A MANUAL

OF THE

OPERATIONS OF SURGERY

FOR THE USE OF

SENIOR STUDENTS, HOUSE SURGEONS, AND
JUNIOR PRACTITIONERS.

ILLUSTRATED.

BY JOSEPH BELL, F.R.C.S. Edin.

LECTURER ON CLINICAL SURGERY, SURGEON TO THE ROYAL INFIRMARY AND TO
THE EYE INFIRMARY, AND LATE DEMONSTRATOR OF ANATOMY
IN THE UNIVERSITY OF EDINBURGH.

FIFTH EDITION, REVISED AND ENLARGED.

EDINBURGH: MACLACHLAN & STEWART,

BOOKSELLERS TO THE UNIVERSITY.

LONDON: SIMPKIN, MARSHALL, & CO.

1883.

TO THE MEMORY OF

JAMES SYME, ESQ., F.R.C.S. AND F.R.S.E.

SURGEON TO THE QUEEN IN SCOTLAND

PROFESSOR OF CLINICAL SURGERY
IN THE UNIVERSITY OF EDINBURGH
ETC. ETC.

THIS BOOK IS DEDICATED
BY HIS OLD HOUSE-SURGEON AND ASSISTANT

THE AUTHOR.

PREFACE TO FIFTH EDITION.

To retain the small size of the work and to keep it up to date have been the Author's aim in the Fifth Edition.

PREFACE TO THE FIRST EDITION.

Having been asked, year after year, by the members of my Class for Operative Surgery, to recommend to them some Manual of Surgical Operations which might at once guide them in their choice of operations, and give minute details as to the mode of performance, I have been gradually led to undertake the production of this little work.

My aim has been to describe as simply as possible those operations which are most likely to prove useful, and especially those which, from their nature, admit of being practised on the dead body.

In accordance with this plan, neither historical completeness of detail, nor much variety in the methods of performing any given operation, is to be expected. Hence, also, many omissions which would be unpardonable in the briefest system of Surgery are unavoidable. For example, excision of tumours and operations for necrosis are hardly mentioned, because for these no special instructions can well be given; for, while general principles may guide us to what should be done, the special circumstances of each case must dictate how it is to be done.

In such a work as this, to attempt originality would be undesirable and intrusive; a judicious selection, a faithful compilation, are all that can be expected.

That the selection of operations may sometimes show "Northern Proclivities" is possible; and this is perhaps not unnatural to a scholar and teacher in the Edinburgh School.

An earnest endeavour has been used to make the references correct and copious: for any mistakes or omissions the author would crave indulgence.

The four plates which precede the letterpress were drawn on wood (from original photographs) by Mr. D.W. Williamson, Melbourne Place, and the lines of incision for the various operations were added by the author.

The rough woodcuts scattered through the work were drawn on wood by the author, and for their roughness he, not his engraver, is responsible. He also hopes that the references in the letterpress will be accepted as sufficient acknowledgment of the true ownership, in those few instances in which the idea of the diagram has been borrowed.

It has been thought unnecessary to introduce woodcuts of surgical instruments, as the illustrated catalogues lately published by Weiss, Maw, and others, are sufficiently accurate.

In excuse of the frequent baldness and brevity of the style, the author must point to the size and price of the work. Its composition would have been easier had its dimensions been greater.

Though intended chiefly to guide the studies, on the dead subject, of students and junior practitioners, the author ventures to hope that the Manual may be useful to those who, in the public services, in the colonies, or in lonely country districts, find themselves constrained to attempt the performance of operations which, in the towns, usually fall to the lot of a few Hospital Surgeons.

JOSEPH BELL.

CONTENTS.