OPERATIONS 



904 



OPERATIONS 



the capsule having previously been lacerated by a stop- 

 needle. Briggs' : I. For traumatic epilepsy ; excision 

 of the painful cicatrix. 2. For varicocele ; ligation of 

 the veins at two points with subcutaneous division. 

 Brinton's, fox amputation through the knee-joint ; the 

 same as Stephen Smith's operation with the exception 

 that the semilunar cartilages are left in situ. 

 Brown's, for nymphomania ; amputation of the clit- 

 oris. Browne's, for inversion of the uterus ; incis- 

 ion of the fundus, and dilatation of the inverted 

 cervix through the incision. Brims' ( V. ) : 1. For am- 

 putation through the foot ; a modification of Pirogoff's 

 amputation, in which the sawn surface of the os calcis 

 is made concave and the tibia convex. 2. For arthrec- 

 tomy ; the interior of the ankle-joint is exposed by two 

 anterior and two posterior vertical incisions, and all 

 diseased tissue, including the synovial membrane, lig- 

 aments, cartilage and bone, is removed by erasion. 

 3. Plastic ; a quadrilateral gap is closed by displacing 

 a rectangular flap from each side and uniting them in 

 the median line. 4. For removal of a naso-pharyngeal 

 polypus ; it is done through the upper jaw by an 

 osteoplastic operation, the whole nose being turned 

 over to one side. 5. For restoration of the lower lip ; 

 two quadrilateral flaps are fashioned out of the whole 

 thickness of the cheek and upper lip on each side of 

 the mouth, and so turned downward that their upper 

 borders can be sutured together in the median line. 

 Bryant's ( T. ) : 1 . For lumbar colotomy ; an oblique 

 incision is made midway between the last rib and the 

 iliac crest. The bowel is fixed in position and opened. 



2. For splenectomy ; the incision is made a little to the 

 outer side of the linea semilunaris. 3. For varicocele ; 

 subcutaneous ligation of the veins at two points by 

 means of two needles. Buchanan's : 1 . For lithot- 

 omy ; the medio-lateral operation, with the use of an 

 angular staff. 2. For restoration of the lower lip ; 

 elevation of an oblique flap from each side of the 

 chin and union of the two flaps in the middle line. 



3. For tenotomy for talipes varus in children ; division 

 of the tendo Achillis and abductor pollicis muscle, to- 

 gether with the adjoining half of the flexor brevis digi- 

 torum muscle, and, insome cases, part of the deep plan- 

 tar ligament. Buck's : 1. F or bone- suture ; the use of 

 metallic sutures to keep the bones together after excis- 

 ion of the knee. 2. For chiloplasty ; to form a lower 

 lip. Pins are inserted into the skin to mark the points 

 of the incisions, and a triangular flap is made from the 

 cheek on either side of the mouth. 3. F 'or genu val- 

 gum ; a cuneiform osteotomy in which the tibia, fibula, 

 and patella are included. 4. For restoration of the 

 upper lip ; {a) for one-sided deficiency, a quadrilateral 

 flap from the lower lip is twisted upward and connected 

 by sutures with the freshened edge of the upper lip ; 

 (b) for contracted angle, an incision is made along 

 the red border of the lip skirting the deformed angle ; 

 a transverse cut is then made outward, and sutures 

 are introduced. Bumstead's : 1. Y ax circumcision; 

 the method formerly employed of grasping the fore- 

 skin with forceps and snipping off with a bistoury. 

 2. For internal urethrotomy ; done with a modification 

 of Maisonneuve 's or Peter's urethrotome. Burck- 

 hardt's, for retropharyngeal abscess : an opening is 

 made on the outside of the neck. Von Burow's : 

 I. For chiloplasty ; the large triangular gap is closed 

 by raising flaps on each side after making lateral incis 

 ions. 2. For entropion : a deep groove is made par- 

 allel to and 3 mm. inside the ciliary margin, with ex- 

 cision of a narrow strip of skin, and closure by su- 

 tures. Busch's : I. For Dupuytrett's contraction; 

 a triangular flap of skin and subcutaneous tissue is 

 dissected over the palmar cord, the base of the flap 



being where the finger and palm join, and the apex at 

 the proximal extremity. 2. F'or entropion ; removal 

 of a V-shaped piece of skin from the lower lid, fol- 

 lowed by suturing. Butcher's: 1. For dentigereus 

 cysts ; cutting away of the expanded bone, followed by 

 the use of the gouge. 2. For double hai-elip ; cutting 

 through the projecting pieces, without dividing the soft 

 parts, or interfering with the vascular supply from 

 behind, previous to bending them back. Buzzi's, for 

 the formation of an artificial pupil ; separation of 

 the iris from its peripheral attachment by means of a 

 needle inserted through the cornea. Byrd's : 1. For 

 closure of an artificial anus ; the same as Dup 

 operation. 2. For imperfoj-ate rectum ; the formation 

 of an artificial anus in the perineum, after colotomy. 

 Calignani's, for neurectomy ; resection of the inferior 

 dental nerve through an incision made between the 

 lobe of the ear and the angle of the jaw. Callisen's 

 for lumbar colotomy ; a vertical incision is made 

 following the line of the colon. Carden's (/.'. ): 1. 

 A method of performing amputations ; the formation 

 of a single anterior tegumentary flap. 2. For ampu- 

 tation above the knee-joint ; a single rounded flap is 

 removed from the front of the joint, and the operation 

 is completed by a circular incision. Carnochan's: 1. 

 For elephantiasis ; ligation of the main artery of the 

 limb. 2. For neurectomy ; removal of the second 

 division of the fifth nerve, together with the spheno- 

 palatine ganglion as far back as the foramen rotun- 

 dum. A horizontal incision is made just below 

 the orbit, and this is joined in the middle by a 

 vertical one running downward ; this is followed by 

 exposure of the spheno-maxillary fossa by trephining 

 through the antrum. Carpue's, rhinoplasty : repair 

 of the nose by taking a heart-shaped flap from the 

 forehead. Carter's, for the formation of an artifi- 

 cial pupil ; a small incision is made through the 

 cornea, in front of the plane of the iris, followed b 

 iridotomy. Cassel's, for exostoses of the car: re- 

 moval through the external orifice of the ear. Celsus': 



1 . A method of performing amputations ; division of 

 the skin by the circular method, its retraction, and fli 

 cutting to the bone at the level of the retracted 

 skin. 2. For chiloplasty ; the removal of tumors 

 the lower lip by a V-shaped incision ; horizontal in- 

 cisions are carried out from the base to enable tl 

 wound to be approximated more easily. 3. A meth< 

 of performing embryotomy ; also called cervical emhn - 

 otomy ; it is the method of decapitation of the fetu- 

 4. For lithotomy ; localization of the stone 1 



in the rectum with perineal incision. 5. For n 

 plasty; flaps are secured from the cheeks, tl 

 septum being formed, if necessary, from the u[ 

 lip. Cesarean, in case of otherwise impossible labt 

 incision into the gravid uterus through the abdomin. 

 wall, and removal of the fetus. Chalot's, for tl. 

 removal of naso-pharyngeal polypi ; the nasal 

 opened by dividing the attachments of the upper Iff 

 the bone. The two upper canine teeth are then 1 

 moved, and the alveolus and hard palate divided fro 

 before backward from the starting-point. The 

 bone thus isolated is turned down into tin 

 and the polypus is exposed. Chamberlaine's I 

 For ligation of the first part of the axilla) 

 the vessel is exposed by means of a curved 

 having its convexity downward, across the su] 

 ular fossa and extending ]/ 2 inch below the clavick 



2. For ligation of the brachial artery; an incis* 

 made along the lower margin of the clavicle , and tn 

 is joined near its middle by a second incision over 

 deltoid and pectoral muscles. Championniere's, _■> 

 method of performing embryotomy ; it consists 



