. The science and art of surgery, embracing minor and operative surgery. Comp. from standard allopathic authorities, and adapted to homoeopathic therapeutics, with a general history of surgery from the earliest periods to the present time .. . nder the influence ofan anaesthetic. All being ready, the surgeon may select eitherBaker Browns or Sirnss operation, as he may prefer. My pre-ference leads me to adopt the latter procedure, as the simplestand most efficacious. Baker BrowrCs Operation.— The instruments requiredare a scalpel, a blunt-pointed, straight bistoury, a pair of longdissecting for
. The science and art of surgery, embracing minor and operative surgery. Comp. from standard allopathic authorities, and adapted to homoeopathic therapeutics, with a general history of surgery from the earliest periods to the present time .. . nder the influence ofan anaesthetic. All being ready, the surgeon may select eitherBaker Browns or Sirnss operation, as he may prefer. My pre-ference leads me to adopt the latter procedure, as the simplestand most efficacious. Baker BrowrCs Operation.— The instruments requiredare a scalpel, a blunt-pointed, straight bistoury, a pair of longdissecting forceps, three large needles, several small ones, atenaculum, pieces of gum-elastic catheter to act as quills, commonhemp twine waxed, and sponges. All being in readiness, anassistant holds the sides of the fissure so as to secure tension,and the operator, by means of: a bistoury, removes all the cica-tricial tissue, first from one edge and then from the other. Thisshould be done so as not only to vivify all the cicatricial surface,but also the superficial layer of tissue above the cicatrix. Afterthis, the external sphincter of the anus is divided, with the skinand areolar tissue lying over it. The muscle is cut on both sides, Fig. Shows the denuded surfaces and the insertion of the quill suture before the parts are brought together, and also the division of the sphincter on each side of tiic coccyx. LACERATION OF THE PERINEUM. 187 about a quarter of an inch in front of its attachment to theos coccygis, by two incisions, carried outwards and backwards, asrepresented in Fig. 248. For this purpose a blunt-pointed bis-toury, guided by the finger, is carried up the rectum for an inchand a quarter, and by it an incision of an inch in length is made,■extending outward from the anus, between the coccyx and tuber-osity of the ischium. The thighs are then approximated and thesutures introduced. The left edge being grasped between thethumb and forefinger of the left hand, a strong
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