SURGERY. 217 



', trachea ; ', carotid artery ; ', inferior thyroid artery ; ', laryngeal nerve 

 and branches ; ", cellular tissue. 



To extract the foreign body after the operation, we may make use of a 

 straight forceps {pi. 140, fig. 15), or if it be some distance from the opening, 

 of a curved forceps as shown in fig. 78. Degenerate portions of the mem- 

 brane of the oesophagus, false membranes, &c., may be removed with the 

 knife or with the scissors. The introduction of nourishment when necessary 

 is to be effected by means of a flexible tube. 



If the foreign body be not too large it may in most instances be removed 

 without an operation. An instrument for extracting such substances, 

 invented by Petit, and improved by Eckholdt, is shown in fig. 79. It con- 

 sists of a handle, a ; a ferule, h; a whalebone rod, c c; a silver tube with 

 two hooks, c7, to which is fastened an elastic tube, e e; /is a long cylindri- 

 cal piece of sponge to which are attached some loops of thread, g, to catch 

 hold of small angular bodies. 



For the extraction of bodies of moderate size Eckholdt made use of the 

 apparatus shown in fig. 80. An elastic catheter, g g^ is provided at its 

 superior extremity with an open convex silver ferule attached to it by two 

 arms. Into the catheter is passed a round Avhalebone rod with a wooden 

 handle, which carries a silver ferule, b. This ferule, c. has a ridge, c, round 

 its margin, cut through in two opjiosite places ; a silver tube, e, on the 

 catheter has a small hook, f, on each side, which passing through the breaks 

 in the ridge, e, and slightly rotated, serves to unite the catheter to the han- 

 dle. The whalebone rod projects about two inches beyond the tube, and 

 to its anterior end is fastened a small silver button having eight grooves 

 radiating from the centre, cut on its surface. In these are laid four thin 

 whalebone rods about five inches long, and crossing each other in the cen- 

 tre of the button ; these are held in place by a small cap with eight teeth, 

 which bend down between the rods and thus keep them in place ; they are 

 then bent over and tied along the anterior end of the tube, and afterwards 

 surrounded by a ferule with the anterior margin bent in between the rods 

 to keep them at a proper distance apart. The cage thus formed will of 

 course be enlarged and expanded on drawing back the rod, and on the 

 other hand elongated and greatly diminished in diameter by pushing the 

 rod out or forwards. To extract pins or other sharp bodies, the cage may 

 be covered with a small bag of fine silk, and also encircled by numerous 

 loops of thread. . 



12. Amputation. 



Amputation proper has reference to the cutting through of a limb : when 

 the separation takes place at a joint, we have excision, or ex-articulation. 



Amputating apparatus consists of the following instruments : two tour- 

 niquets (pi. 140, figs. 86-88, those of Henkel and Savigny); amputating 

 knives of various sizes, single edged for circular sections, and double edged 

 for flap operations {fig. 84, Savigny's knife ; fig. 85, Weiss's knife for cir- 



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