The homeopathic practice of surgery : together with operative surgery . 133 is necessary to give room for the operation. The brachial arterylies near the surface, and may easily be compressed against thehumerus at any part of its course. Near the elbow it lies in frontof the brachialis anticus, but runs up obliquely towards the axilla,having afterwards, in front of it, the biceps and coraco-brachialis,and, behind it, the triceps with the insertions of the latissimusdorsi and teres major. The patient is seated in a chair, or laid, in a convenient pos-ture, upon a table or bed. One assistant has
The homeopathic practice of surgery : together with operative surgery . 133 is necessary to give room for the operation. The brachial arterylies near the surface, and may easily be compressed against thehumerus at any part of its course. Near the elbow it lies in frontof the brachialis anticus, but runs up obliquely towards the axilla,having afterwards, in front of it, the biceps and coraco-brachialis,and, behind it, the triceps with the insertions of the latissimusdorsi and teres major. The patient is seated in a chair, or laid, in a convenient pos-ture, upon a table or bed. One assistant has hold of the fore-armto support and steady it, while another grasps the arm with bothhis hands above the part to be operated on, and pulls back theinteguments as tight as possible. If the CIRCULAR OPERATION —is the one to be performed, the surgeon, knife in hand, passeshis hand under the patients arm, bringing the knife completelyover it towards himself, with the point downwards (see the positionof the hands in Fig. 86, representing the commencement of the Fig. operation on the left arm); and proceeds with his first incision,drawing the blade backwards from hilt to point, completely roundthe limb, merely cutting through the skin and superficial instrument is then laid aside or handed to an assistant, andthe integument loosened from the muscles beneath by detachingthe cellular membrane with scalpel or bistoury. The skin is nowforcibly retracted further up, and another incision made, in the 134 AMPUTATION IN GENERAL AND OF THE ARM. same manner as the first, as far up as the skin will permit, divid-ing all the flesh down to the bone. It is perhaps better to makeboth incisions somewhat eliptical — or rather twice varied fromthe circular direction — leaving the muscles longer both beforeand behind than at the sides. The next step is to separate the muscles from the bone for aninch or two, with the point of the knife (if a pointed one is used)or a scalpel; and
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