. American practice of surgery ; a complete system of the science and art of surgery . mbarrassment. As a precautionary measure it iswell to avoid suddenly returning the patient to the horizontal position, sincein feeble patients syncope may, under these circumstances, result from suddencerebral anaemia. All of the modem operating tables are fitted with mechanical arrangementsfor placing the patient in the elevated pehdc position. In some of these tablesthe arrangements are such that the pehdc elevation is secured by bending thetrunk at the level of the lower edge of the scapukc, the weight of
. American practice of surgery ; a complete system of the science and art of surgery . mbarrassment. As a precautionary measure it iswell to avoid suddenly returning the patient to the horizontal position, sincein feeble patients syncope may, under these circumstances, result from suddencerebral anaemia. All of the modem operating tables are fitted with mechanical arrangementsfor placing the patient in the elevated pehdc position. In some of these tablesthe arrangements are such that the pehdc elevation is secured by bending thetrunk at the level of the lower edge of the scapukc, the weight of the patientsbody resting on the shoulders, with the neck bent fonvard; while in other tablesthe whole body is tilted by means of a plane inclined downward (Fig. 53). The position which is generally employed in operations on the liver, gall-bladder, and gall-ducts is that in which the patient lies on the back over a cushionor sand-bag, ^dth the shoulders slightly raised. The advantages of this positionwere first mentioned, about ten years ago, by Dr. J. ^Mieelock Elliot, who showed. Fig. 54.—Patient in Elliots Position on the Scanlon-Morris Table. (Elevation by Angulation.) that, when the patient is placed on a plane inclined at an angle of forty-fivedegrees, with a sand-bag under the back at the level of the Hver, the intestinesfall away toward the lower abdomen and the liver is thrust forward; and that,as a result of these changes in the positions of the different organs, the field ofoperation is much enlarged, and ready access is afforded to the gall-bladder andcystic and common ducts. A pneumatic mbber cushion is preferable to the sand-bag, because it is more elastic and because the can be regulated by a .IBDOMIXAL SECTION. 123 stop-cock attached to the cushion. \Mierc a vertical incision is made, theposition just advocated, by putting the muscles on the stretch through thepushing forward of the costal margins, rendci-s the edges of the incision tenseand difficul
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
