Elements of Surgery

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Longman, Orme, Brown, Green, and Longmans, 1840 - Surgery - 800 pages
 

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Page 256 - No injury of the head is too slight to be despised, or too severe to be despaired of. Punctured and lacerated wounds, more especially those penetrating all the layers of covering, are frequently followed by violent and extensive inflammation of all the tissues, with severe constitutional disturbance, and with delirium and other symptoms denoting functional derangement of the brain. The swelling is often extensive, involving the whole scalp, and the integuments of the face, and completely shutting...
Page 376 - A sharp-pointed bistoury is then passed through the upper lip — previously stretched and raised by an assistant — close to the ruins of the former columna, and about an eighth of an inch on one side of the mesial line. The incision is continued down, in a straight direction, to the free margin of the lip ; and a similar one, parallel to the former, is made on the opposite side of the mesial line, so as to insulate a flap about a quarter of an inch in breadth, and composed of skin, mucous membrane,...
Page 376 - It is to be observed that the flap is not twisted round, as in the operation already detailed, but simply elevated, so as to do away with the risk of failure. Twisting is here unnecessary, for the mucous lining of the lip, forming the outer surface of the columna, readily assumes the colour and appearance of integument, after exposure for some time. The fixing of the columna having been accomplished, the edges of the lip must be neatly brought together.
Page 376 - I have for some years practised successfully, and in a great many instances, is thus performed: — The inner surface of the apex is first pared. A sharp-pointed bistoury is then passed through the upper lip, previously stretched and raised by an assistant, close to the ruins of the former columna, and about an eighth of an inch on one side of the mesial line. The incision is continued down, in a straight direction, to the free margin of the lip; and a similar one, parallel to the former, is made...
Page 377 - Some care is afterwards required from the surgeon and patient in raising up the alae, by filling them with lint, and thus compressing the pillar, so as to diminish the oedematous swelling which takes place to a greater or less degree in it, and to repress the granulations. It is besides necessary to push upwards the lower part of the column, so that it may come into its proper situation ; and this is done by the application of a small round roll of linen, supported by a narrow bandage passed over...
Page 376 - The deformity produced by its loss is not far short of that caused by destruction of the whole nose. Happily, after the ulceration has been checked, the part can be renewed neatly, safely, and without much suffering to the patient. The operation, which I have...
Page 409 - They are frequently the cause, and the sole cause, of violent and continued headache ; of glandular swellings in the neck, terminating in or combined with abscess ; of enlargement and inflammation of the tonsils, either chronic or acute ; of ulcerations of the tongue and lips, often assuming...
Page 377 - The fixing of the columna being accomplished, the edges of the lip must be neatly brought together by the twisted suture. Two needles will be found sufficient, one being passed close to the edge of the lip; and they should be introduced deeply through its substance; two thirds, at least, of its thickness must be superficial to them.
Page 53 - The exhibition of the extract of aconite in this and other inflammatory affections, is often followed by great abatement of vascular excitement, so that the necessity for abstraction of blood is done away with.

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