Lectures on the American eclectic system of surgery . Compression of the sub-clavian artery—which is very neces-sary, if the axillary artery is cut before being tied—is a verydifficult matter. If, however, circumstances absolutely requirethe operation to be performed differently, in this respect, fromwhat has been described, the sub-clavian may be commanded bythe thumb of an assistant where it passes over the first rib, inthe space between that bone and the clavicle. There is nosafety in attempting to control it by a key or any mere mechan-ical compress there; the assistant can feel when he ha
Lectures on the American eclectic system of surgery . Compression of the sub-clavian artery—which is very neces-sary, if the axillary artery is cut before being tied—is a verydifficult matter. If, however, circumstances absolutely requirethe operation to be performed differently, in this respect, fromwhat has been described, the sub-clavian may be commanded bythe thumb of an assistant where it passes over the first rib, inthe space between that bone and the clavicle. There is nosafety in attempting to control it by a key or any mere mechan-ical compress there; the assistant can feel when he has hold ofthe artery or when he has lost it. At the Hip Joint. This is the most formidable operation in the whole list ofamputations—not only on account of the large extent of surfaceto be divided, and the large number of nerves and blood-vessels, but the fact that the latter can not all be secured beforecutting. Happily the occasions for a resort to this operationare very rare. The femoral artery being compressed by the thumb of an Fia. assistant—the point of the knife is to be entered about half waybetween the anterior superior spinous process of the ilium AT THE ELBOW, WRIST, KNEE AND ANKLE. 717 and the trochanter major, and then directed through across thefront of the articulation, until it emerges on the inside of thethigh. The assistant rotates the limb a little inward, and theknife cutting downward is brought out in front, so as to form asuitable anterior flap. The assistant then abducts the thighand presses it backward, another holding up the anterior flap,when the capsular ligament is divided in front; and the headof the bone being dislocated by a lever-like motion, the roundligament is severed, and the blade of the knife brought behindthe neck of the bone, passing through the posterior part of thecapsule (see Fig. 111). The posterior flap is then formed bycutting downward, and outward. The vessels upon the poste-rior flap are to be tied before any others,
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Keywords: ., bookcentury1800, bookdecade1860, booksubjectgeneralsurgery, booky
