SOF AMPUTATING THE ARM, ie. 
Met MSO Sci ae Aer Get cnet AEA 1h 
The general observations made upon the Sake aun tink ei 
g and thigh, apply equally to the amputation of the fore-arim and afm, 
And it is only oda therefore, forme to observe, that in taking off a 
_ the arm, no more of it should be removed than is diseased ; for the _ 
longer the stump is, the more useful it proves ; and the same atten- 
tion should be given to saving the integuments for covering the sore, 
_ that is advised in amputating the leg. # 
* ail : i r : OF ISSUES. 
25 Issues are small artificial ulcers that we form in different parts of eck 
in f = ] e pt oe 0 2 pk es a ee ee ge of purulent mat- 
eet yistaibs Mt 
SN I I Re BP i 
S$ serve as drains for noxious humors, and to draw away the 
determination from a more vital or important part; and I hiave found 
them to be of gréat utility in many eases, particularly in chronic af 
fections of the head, and eyes, &e., when I place the seton in the 
back of the rieck. Generally, it is not necessary that they be placed 
near the affected part; for as they prove useful by the quantity of 
matter they afford, it is of little importance where they are placed, — 
_ and accordingly they may be inserted where the patient thinks it 
most convenient. ’ 
Some general rules should be observed in the introduction of setoné. — 
They should never be placed immediately above a bone thinly cover- 
ed; nor directly above a tendon ; not very close to a large blood-ves+ 
se] 6f nerve ; nor upon the belly of aniuscle, — The best situation for 
issues is that space which lies between the tendons on the back part of 
_ the neck, where there is considefable depth of cellular substance ; the 
middle of the upper-arm ; and 4 considerable hollow dbove the bend- 
ing tendon of the kriee. “They may likewise be inserted between the _ 
ribs, on each side of the back bone; in the lower part of the calf of 
ar 
ing Ointment. The seton. 
