OPERATIONS 



912 



OPERATIONS 



which can then be operated upon by simply separating 

 the adhesions. Von Hippel's, fox transplantation of the 

 cornea ; a circular portion of the leukomatous cornea 

 is removed by means of a trephine, the membrane of 

 Descemet being left intact ; a piece of the whole 

 thickness of a rabbit's cornea is then excised with 

 the same trephine and transplanted. Hirschberg's, 

 for detaclunent of the retina ; paracentesis of the 

 sclera over the seat of the effusion. "Hodgson's : 



1. For ligation of the axillary artery ; a semilunar 

 incision is made just below the clavicle, terminating 

 near the anterior margin of the deltoid muscle. 2. 

 For ligation of the femoral artery ; ligation at the 

 apex of Scarpa's triangle. Hoffa's, for congenital 

 dislocation of the hip; the head of the femur is 

 reached through a 3-inch incision and freed from its 

 attachments ; the cotyloid cavity is then gouged out 

 to receive it, and reduction is accomplished under ex- 

 tension. The dressing consists of a plaster-of- Paris 

 bandage, with continuous extension. Hoin's, for 

 amputation at the knee-joint ; it is done by the posterior- 

 flap method. Holmes' (T.) : I. For ectopia vesica: ; 

 closure by means of reversed and superimposed flaps. 



2. For excision of the os calcis ; an incision is made 

 from the inner edge of the tendo Achillis along the 

 upper border of the os calcis and the outer border of 

 the foot to the calcaneo-cuboid joint, and this is 

 joined by another incision running across the sole, the 

 peroneal tendons being divided. 3. For varicocele ; a 

 small incision is made in the scrotum, and the veins are 

 ligated with kangaroo tendon. Holt's, for internal 

 urethrotomy ; rupture of the stricture by rapid dilata- 

 tion. Horn's, for chiloplasty ; removal of the diseased 

 tissue by a V-shaped incision, and filling in of the gap 

 by tissue from the maxillary bones. Horner's: I. For 

 cicatricial ectropion ; the lid is dissected loose and a flap 

 from the cheek is used to fill in the gap produced. 2. 

 For salivary fistula ; the diseased tissues are cut out 

 with a punch, on a wooden spatula held in the mouth ; 

 the external wound is then closed. Horsley's ( V. ) , for 

 craniectomy ; the skull is exposed by raising a flap, 

 and the bone is removed with the trephine and bone- 

 cutting forceps. Hotz's : I. For entropion; it is 

 on the" same principle as Anagnostahis' operation, but 

 more of the orbicularis muscle is removed, and the 

 sutures are placed higher up. 2. For trichiasis ; the 

 skin above the lid-margin is united to the upper border 

 of the tarsal cartilage. Howse's : I. A method 

 of performing gastrostomy ; a vertical incision is made 

 in the sheath of the rectus muscle, a little to the inner 

 side of its outer border. 2. For lumbar colotomy ; 

 a modification of Bryant's operation in which the oper- 

 ation is carried out in two stages, two pairs of pressure- 

 forceps being made to grasp the muscular coats of the 

 colon, and to hold the bowel until the time for estab- 

 lishing the artificial anus. 3. For nephro-lithotomy ; 

 an incision is made in a vertical direction, and this is 

 supplemented by a transverse one ; the knife is entered 

 close to the edge of the erector spinse muscle, below 

 the lower border of the twelfth rib, and is carried 

 obliquely downward and forward toward the crest of 

 the ilium. 4. For varicocele ; after the vas deferens has 

 been separated from the veins, an incision 1^ or 2 

 inches long is made over the varicocele ; the veins are 

 then ligated above and below, and the included 

 bundle is excised. Hue's, for performing circumcision ; 

 an elastic ligature is made to transfix the dorsal aspect 

 of the prepuce by means of a curved needle ; the 

 ligature is then tied in front and allowed to cut through. 

 Hueter's : I. For excision of the elbow ; a modifica- 

 tion of Oilier' s operation. 2. For excision of the facial 

 nerve ; the incision is made in front of the ear, and one 



of the branches of the nerve is exposed in the parotid 

 gland ; this is to be followed back to the trunk. 3. For 

 excision of the shoulder ; it is done by a single anterior 

 vertical or oblique incision. 4. For chiloplasty (lower 

 lip); the margins of the defect are brought together and 

 an incision is made in the cheek horizontally outward 

 from the oral angle, involving the whole thickness on 

 the distorted side ; the mucosa on each side of the 

 new wound is reflected a little and then united 

 to the skin by sutures. 5. For rhinoplasty ; a quadri- 

 lateral flap is taken from the dorsum of the nose to form 

 a new columna. 6. For stretching the facia/ nerve ; 

 an incision two inches long is made in front of the 

 ear, its center being opposite to the upper part of the 

 lobule. Huguier's : 1. A method of performing 

 colotomy ; the right lumbar operation. 2. For irido- 

 dialysis ; the iris is divided from the center to the cir- 

 cumference, and each lip is then detached. 3. For 

 the removal of a naso-pharyugeal tumor ; the same as 

 Berard's operation, except that a smaller fragment is 

 removed ; the bone is divided horizontally from the 

 maxillary tuberosity to the anterior nares, and the base 

 of the pterygoid process is cut through: the lower part 

 of the jaw is then dislocated downward within the 

 mouth. Hulke's, for fistula of the lacrymal gland ; 

 a silk thread armed with a needle at either end is 

 passed from the orifice of the fistula through the con- 

 junctiva and allowed to remain ; a triangular portion 

 of the upper lid is thus included in the thread. Hum- 

 phrey's : I. J or amputation of the penis ; a circular 

 skin-flap is made, the urethra is dissected loose from 

 its attachments to the stump of the corpora cavernosa, 

 drawn through a slit made at the base of the scrotum 

 on the under side and attached to the margins of the 

 slit so as to make an artificial meatus in the perineum. 



2. For excision of the condyle of the lower jaw; the 

 condyle is exposed by reflecting a triangular flap up- 

 ward, and the bone is sawn through the neck, all of the 

 condyle and external pterygoid process being removed. 

 Hunter's (John) : I. For aneurysm ; ligation of the 

 artery on the cardiac side of the aneurysm at some dis- 

 tance from it. 2. For internal urethrotomy ; it is done 

 with a special dilating urethrotome. 3. For ligation of 

 the femoral artery ; it is done in the aponeurotic canal. 

 4. For trichiasis ; after puncturing the hair-bulb with a 

 fine knife to the depth of ]/% of an inch, a needle, dipped 

 in some irritant, is introduced and the hair extracted. 

 Hutchinson's: 1. A method of performing ovarii 

 otomy ; application of a clamp to the pedicle. 2. A 

 method of transfusion : the indirect method, with the 

 use of a fountain-syringe devised for the purpose. 



3. For varicocele ; the open method of deligation. 

 Indian, for rhinoplasty ; a flap is taken from the 

 forehead, with its pedicle at the root of the nose ; 

 hollow plugs are inserted into the nostrils, and the 

 flap is secured. See Keegati 1 s operation. Invagina- 

 tion Method. See Jobert's operation. Italian 

 Operation: I. For cystotomy. See Alia rtoti's opera- 

 tion. 2. For rhinoplasty ; the skin is taken from the 

 arm over the biceps ; the flap is cut on three sides, 

 and after the skin has shrunk it is fitted to the fresh 

 margins of the defect, the arm being bandaged in 

 position for at least eight days. Jaboulay's. See 

 Exothyropexy. Jacobs', for trichiasis ; scalping of 

 the edge of the lid, including the cilia and the hair 

 bulbs. Jacobson's : 1. For amputation of the penis; 

 it is done by the flap-method, the flap being 1 

 from above. 2. For cataract-extraction ; scleral sec- 

 tion, the flap skirting the lower margin of the con 

 iridectomy. Jacque's, for excision of the tongue; it 

 is done through an opening made in the cheek. 

 Jaeger's: 1. For cataract-extraction; the incision il 



