SURGERY. 203 



SURGERY 



By Surgery is to be understood that portion of the Healing Art which 

 seeks to remedy such diseases and malformations of the human body as can 

 be affected by external applications, whether they be medicines or instru- 

 ments, &c. ; keeping, however, in mind that internal medicines acting upon 

 the whole system, and a proper diet, are almost always to be conjoined. 



The following preliminaries to every surgical operation are carefully to 

 ■be borne in mind : The S3^stem of the patient, as well as his mind, must first 

 receive proper preparation. When possible, sufficient and skilful assistance 

 must be at hand ; the location and the position of the patient must be 

 suitable both for the individual and the operator ; all necessary apparatus, 

 instruments, bandages, &c., must be in proper order and prepared for all 

 emergencies ; finally, the operation must be finished as quickly as possible, 

 to relieve the patient from pain. 



As it is the pain of a surgical operation that is most dreaded by the 

 patient, due attention should be directed to alleviating this as much as 

 possible. To this end various means may be employed ; such as compres- 

 sion of the nerves between the part to be operated upon and the brain, 

 which may be effected partly by the hands, and j^artly by means of instru- 

 ments. Narcotic appliances, as opium, are also used for the same purpose. 

 In the use of sharp instruments, they should be perfectly sharp and free 

 from rust, and ever}^ instrument, before being used, should be heated slightly 

 and rubbed with fresh olive oil : the application of this substance not only 

 diminishes pain, and increases the sharpness of cutting instruments, but also 

 facilitates the introduction of such as are blunt. Quite recently the inhala- 

 tion of ether and chloroform has been used as an anaesthetic agency to the 

 greatest advantage. To give a complete description of all surgical instru- 

 ments now in use would require many volumes, as every operator has 

 forms peculiar to himself We shall restrict ourselves to a brief notice of 

 such as are most generally employed, considering them under the heads of 

 the principal varieties of operations. Instruments almost always in the hands 

 of the operator are lancets, trochars, knives of the most varied forms, hooks, 

 probes, sondes, forceps, nippers, scissors, saws, chisels, hammers, needles, &c. 

 Figures of some of these are given on pi. 140. Fig. 1, usual form of thumb 

 lancet ; fig. 2, Spanish lancet ; fig. 3, abscess lancet ; fig. 4, Petit's trochar, 

 with the canula ; fig. 11, common tenaculum ; fig. 13, simple button-headed 

 sound; fi^. 14, common forceps; Jig. 16, straight scissors; fig. 17, curved 

 scissors. 



1. Blood-Letting. 



Blood-letting is made use of partly to diminish the amount in the system, 

 and partly to restore circulation and to conduct it to or from some parti- 



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