Elements of surgery: for the use of students : with plates (Volume 2).

  • Dorsey, John Syng, 1783-1818.
Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: Elements of surgery: for the use of students : with plates (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    merely cut away the parts already indurated and diseas- ed, but likewise some portion of the surrounding sub- stance in which a diseased disposition may probably have been excited. In performing the operation the patient is to be seated in a chair in a good light. If the skin be sound, and a tumour only exists in the breast, a straight incision may be made through it, and the diseased part dissected out. But if it is determined that a part of the skin should be removed with the tumour, two incisions are to be made, forming an oval figure between them, in which all the skin to be taken away, is included; and as dividing the skin is the most painful part of the operation, both these incisions should be completed before any thing else is done ; and the lower part of the skin should be divided first, since, if a wound is made in the upper part, the effused blood covers the skin below, and prevents the surgeon from seeing accurately where the second incision ought to be made. These incisions should be nearly in the direction of the fibres of the pectoral muscle. If the glands in the axilla are diseased, the incision should be high enough in that direction to allow of their removal with the tumour. The best way to do this is to dissect the diseased breast out first, and then to dissect upwards, without cutting it off, and detach the hardened lympha- tics and glands in the arm pit which will be pulled down by the weight of the tumour, and thus the operator will be enabled to extirpate them more conveniently. As soon as the fingers can be passed above the indurated axillary glands, they are to be cut off, but before this, the cellular membrane connecting them above is to be tied by a firm ligature, to prevent hemorrhage from any vessel that may be contained in it. This direction is of the utmost importance; for if it be neglected, the vessels will retract so high into the axilla, that the surgeon will