22 INTRODUCTION 



scalpels should never be used; even the smallest ones must be 

 very carefully employed for such dissection, or important struct- 

 ures will be injured. 



The scalpel with the straight edge and sharp point has a use 

 entirely different from that of the belly-bladed knife. Although 

 the blade of the knife with the straight edge may be quite long, 

 one uses only the point of the knife in dissection ; the action of 

 such a knife is, therefore, much more limited than is that of the 

 belly-bladed scalpel, and it should be used in making only the 

 smaller, less extensive cuts. Students are frequently seen try- 

 ing unsuccessfully to make large incisions with such knives, 

 especially when their convex blades are dull. The scalpel with 

 straight edge and sharp point is especially valuable in the dis- 

 section of the viscera, sense organs, blood-vessels, and nerves. 

 It may well be employed whenever a small, careful cut is to be 

 made, and it will be found of the greatest convenience when the 

 student is working in corners or in deep fossae. 



The dissector should early learn the right way to hold a scal- 

 pel. The manner of holding in the dissecting-room is quite 

 different from that in the autopsy-room of the pathologist. In 

 the former case and in surgical work the knife is to be held ' ' like 

 a pen," between the thumb and the first two fingers, the handle 

 of the scalpel pointing obliquely upward. In the post-mortem 

 room the pathologist usually holds his knife " in his fist," the 

 handle of the scalpel being raised only slightly above the level 

 of the blade and resting in the palm of the hand. The only time 

 the dissector in the laboratory of human anatomy is permitted 

 to hold the knife " in his fist" is when he makes a long incision 

 through tough skin ; in all other circumstances the knife should 

 be held ' ' like a pen. ' ' 



The thumb, index and middle fingers should alone be used in 

 holding the knife ' ' like a pen. ' ' The ring-finger should not be 

 permitted to touch the knife, no matter how much the dissector 

 is inclined thereto. Only by following this rule can the anatomi- 

 cal workman secure the necessary freedom and acquire the deli- 

 cacy of movement requisite to good work. The ring-finger and 

 the little finger will be found very useful in making tissues tense, 

 in retracting tissues, or in displacing them to the side. 



The scalpel should be grasped by the thumb and fingers at 

 about the junction of blade and handle, certainly not high up on 

 the handle, certainly not far down on the blade. In making 

 careful cuts the hand should be supported upon its ulnar margin. 

 This support permits of greater precision ; the cut desired may 



