moreperfectly, flexes it to a right angle with the humerus, and then raises thehumerus to a
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