Much has happened since this Manual was last revised, and many surgical lessons have been learned in the hard school of war. Some may yet have to be unlearned, and others have but little bearing on the problems presented to the civilian surgeon. Save in its broadest principles, the surgery of warfare is a thing apart from the general surgery of civil life, and the exhaustive literature now available on every aspect of it makes it unnecessary that it should receive detailed consideration in a manual for students. In preparing this new edition, therefore, we have endeavoured to incorporate only such additions to our knowledge and resources as our experience leads us to believe will prove of permanent value in civil practice.

For the rest, the text has been revised, condensed, and in places rearranged; a number of old illustrations have been discarded, and a greater number of new ones added. Descriptions of operative procedures have been omitted from the Manual, as they are to be found in the companion volume on Operative Surgery, the third edition of which appeared some months ago.

We have retained the Basle anatomical nomenclature, as extended experience has confirmed our preference for it. For the convenience of readers who still employ the old terms, these are given in brackets after the new.

This edition of the Manual appears in three volumes; the first being devoted to General Surgery, the other two to Regional Surgery. This arrangement has enabled us to deal in a more consecutive manner than hitherto with the surgery of the Extremities, including Fractures and Dislocations.

We have once more to express our thanks to colleagues in the Edinburgh School and to other friends for aiding us in providing new illustrations, and for other valuable help, as well as to our publishers for their generosity in the matter of illustrations.

Edinburgh,
March 1921.

CONTENTS

page
[CHAPTER I]
Repair [1]
[CHAPTER II]
Conditions which interfere with Repair [17]
[CHAPTER III]
Inflammation [31]
[CHAPTER IV]
Suppuration [45]
[CHAPTER V]
Ulceration and Ulcers [68]
[CHAPTER VI]
Gangrene [86]
[CHAPTER VII]
Bacterial and other Wound Infections [107]
[CHAPTER VIII]
Tuberculosis [133]
[CHAPTER IX]
Syphilis [146]
[CHAPTER X]
Tumours [181]
[CHAPTER XI]
Injuries [218]
[CHAPTER XII]
Methods of Wound Treatment [241]
[CHAPTER XIII]
Constitutional Effects of Injuries [249]
[CHAPTER XIV]
The Blood Vessels [258]
[CHAPTER XV]
The Lymph Vessels and Glands [321]
[CHAPTER XVI]
The Nerves [342]
[CHAPTER XVII]
Skin and Subcutaneous Tissues [376]
[CHAPTER XVIII]
The Muscles, Tendons, and Tendon Sheaths [405]
[CHAPTER XIX]
The Bursæ [426]
[CHAPTER XX]
Diseases of Bone [434]
[CHAPTER XXI]
Diseases of Joints [501]
[INDEX] [547]

LIST OF ILLUSTRATIONS

fig.page
[1.]Ulcer of Back of Hand grafted from Abdominal Wall [15]
[2.]Staphylococcus aureus in Pus from case of Osteomyelitis [25]
[3.]Streptococci in Pus from case of Diffuse Cellulitis [26]
[4.]Bacillus coli communis in Pus from Abdominal Abscess [27]
[5.]Fraenkel's Pneumococci in Pus from Empyema following Pneumonia [28]
[6.]Passive Hyperæmia of Hand and Forearm induced by Bier's Bandage [37]
[7.]Passive Hyperæmia of Finger induced by Klapp's Suction Bell [38]
[8.]Passive Hyperæmia induced by Klapp's Suction Bell for Inflammation of Inguinal Gland [39]
[9.]Diagram of various forms of Whitlow [56]
[10.]Charts of Acute Sapræmia [61]
[11.]Chart of Hectic Fever [62]
[12.]Chart of Septicæmia followed by Pyæmia [63]
[13.]Chart of Pyæmia following on Acute Osteomyelitis [65]
[14.]Leg Ulcers associated with Varicose Veins [71]
[15.]Perforating Ulcers of Sole of Foot [74]
[16.]Bazin's Disease in a girl æt. 16 [75]
[17.]Syphilitic Ulcers in region of Knee [76]
[18.]Callous Ulcer showing thickened edges [78]
[19.]Tibia and Fibula, showing changes due to Chronic Ulcer of Leg [80]
[20.]Senile Gangrene of the Foot [89]
[21.]Embolic Gangrene of Hand and Arm [92]
[22.]Gangrene of Terminal Phalanx of Index-Finger [100]
[23.]Cancrum Oris [103]
[24.]Acute Bed Sores over right Buttock [104]
[25.]Chart of Erysipelas occurring in a wound [108]
[26.]Bacillus of Tetanus [113]
[27.]Bacillus of Anthrax [120]
[28.]Malignant Pustule third day after infection [122]
[29.]Malignant Pustule fourteen days after infection [122]
[30.]Colony of Actinomyces [126]
[31.]Actinomycosis of Maxilla [128]
[32.]Mycetoma, or Madura Foot [130]
[33.]Tubercle bacilli [134]
[34.]Tuberculous Abscess in Lumbar Region [141]
[35.]Tuberculous Sinus injected through its opening in the Forearm with Bismuth Paste [144]
[36.]Spirochæte pallida [147]
[37.]Spirochæta refrigerans from scraping of Vagina [148]
[38.]Primary Lesion on Thumb, with Secondary Eruption on Forearm [154]
[39.]Syphilitic Rupia [159]
[40.]Ulcerating Gumma of Lips [169]
[41.]Ulceration in inherited Syphilis [170]
[42.]Tertiary Syphilitic Ulceration in region of Knee and on both Thumbs [171]
[43.]Facies of Inherited Syphilis [174]
[44.]Facies of Inherited Syphilis [175]
[45.]Subcutaneous Lipoma [185]
[46.]Pedunculated Lipoma of Buttock [186]
[47.]Diffuse Lipomatosis of Neck [187]
[48.]Zanthoma of Hands [188]
[49.]Zanthoma of Buttock [189]
[50.]Chondroma growing from Infra-Spinous Fossa of Scapula [190]
[51.]Chondroma of Metacarpal Bone of Thumb [190]
[52.]Cancellous Osteoma of Lower End of Femur [192]
[53.]Myeloma of Shaft of Humerus [195]
[54.]Fibro-myoma of Uterus [196]
[55.]Recurrent Sarcoma of Sciatic Nerve [198]
[56.]Sarcoma of Arm fungating [199]
[57.]Carcinoma of Breast [206]
[58.]Epithelioma of Lip [209]
[59.]Dermoid Cyst of Ovary [213]
[60.]Carpal Ganglion in a woman æt. 25 [215]
[61.]Ganglion on lateral aspect of Knee [216]
[62.]Radiogram showing pellets embedded in Arm [228]
[63.]Cicatricial Contraction following Severe Burn [236]
[64.]Genealogical Tree of Hæmophilic Family [278]
[65.]Radiogram showing calcareous degeneration of Arteries [284]
[66.]Varicose Vein with Thrombosis [289]
[67.]Extensive Varix of Internal Saphena System on Left Leg [291]
[68.]Mixed Nævus of Nose [296]
[69.]Cirsoid Aneurysm of Forehead [299]
[70.]Cirsoid Aneurysm of Orbit and Face [300]
[71.]Radiogram of Aneurysm of Aorta [303]
[72.]Sacculated Aneurysm of Abdominal Aorta [304]
[73.]Radiogram of Innominate Aneurysm after Treatment by Moore-Corradi method [309]
[74.]Thoracic Aneurysm threatening to rupture [313]
[75.]Innominate Aneurysm in a woman [315]
[76.]Congenital Cystic Tumour or Hygroma of Axilla [328]
[77.]Tuberculous Cervical Gland with Abscess formation [331]
[78.]Mass of Tuberculous Glands removed from Axilla [333]
[79.]Tuberculous Axillary Glands [335]
[80.]Chronic Hodgkin's Disease in boy æt. 11 [337]
[81.]Lymphadenoma in a woman æt. 44 [338]
[82.]Lympho Sarcoma removed from Groin [339]
[83.]Cancerous Glands in Neck, secondary to Epithelioma of Lip [341]
[84.]Stump Neuromas of Sciatic Nerve [345]
[85.]Stump Neuromas, showing changes at ends of divided Nerves [354]
[86.]Diffuse Enlargement of Nerves in generalised Neuro-Fibromatosis [356]
[87.]Plexiform Neuroma of small Sciatic Nerve [357]
[88.]Multiple Neuro-Fibromas of Skin (Molluscum fibrosum) [358]
[89.]Elephantiasis Neuromatosa in a woman æt. 28 [359]
[90.]Drop-Wrist following Fracture of Shaft of Humerus [365]
[91.]To illustrate the Loss of Sensation produced by Division of the Median Nerve [367]
[92.]To illustrate Loss of Sensation produced by Complete Division of Ulnar Nerve [368]
[93.]Callosities and Corns on Sole of Foot [377]
[94.]Ulcerated Chilblains on Fingers [378]
[95.]Carbuncle on Back of Neck [381]
[96.]Tuberculous Elephantiasis [383]
[97.]Elephantiasis in a woman æt. 45 [387]
[98.]Elephantiasis of Penis and Scrotum [388]
[99.]Multiple Sebaceous Cysts or Wens [390]
[100.]Sebaceous Horn growing from Auricle [392]
[101.]Paraffin Epithelioma [394]
[102.]Rodent Cancer of Inner Canthus [395]
[103.]Rodent Cancer with destruction of contents of Orbit [396]
[104.]Diffuse Melanotic Cancer of Lymphatics of Skin [398]
[105.]Melanotic Cancer of Forehead with Metastasis in Lymph Glands [399]
[106.]Recurrent Keloid [401]
[107.]Subungual Exostosis [403]
[108.]Avulsion of Tendon [410]
[109.]Volkmann's Ischæmic Contracture [414]
[110.]Ossification in Tendon of Ilio-psoas Muscle [417]
[111.]Radiogram of Calcification and Ossification in Biceps and Triceps [418]
[112.]Ossification in Muscles of Trunk in generalised Ossifying Myositis [419]
[113.]Hydrops of Prepatellar Bursa [427]
[114.]Section through Gouty Bursa [428]
[115.]Tuberculous Disease of Sub-Deltoid Bursa [429]
[116.]Great Enlargement of the Ischial Bursa [431]
[117.]Gouty Disease of Bursæ [432]
[118.]Shaft of the Femur after Acute Osteomyelitis [444]
[119.]Femur and Tibia showing results of Acute Osteomyelitis [445]
[120.]Segment of Tibia resected for Brodie's Abscess [449]
[121.]Radiogram of Brodie's Abscess in Lower End of Tibia [451]
[122.]Sequestrum of Femur after Amputation [453]
[123.]New Periosteal Bone on Surface of Femur from Amputation Stump [454]
[124.]Tuberculous Osteomyelitis of Os Magnum [456]
[125.]Tuberculous Disease of Tibia [457]
[126.]Diffuse Tuberculous Osteomyelitis of Right Tibia [458]
[127.]Advanced Tuberculous Disease in Region of Ankle [459]
[128.]Tuberculous Dactylitis [460]
[129.]Shortening of Middle Finger of Adult, the result of Tuberculous Dactylitis in Childhood [461]
[130.]Syphilitic Disease of Skull [463]
[131.]Syphilitic Hyperostosis and Sclerosis of Tibia [464]
[132.]Sabre-blade Deformity of Tibia [467]
[133.]Skeleton of Rickety Dwarf [470]
[134.]Changes in the Skull resulting from Ostitis Deformans [474]
[135.]Cadaver, illustrating the alterations in the Lower Limbs resulting from Ostitis Deformans [475]
[136.]Osteomyelitis Fibrosa affecting Femora [476]
[137.]Radiogram of Upper End of Femur in Osteomyelitis Fibrosa [478]
[138.]Radiogram of Right Knee showing Multiple Exostoses [482]
[139.]Multiple Exostoses of Limbs [483]
[140.]Multiple Cartilaginous Exostoses [484]
[141.]Multiple Cartilaginous Exostoses [486]
[142.]Multiple Chondromas of Phalanges and Metacarpals [488]
[143.]Skiagram of Multiple Chondromas [489]
[144.]Multiple Chondromas in Hand [490]
[145.]Radiogram of Myeloma of Humerus [492]
[146.]Periosteal Sarcoma of Femur [493]
[147.]Periosteal Sarcoma of Humerus [493]
[148.]Chondro-Sarcoma of Scapula [494]
[149.]Central Sarcoma of Femur invading Knee Joint [495]
[150.]Osseous Shell of Osteo-Sarcoma of Femur [495]
[151.]Radiogram of Osteo-Sarcoma of Femur [496]
[152.]Radiogram of Chondro-Sarcoma of Humerus [497]
[153.]Epitheliomatus Ulcer of Leg invading Tibia [499]
[154.]Osseous Ankylosis of Femur and Tibia [503]
[155.]Osseous Ankylosis of Knee [504]
[156.]Caseating focus in Upper End of Fibula [513]
[157.]Arthritis Deformans of Elbow [525]
[158.]Arthritis Deformans of Knee [526]
[159.]Hypertrophied Fringes of Synovial Membrane of Knee [527]
[160.]Arthritis Deformans of Hands [529]
[161.]Arthritis Deformans of several Joints [530]
[162.]Bones of Knee in Charcot's Disease [533]
[163.]Charcot's Disease of Left Knee [534]
[164.]Charcot's Disease of both Ankles: front view [535]
[165.]Charcot's Disease of both Ankles: back view [536]
[166.]Radiogram of Multiple Loose Bodies in Knee-joint [540]
[167.]Loose Body from Knee-joint [541]
[168.]Multiple partially ossified Chondromas of Synovial Membrane from Shoulder-joint [542]
[169.]Multiple Cartilaginous Loose Bodies from Knee-joint [543]