GENERAL REMARKS ON OPERATIONS. 3 



surface ; I can therefore enucleate it. For this purpose I require the 



following instruments To reach it I must divide 



How shall I fashion the primar}- incision to insure free exit to discharge 



to prevent the wound gaping, and to promote healing ? 



During dissection I may injure important structures, for instance . . 



. . . ; should this happen what must I do immediately ? 



what shall I require for the purpose ? If division of blood- 

 vessels is unavoidable I must check bleeding by ligation or torsion of 



vessels ; dressings must afterwards be applied to promote 



healing by primary intention over as large an area as possible ; how 

 can this be best effected ? ; where shall I insert the drainage-tube ? ; is 

 it possible to apply a dressing, may it not in reality do more harm than 

 good, and should not I attempt to protect the wound in some other 

 fashion ? Such a mental process is unconsciously performed before the 

 simplest operation, but only when rare and difficult operations are 

 projected does its necessity force itself on our recognition. In very 

 difficult cases operation may previously be performed on the dead body 

 and the anatomical conditions noted. 



During the above process one also determines the method of 

 operation, for one method does not suit every case and it must be left 

 to the ability of the operator to select the method he regards as being 

 the best suited to the case in hand, the simplest to practise and as 

 promising the desired result in the shortest time. Circumstances 

 arising during the operation itself often necessitate unforeseen modifica- 

 tions, and test to the utmost the operator's resource and ingenuity. 



The instruments selected must include not only those required for 

 the operation itself, but for all complications which may possibly arise. 

 At the same time the simpler they are, ccuteris paribus, the better. 



Preparation of the Animal. — Great importance used formerly 

 to be attached to the preparation of the animal, which was bled and 

 purged secundum artem. Such methods are now nearly obsolete, and the 

 chief precaution required is to avoid casting an animal with a full 

 stomach, overloaded bowel, or distended bladder, although the fear of 

 rupturing the stomach, bowel, or bladder has been greatly exaggerated, 

 as is proved by the small mortality in animals cast for urgent operations 

 without reference to the state of the bowels, etc. It is however 

 certainly advantageous to regulate the diet for a day or two beforehand. 



The seat of operation should be thoroughly cleansed, the hair 

 shaved off, and in the case of operations on the foot a local antiseptic 

 bath may be given. 



Operations become necessary at all times of the day, but when a 

 choice is available the best time is probably the morning, as any 



