216 ANTHROPOLOGY. 
opposite side. The position of the side bands is secured by the six strings 
attached to the cap. | 
Fig. 27 represents the flap of skin dissected from the arm and attached t 
it-only by its base. It is cicatrized along its margin and under surface, and 
thereby prepared for attachment to the stump of the nose. 
10. EXTIRPATION OF PORTIONS OF THE TONGUE. 
For this operation will be needed a piece of cork, and a polypus forceps, 
or Muzeux’ tenaculum forceps (pl. 140, jig. 12). It will sometimes be 
necessary to pass a string or loop through the sound part of the tongue, for 
the purpose of drawing it out during the operation, and for stopping the flow 
of blood. There will also be required a straight, a sharp, and a blunt bis- 
toury, a Cooper’s scissors, ligature apparatus, cautery irons, cold water, ice, 
&e. The tongue of the patient is to be protruded as far as possible, and 
held by forceps or a loop. The operation itself is conducted either by means 
of an incision or by hgature. 
Pi. 139, fig. 80: at the points g and h, two needles are passed through 
from beneath, each provided with a separate and a common thread, the 
latter of which, g, &, h, 7, is tied on the back of the tongue; the two former, 
g, l,m, and h,n, 0, are fastened in the edges. For removing the small por- 
tion of the side of the tongue, a needle with a double thread is passed 
through at », and the two ends of those tied together at g and 7. 
li. CHSOPHAGOTOMY. 
This is resorted to sometimes for the removal of foreign bodies, partly for 
the purpose of introducing. food. 
For the first end, three methods have been proposed, that of Eckholdt 
with the most favor. The operation is to be performed in the triangular 
space included between the two ecrura of the sterno-cleido-mastoid and the 
clavicle. The skin is in an obliquely transverse fold, and an incision made 
of about two inches in leneth, running downwards and inwards to the 
sternal end of the clavicle, and the platysma separated. Should the space 
between the muscular portion be too much confined to permit a sight of 
the laryngeal nerve lying along the cesophagus, the angle of the two heads 
is opened up on a director by introducing this close behind the muscle, and 
thus avoiding any danger of injuring the inferior thyroid artery and the 
omo-hyoid muscle. The omo-hyoid may be then pushed up, the carotid 
artery and jugular vein outwards, the cesophagus laid bare, and then opened 
either against the foreign body or a small aperture made and enlarged with 
forceps, or by the introduction of a director. 
Pi. 189, fig. 82, the lips of the incision are separated by means of two 
double tenacula: ’, sternal, ?, clavicular portion of the sterno-cleido-mastoid 
muscle; *, sterno-thyroid muscle; *, omo-hyroid do.; °, thyroid gland: 
922 
