218 ANTHROPOLOGY. 
cular incision); a straight or bellied bistoury; knives for separating bone 
and cutting periosteum; amputating saws (jig. 21, Pott’s saw); bone nip- 
pers for extracting spicula (fig. 20); bone scissors (jig. 19) and rasps; a 
chisel (jigs. 22, 23); forceps (jigs. 35, 86); artery tenaculum (fig. 37, Bell’s); 
and the necessary bandages. Good assistants, generally five im number, 
will be required. The suggestion of Moore, to diminish the pain of an 
operation by compressing se principal nerves (jig. 89, nerve ——— 
has not been much fol owed. 
Various tables have been constructed for the suitable arrangement of the 
patient (jig. 90, Kluge’s table), but these are only applicable in hospitals. 
The principal modes of amputation, subject, however, to numerous modi- 
fications for the different regions, are two in number. 
1. The Circular Method. This may be either simple or double. In eh 
simple incision, all the soft parts are cut to the bone, then pushed up, and 
the bone sawed off close to the muscle. Subsequently it was considered 
preferable to cut first through the skin, then pushing this up to cut through 
the muscle, and finally to separate the bone as before. 
2. Flap Operation. The flesh is grasped by the surgeon, and lifted from 
the bone; the double edged knife is passed horizontally through it, the point 
carried over the bone, and pushed through the other side of the limb; it is 
then made to cut its way out upwards and forwards, so as to make the 
anterior flap. The knife is again entered on the inner side a little below — 
the top of the incision, passed behind the bone, brought out at the wound 
on the outside, and directed so as to make a posterior flap. Both flaps are 
now drawn back, the knife swept around the bone to divide any remaining 
muscular fibres, and the bone sawed through. 
Pl. 189, fig. 88, amputation of the thigh: a, 4, hands of the first assistant; 
c, d, do. of second assistant; e, 4, operator. 
The following figures are intended to illustrate the respective positions of 
the individual parts after an amputation. 
Pl. 189, fig. 84, circular amputation of the upper arm, three and a half 
inches above the middle: a, humerus; 0, c, deltoid muscle; d, long, e, short 
head of the biceps brachii; f latissimus dorsi muscle; g, h, 7, &, J, triceps 
_ brachii; m, 7, 0, p, subcutaneous adipose and cellular tissue: *, brachial 
artery; *, posterior circumflex artery; *, basilic vein; **, deep seated 
brachial vein; °, cephalic vein; ', median nerve; *, ulnar nerve; °, middle 
cutaneous nerve. Jy. 35, circular amputation of the thigh two inches. 
below Poupart’s ligament: a, femur; 0, rectus femoris; c, sartorius; d, vastus 
externus and tensor vaginee femoris; e, vastus internus; f, adductor longus; 
g, gracilis; h, 2, k, 1, adductor magnus, adductor brevis, and semi-membra- 
nosus muscles; m, biceps crurseus; 7, semi-tendinosus; 0, adipose and cellu- 
lar tissue between the adductors and gracilis; p, 9, 7, ¢, subcutaneous adipose 
and cellular tissue; s, intermuscular tissue; ', crureeal artery; *, deep do.; 
*, external circumflex artery ; *, crureal vein; **’, deep seated veins; 
", saphena major vein; °~”, small and large muscular and cutaneous arterial 
branches; **-**, branches of the crurzeal nerve. 
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