OPERATIONS 



riioidal tumor; cauterize with turning nitric acid. 

 Assalini's, for iridodialysis ; the iris is detached with 

 eye forceps through a large opening in the cornea. 

 Atlee's, for ovariotomy ; the ecraseur is applied 

 to the pedicle. Aveling's : i. For suture of the 

 soft palate ; a double loop of suture is passed on one 

 side and the loop drawn out of the mouth ; a sin- 

 gle suture is then passed through the opposite side 

 and looped into the double one; by pulling the 

 latter back, the single suture is drawn across the 

 cleft. 2. Transfusion by the direct method ; this 

 permits measurement of the amount of blood trans- 

 fused. Avery's, for uranoplasty. Same as Lang- 

 enbeck's operation. Ayres', for ectopia vesica; clo- 

 sure by means of a flap of skin turned down from 

 the abdomen over the bladder. Bader's : I. For 

 conical cornea ; an elliptic piece of the cornea is re- 

 moved from the apex of the cone, and this is followed 

 by the application of a tight bandage. 2. For the re- 

 lief of pain in glaucoma ; stretching or laceration of 

 the infratrochlear nerve. 3. ¥ ox sclerotomy ; the inci- 

 sion is confined to the scleral margin, without division 

 of the overlying conjunctiva. Baer's (B. F.): I. 

 For perineorrhaphy ; the same denudation is made as 

 in Emmet's operation. The needle is passed deeply 

 on the outer side of the denuded sulcus, brought out 

 at the bottom of the sulcus, again introduced on the 

 rectal side and brought out at the top of the opposite 

 side of the sulcus ; the crest of the rectocele is then 

 picked up at the upper border of the denudation, the 

 needle is passed down the inner side of the left sulcus 

 and up on the outer side, the entire sweep being made 

 with one suture. The same process is repeated once 

 or twice. 2. For supravaginal hysterectomy ; median 

 celiotomy, ligation of the ovarian arteries in the broad 

 ligament ; the clamp is applied close to the uterus and 

 the ligament divided between the ligature and the 

 I clamp ; ligation of the uterine arteries in the broad 

 1 ligament ; formation of anterior and posterior perito- 

 1 neal flaps ; division of the cervix ; if necessary, suture 

 ' of the flaps over the cervical stump. Neither ligature 

 ! nor suture must pierce or embrace cervical tissue, and 

 nothing whatever is done to the cervical canal. 

 Baker's (M.) : I. To secure union of bone ; the use of 

 j steel pins to keep the bones together after excision of 

 the knee. 2. For carcinoma of the cervix uteri ; the 

 cervix is removed by means of a uterotome that 

 makes a funnel-shaped excavation, the base of which is 

 j on a line with the internal os, and the apex approaches 

 j or meets the fundus. 3 . For excision of the tongue ; 

 j removal through the mouth with the use of the ecra- 

 ! seur as a supplemental means. Ball's: 1. For iliac 

 colotomy ; a modification of Cripps' operation, in 

 ; which the incision is made in the left linea semilunaris, 

 ; and the bowel secured above and below the future 

 j artificial opening by means of two special clamps, 

 which are removed after suturing and opening of the 

 i bowel. 2. For inguinal hernia ; the sac is separated up 

 I to the abdominal portion of the neck and then twisted 

 I around its own axis, after which the fundus is cut away 

 ' and the stump is secured in the ring. Ballingall's, 

 for excision of the upper jaio. The same as VelpeaiS s 

 n. Bandl's, for uretero-vaginal fistula ; a 

 catheter is passed into the bladder, and through an 

 artificial opening in the bladder into the ureter, and 

 the original opening is closed over the catheter. Banks' 

 • '/ : I. For aneurysm of the third part of the sub- 

 artery ; ligation of the first part of the artery. 

 2. For the radical cure of inguinal hernia ; the sac is 

 exposed and separated from the surrounding parts ; a 

 ligature is then applied close to the ring, and the fundus 



901 OPERATIONS 



of the sac is cut away, after which the inguinal ring is 

 closed by sutures. 3. For internal urethrotomy ; a 

 special urethrotome is used to divide the stricture from 

 within outward. 4. For removal of the breast ; it con- 

 sists in removal of the entire breast, the overlying skin, 

 the fascia over the pectoral muscle, and (if suspicious- 

 looking) the fibers of the muscle. The axilla is 

 always to be cleaned out. -5. For removal of nasal 

 polypi ; avulsion with forceps, when the nostrils are in 

 a dependent position, so as to prevent choking by the 

 blood. Bardeleben's, for double harelip ; the mucous 

 membrane and periosteum are stripped up behind the 

 pre-maxillary bone ; the septum is then divided and 

 the projection reduced, or grasped by forceps and 

 twisted upon itself. Barden's, for angular anky- 

 losis of the knee ; removal of a wedge-shaped piece 

 of bone from the shaft of the femur, and fracture 

 of the remaining part. Bardenheuer's : 1. For 

 cholecystotomy ; performed in two stages: the first 

 operation consists in fixing the gall-bladder to the 

 abdominal incision. After adhesions have formed, the 

 bladder is opened and the operation completed. 2. 

 Exploratory incision ; an extraperitoneal explora- 

 tory incision, to allow of the palpation of the contents 

 of the abdomen through the parietal peritoneum. 

 3. For resection of the sacrum ; the removal of the 

 entire lower part of the bone at the third sacral fora- 

 men. 4. For suprapubic cystotomy; a skin-incision, 

 about the length of a finger, in the middle line, close 

 above, and parallel with, the upper border of the pubis. 

 Barker's (A. £.) : I. For excision of the astragalus ; 

 the incision runs from just above the tip of the exter- 

 nal malleolus forward and a little inward, curving 

 toward the dorsum of the foot. 2. For excision of the 

 hip ; by an anterior incision, commencing on the front 

 of the thigh, one-half inch below the anterior superior 

 iliac spine, and running downward and inward for 

 three inches. 3. For gastroenterostomy ; the visceral 

 incision is made only through the serous and muscular 

 coats, and the most important part of the suturing is 

 done before the stomach or bowel is opened. 4. For the 

 radical cure of inguinal hernia; a modification of 

 Banks' operation, in which the neck of the sac is 

 ligatured and the sac below the ligature divided, but 

 not dissected out, being used to occlude the internal 

 ring. 5. For spinal abscess ; the abscess is opened 

 and scraped, and the debris washed out by the use of 

 the flushing-curet. 6. For ununited fracture of the 

 clavicle ; the false joint is exposed by an incision ; 

 the two ends of the bone are removed by oblique 

 cuts in the same plane, and held together by silver 

 wire. 7. For varicocele; the application of subcu- 

 taneous aseptic silk ligatures at one or two points. 

 Bartisch's, for entropion ; removal of the entire ciliary 

 margin of the lid. Barton's {J. Rhea) : 1. For bony 

 ankylosis of the knee ; the removal of a wedge-shaped 

 piece of bone from the lower end of the femur, to 

 allow of the correction of the deformity. 2. For oste- 

 otomy ; division of the femur between the two trochan- 

 ters. Barwell's {R. ): I. For aneurysm ; (a) the 

 use of ox aorta in the ligation of aneurysm ; (b) pass- 

 ing a needle, armed with a silver wire, subcutaneously 

 around vascular tumors to avoid scars. 2. For aneu- 

 rysm of the innominate or aorta ; ligation of the carotid 

 and subclavian arteries. 3. For ligation of the first part 

 of the subclavian artery ; the formation of a triangular 

 flap turned upward and outward, with division of both 

 heads of the sterno-mastoid muscle and the sterno- 

 thyroid muscle. 4. Osteotomy for genu valgum ; 

 division of the lower end of the femur and upper end 

 of the tibia, above and below their respective epiph- 

 yses. 5. For varicocele; the subcutaneous applica- 



