CHAPTER n. 

 SURGICAL DIAGNOSIS. 



The first query to be settled in examining a diseased animal is 

 whetlier the ailment with which he is attacked is merely a case of 

 disordered function, requiring only the administration of the 

 proper drugs to restore the usual order of thiags, or a case de- 

 manding the operative skill and expert ministrations of the sur- 

 geon, with bistoury and cautery and suture. The decision of this 

 query Lavolves a thorough knowledge of anatomy, and is compara- 

 tively more difficult, as well as more important, than the mere 

 medical diagnosis of diseases pertaining to internal pathology. 

 Errors ia surgical diagnosis are always both more dangerous and 

 more important than those of a mere medical character, inasmuch 

 as they are likely to be more readily exposed, and to involve a 

 greater amount of responsibUity on the part of the surgeon. 



To insure the certainty of his diagnosis, the surgeon must call 

 into exercise aU his resources of knowledge and experience, and 

 employ all his faculties of observation and discrimination, with 

 such instrumental aid as may serve to facHitate and confirm his 

 conclusion, as to the nature of the cases before him. He must 

 especially employ all his organs of sense in the investigation. A 

 single sense is sometimes sufficient to diagnosticate the character 

 of some special lesions, but more commonly each sense is an 

 auxiUary of the others, and all are complementary to each. In 

 fact, the surgeon is not justified in reaching a conclusion as to the 

 detection of an affection, which is discovered by the . sight, 

 or touch, or smell, or hearing, alone, but to escape the possibUity 

 of error, he is bound to confirm his discovery by the corroboration 

 of another, or what is still better, of all the others, if possible. 

 In these cases, as in others, the eye is the most valuable and 

 comprehensible of the organs. 



1st. Sight. — Visible changes of contour, or color, or other 

 deviations from the usual appearance of tissues, or of regions, are 

 of course first made known through the sight of the eye. De- 

 formities, unless of very minute dimensions, with abnormal 



