This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1867 Excerpt: ...yet as the pain and want of sleep rendered it unlikely that further favourable change would be obtained, on the 8th of August it was resolved to perform the operation on the following day. The patient having been brought under the influence of chloroform, the limb having been laid upon its inner side, with the leg well ...
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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1867 Excerpt: ...yet as the pain and want of sleep rendered it unlikely that further favourable change would be obtained, on the 8th of August it was resolved to perform the operation on the following day. The patient having been brought under the influence of chloroform, the limb having been laid upon its inner side, with the leg well bent, and the femoral artery compressed by Dr. Fiddes, I made an incision six inches long, beginning at the head of the fibula, ending on the spine of the tibia, and directed sufficiently inwards to avoid the peroneal nerve. The coverings of the tumour on the tibial side of the incision were quickly dissected inwards, and then those to the fibular side on the front and external aspect of the swelling, and the tissues between the bones were carefully turned backwards to a sufficient extent to make a clearance for the saw. In the movements of the knife in this stage of the operation the anterior tibial artery was divided, which was foreseen to be inevitable; but in accomplishing this part of the denudation of the tumour and bone, and in making a clearance for the saw, the peroneal nerve above and the anterior tibial below were turned back without being injured or their function in the least impaired. The immunity from injury on the part of the peroneal nerve was owing to two circumstances: --First, the edge of the knife was kept moving close on the tumour, so that the tissues were cut upon the tumour and only at their adhesion to it. Second, the nerve had the relation dissection has almost constantly revealed between the trunk of a nerve and a cartilaginous tumour in close proximity--namely, it passed over it in a winding depressure between irregularities of the tumour, and was not involved in its substance. The fibula was then divided above and..
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