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Kultur Dokumente
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[Transcriber's Notes]
Thanks to Carol Presher of Timeless Antiques, Valley, Alabama,
for
lending the original book for this production. The 140 year old
binding
had disintegrated, but the paper and printing was in amazingly good
condition, particularly the multicolor images.
Thanks also to the Mayo Clinic. This book has increased my
appreciation
of their skilled care of my case by showing the many ways that
things
could go wrong.
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Transciber's Glossary
[End Transcriber's Notes]
SURGICAL ANATOMY
BY
JOSEPH MACLISE
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PREFACE.
The object of this work is to present to the student of medicine and
the
practitioner removed from the schools, a series of dissections
demonstrative of the relative anatomy of the principal regions of the
human body. Whatever title may most fittingly apply to a work with
this
intent, whether it had better be styled surgical or medical, regional,
relative, descriptive, or topographical anatomy, will matter little,
provided its more salient or prominent character be manifested in its
own form and feature. The work, as I have designed it, will itself
show
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that my intent has been to base the practical upon the anatomical,
and
to unite these wherever a mutual dependence was apparent.
That department of anatomical research to which the name
topographical
strictly applies, as confining itself to the mere account of the form
and relative location of the several organs comprising the animal
body,
is almost wholly isolated from the main questions of physiological
and
transcendental interest, and cannot, therefore, be supposed to speak
in
those comprehensive views which anatomy, taken in its widest
signification as a science, necessarily includes. While the anatomist
contents himself with describing the form and position of organs as
they
appear exposed, layer after layer, by his dissecting instruments, he
does not pretend to soar any higher in the region of science than the
humble level of other mechanical arts, which merely appreciate the
fitting arrangement of things relative to one another, and
combinative
to the whole design of the form or machine of whatever species this
may
be, whether organic or inorganic. The descriptive anatomist of the
human
body aims at no higher walk in science than this, and hence his
nomenclature is, as it is, a barbarous jargon of words, barren of all
truthful signification, inconsonant with nature, and blindly
irrespective of the cognitio certa ex principiis certis exorta.
Still, however, this anatomy of form, although so much requiring
purification of its nomenclature, in order to clothe it in the high
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practical
bearing, such study could not deserve the name of anatomical,
while
anatomical means comparative, and whilst comparison implies
inductive
reasoning.
However, practical anatomy, such as it is, is concerned with an
exact
knowledge of the relationship of organs as they stand in reference
to
each other, and to the whole design of which these organs are the
integral parts. The figure, the capacity, and the contents of the
thoracic and abdominal cavities, become a study of not more urgent
concernment to the physician, than are the regions named cervical,
axillary, inguinal, &c., to the surgeon. He who would combine both
modes
of a relationary practice, such as that of medicine and surgery,
should
be well acquainted with the form and structures characteristic of all
regions of the human body; and it may be doubted whether he who
pursues
either mode of practice, wholly exclusive of the other, can do so
with
honest purpose and large range of understanding, if he be not
equally
well acquainted with the subject matter of both. It is, in fact, more
triflingly fashionable than soundly reasonable, to seek to define the
line of demarcation between the special callings of medicine and
surgery, for it will ever be as vain an endeavour to separate the one
from the other without extinguishing the vitality of both, as it would
be to sunder the trunk from the head, and give to each a separate
living
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Anatomy--the
the knowledge based on
principle--is the
foundation of the curative art, cultivated as a science in all its
branchings; and comparison is the nurse of reason, which we are
fain to
make our guide in bringing the practical to bear productively. The
human
body, in a state of health, is the standard whereunto we compare the
same body in a state of disease. The knowledge of the latter can
only
exist by the knowledge of the former, and by the comparison of
both.
Comparison may be fairly termed the pioneer to all certain
knowledge. It
is a potent instrument--the only one, in the hands of the pathologist,
as well as in those of the philosophic generalizer of anatomical
facts,
gathered through the extended survey of an animal kingdom. We
best
recognise the condition of a dislocated joint after we have become
well
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discovery
is a long-forgotten enterprise, except as pursued in the microcosm
on
the field of the microscope, which, it must be confessed, has drawn
forth demonstrations only commensurate in importance with the
magnitude
of the littleness there seen.
The subject of our study, whichever it happen to be, may appear
exhausted of all interest, and the promise of valuable novelty,
owing to
two reasons:--It may be, like descriptive human anatomy, so cold,
poor
and sterile in its own nature, and so barren of product, that it will be
impossible for even the genius of Promethean fire to warm it; or
else,
like existing physiology, the very point of view from which the
mental
eye surveys the theme, will blight the fair prospect of truth, distort
induction, and clog up the paces of ratiocination. The physiologist
of
the present day is too little of a comparative anatomist, and far too
closely enveloped in the absurd jargon of the anthropotomist, ever
to
hope to reveal any great truth for science, and dispel the mists
which
still hang over the phenomena of the nervous system. He is steeped
too
deeply in the base nomenclature of the antique school, and too
indolent
to question the import of Pons, Commissure, Island, Taenia, Nates,
Testes, Cornu, Hippocamp, Thalamus, Vermes, Arbor Vitro,
Respiratory
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TABLE OF CONTENTS.
PREFACE
INTRODUCTORY TO THE STUDY OF ANATOMY AS A
SCIENCE.
COMMENTARY ON PLATES 1 & 2
THE FORM OF THE THORAX, AND THE RELATIVE
POSITION OF ITS
CONTAINED PARTS--THE LUNGS, HEART, AND LARGER
BLOOD VESSELS.
The structure, mechanism, and respiratory motions of the thoracic
apparatus. Its varieties in form, according to age and sex. Its
deformities. Applications to the study of physical diagnosis.
COMMENTARY ON PLATES 3 & 4
THE SURGICAL FORM OF THE SUPERFICIAL, CERVICAL,
AND FACIAL
REGIONS, AND THE RELATIVE POSITION OF THE
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PRINCIPAL BLOOD
VESSELS, NERVES, ETC.
The cervical surgical triangles considered in reference to the
position
of the subclavian and carotid vessels, &c. Venesection in respect to
the
external jugular vein. Anatomical reasons for avoiding transverse
incisions in the neck. The parts endangered in surgical operations
on
the parotid and submaxillary glands, &c.
COMMENTARY ON PLATES 5 & 6
THE SURGICAL FORM OF THE DEEP CERVICAL AND
FACIAL REGIONS,
AND THE RELATIVE POSITION OF THE PRINCIPAL BLOOD
VESSELS,
NERVES, ETC.
The course of the carotid and subclavian vessels in reference to
each
other, to the surface, and to their respective surgical triangles.
Differences in the form of the neck in individuals of different age
and
sex. Special relations of the vessels. Physiological remarks on the
carotid artery. Peculiarities in the relative position of the subclavian
artery.
COMMENTARY ON PLATES 7 & 8
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in
the canal of Nuck. Formation of infantile hernia. Dilatation of the
serous sac. Funnel-shaped investments of the hernia. Descent of the
hernia like that of the testicle. Varieties of infantile hernia.
Sacculated cord. Oblique internal inguinal hernia--cannot be
congenital.
Varieties of internal hernia. Direct external hernia. Varieties of the
inguinal canal.
COMMENTARY ON PLATES 43 & 44
THE DISSECTION OF FEMORAL HERNIA AND THE SEAT
OF STRICTURE.
Compared with the inguinal variety. Position and relations. Sheath
of
the femoral vessels and of the hernia. Crural ring and canal.
Formation
of the sac. Saphenous opening. Relations of the hernia. Varieties of
the
obturator and epigastric arteries. Course of the hernia. Investments.
Causes and situations of the stricture.
COMMENTARY ON PLATES 45 & 46
DEMONSTRATIONS OF THE ORIGIN AND PROGRESS OF
FEMORAL
HERNIA; ITS DIAGNOSIS, THE TAXIS, AND THE
OPERATION.
Its course compared with that of the inguinal hernia. Its investments
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and relations. Its diagnosis from inguinal hernia, &c. Its varieties.
Mode of performing the taxis according to the course of the hernia.
The
operation for the strangulated condition. Proper lines in which
incisions should be made. Necessity for and mode of opening the
sac.
COMMENTARY ON PLATE 47
THE SURGICAL DISSECTION OF THE PRINCIPAL
BLOODVESSELS
AND NERVES OF THE ILIAC AND FEMORAL REGIONS.
The femoral triangle. Eligible place for tying the femoral artery.
The
operations of Scarpa and Hunter. Remarks on the common femoral
artery.
Ligature of the external iliac artery according to the seat of
aneurism.
COMMENTARY ON PLATES 48 & 49
THE RELATIVE ANATOMY OF THE MALE PELVIC
ORGANS.
Physiological remarks on the functions of the abdominal muscles.
Effects
of spinal injuries on the processes of defecation and micturition.
Function of the bladder. Its change of form and position in various
states. Relation to the peritonaeum. Neck of the bladder. The
prostate.
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vessels.
COMMENTARY ON PLATES 67 & 68
THE SURGICAL DISSECTION OF THE ANTERIOR CRURAL
REGION;
THE ANKLES AND THE FOOT.
Varieties of the anterior and posterior tibial and the peronaeal
arteries. The operations for tying these vessels in several situations.
Practical observations on wounds of the arteries of the leg and foot.
CONCLUDING COMMENTARY
ON THE FORM AND DISTRIBUTION OF THE VASCULAR
SYSTEM AS A
WHOLE; ANOMALIES; RAMIFICATION; ANASTOMOSIS.
The double heart. Universal systemic capillary anastomosis. Its
division, by the median line, into two great lateral fields--those
subdivided into two systems or provinces--viz., pulmonary and
systemic.
Relation of pulmonary and systemic circulating vessels. Motions of
the
heart. Circulation of the blood through the lungs and system.
Symmetry
of the hearts and their vessels. Development of the heart and
primary
vessels. Their stages of metamorphosis simulating the permanent
conditions of the parts in lower animals. The primitive branchial
arches
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Section
2.
Section 3.
Foundation
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Section 5.
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