364 SURGERY 



all forms of traumatism of the spine and cord. Still again, the use- 

 fulness of the jacket is demonstrated in a large list of injuries, 

 among which may be mentioned sprains, concussion, hemorrhage, 

 lacerations, and inflammatory thickenings. Thus it is evident that 

 immediate extension and counter-extension with immobilization by 

 means of the jacket, in all forms of spinal injuries, offers the most 

 satisfactory plan of treatment that has been suggested, a plan of 

 treatment, too, in which the results show manifest evidence of im- 

 provement, and further a plan of treatment that has been attended 

 with a most gratifying success. 



Orthopedic surgery is a department by itself, a part of which will 

 be discussed under pediatrics. Under orthopedic surgery there are, 

 however, a few operations that could be referred to briefly in order 

 not to overlook the importance of the subject. Orthopedic surgery 

 literally refers to the treatment of deformities; but the progress in 

 this department has already passed beyond the limits that originally 

 were set for it, and include now some of the operations in general 

 surgery. Among the advances mentioned by Taylor are the Lorenz 

 bloodless method of manual replacement of congenitally dislocated 

 hips, the correction of deformed limbs by forcible movement without 

 division of the tendons, the straightening of the kyphotic spine by 

 great force, as suggested by Calot, the use of Sayre's plaster-of-paris 

 jacket for correction of Pott's disease, the straightening of deform- 

 ities in the limbs by osteotomy, the correction of deformities affect- 

 ing the long bones by osteoclasis, the arrest of disease of the joints 

 by excision, the removal of osteomyelitic foci in bone by excision or 

 by the Rontgen rays, tendon grafting suggested by Dr. Vulpius, nerve 

 suture for transference of functional activity from a healthy nerve 

 to a paralyzed nerve, the tuberculin injection from diagnostic pur- 

 poses, the extirpation of articular disease, the cure of periarticular 

 bursitis and tenosynovitis, the healing of non-tuberculous joint 

 disease where the etiology is dependent upon microorganisms such 

 as are found in typhoid, pneumonia, gonorrhea, syphilis, and septic 

 infection; the management of atrophic and hypertrophic joint 

 disease by improvement in the physical condition and correction by 

 mechanical means, and finally the treatment of Paget's disease of the 

 joints, or osteitis deformans. 



Surgery of the Vascular System. In the surgery of the vascular 

 system American operators have made most valuable contributions. 

 The innominate artery was ligated for the first time in the history 

 of surgery by Valentine Mott, of this city, on May 11, 1818. The 

 operation was performed for the cure of aneurism, and the patient 

 died. The operation was essayed for the second time by Hall, of 

 Baltimore, in 1830, and again by Cooper, of San Francisco, in 1859. 

 Both of these cases terminated fatally. The artery was finally tied 



