CONTENTS

page
[CHAPTER I]
Injuries of Bones[1]
[CHAPTER II]
Injuries of Joints[32]
[CHAPTER III]
Injuries in the Region of the Shoulder and Upper Arm[44]
[CHAPTER IV]
Injuries in the Region of the Elbow and Forearm[79]
[CHAPTER V]
Injuries in the Region of the Wrist and Hand[102]
[CHAPTER VI]
Injuries in the Region of the Pelvis, Hip-Joint, and Thigh[122]
[CHAPTER VII]
Injuries in the Region of the Knee and Leg[155]
[CHAPTER VIII]
Injuries in Region of Ankle and Foot[185]
[CHAPTER IX]
Diseases of Individual Joints[201]
[CHAPTER X]
Deformities of the Extremities[241]
[CHAPTER XI]
The Scalp[319]
[CHAPTER XII]
The Cranium and its Contents[328]
[CHAPTER XIII]
Injuries of the Skull[361]
[CHAPTER XIV]
Diseases of the Brain and Membranes[373]
[CHAPTER XV]
Diseases of the Cranial Bones[406]
[CHAPTER XVI]
The Vertebral Column and Spinal Cord[411]
[CHAPTER XVII]
Diseases of the Vertebral Column and Spinal Cord[431]
[CHAPTER XVIII]
Deviations of the Vertebral Column[461]
[CHAPTER XIX]
The Face, Orbit, and Lips[474]
[CHAPTER XX]
The Mouth, Fauces, and Pharynx[496]
[CHAPTER XXI]
The Jaws, including the Teeth and Gums[507]
[CHAPTER XXII]
The Tongue[528]
[CHAPTER XXIII]
The Salivary Glands[543]
[CHAPTER XXIV]
The Ear[553]
[CHAPTER XXV]
The Nose and Naso-Pharynx[567]
[CHAPTER XXVI]
The Neck[582]
[CHAPTER XXVII]
The Thyreoid Gland[604]
[CHAPTER XXVIII]
The Œsophagus[616]
[CHAPTER XXIX]
The Larynx, Trachea, and Bronchi[634]
[INDEX][645]

LIST OF ILLUSTRATIONS

fig. page
[1.]Multiple Fracture of both Bones of Leg[4]
[2.]Radiogram showing Comminuted Fracture of both Bones of Forearm[5]
[3.]Oblique Fracture of Tibia; with partial Separation of Epiphysis of Upper End of Fibula; and Incomplete Fracture of Fibula in Upper Third[6]
[4.]Excess of Callus after Compound Fracture of Bones of Forearm[9]
[5.]Multiple Fractures of both Bones of Forearm showing Mal-union[11]
[6.]Radiogram of Un-united Fracture of Shaft of Ulna[13]
[7.]Excessive Callus Formation after Infected Compound Fracture of both Bones of Forearm[27]
[8.]Partial Separation of Epiphysis, with Fracture running into Diaphysis[29]
[9.]Complete Separation of Epiphysis[29]
[10.]Partial Separation with Fracture of Epiphysis[29]
[11.]Complete Separation with Fracture of Epiphysis[29]
[12.]Os Innominatum showing new Socket formed after Old-standing Dislocation[41]
[13.]Oblique Fracture of Right Clavicle in Middle Third, united[45]
[14.]Fracture of Acromial End of Clavicle[46]
[15.]Adhesive Plaster applied for Fracture of Clavicle[49]
[16.]Forward Dislocation of Sternal End of Right Clavicle[51]
[17.]Diagram of most common varieties of Dislocation of the Shoulder[53]
[18.]Sub-coracoid Dislocation of Right Shoulder[55]
[19.]Sub-coracoid Dislocation of Humerus[56]
[20.]Kocher's Method of reducing Sub-coracoid Dislocation—First Movement[57]
[21.]Kocher's Method—Second Movement[58]
[22.]Kocher's Method—Third Movement[59]
[23.]Miller's Method of reducing Sub-coracoid Dislocation—First Movement[60]
[24.]Miller's Method—Second Movement[61]
[25.]Dislocation of Shoulder with Fracture of Neck of Humerus[64]
[26.]Transverse Fracture of Scapula[68]
[27.]Fracture of Surgical Neck of Humerus, united with Angular Displacement[70]
[28.]Impacted Fracture of Neck of Humerus[71]
[29.]Ambulatory Abduction Splint for Fracture of Humerus[72]
[30.]Radiogram of Separation of Upper Epiphysis of Humerus[73]
[31.]“Cock-up” Splint[77]
[32.]Gooch Splints for Fracture of Shaft of Humerus; and Rectangular Splint to secure Elbow[77]
[33.]Radiogram of Supra-condylar Fracture of Humerus in a Child[81]
[34.]Radiogram of T-shaped Fracture of Lower End of Humerus[83]
[35.]Radiogram of Fracture of Olecranon Process[86]
[36.]Backward Dislocation of Elbow in a Boy[89]
[37.]Bony Outgrowth in relation to insertion of Brachialis Muscle[90]
[38.]Radiogram of Incomplete Backward Dislocation of Elbow[91]
[39.]Forward Dislocation of Elbow, with Fracture of Olecranon[93]
[40.]Radiogram of Forward Dislocation of Head of Radius, with Fracture of Shaft of Ulna[95]
[41.]Greenstick Fracture of both Bones of the Forearm[98]
[42.]Gooch Splints for Fracture of both Bones of Forearm[99]
[43.]Colles' Fracture showing Radial Deviation of Hand[103]
[44.]Colles' Fracture showing undue prominence of Ulnar Styloid[103]
[45.]Radiogram showing the Line of Fracture and Upward Displacement of the Radial Styloid in Colles' Fracture[104]
[46.]Radiogram of Chauffeur's Fracture[107]
[47.]Radiogram of Smith's Fracture[108]
[48.]Manus Valga following Separation of Lower Radial Epiphysis in Childhood[109]
[49.]Radiogram showing Fracture of Navicular (Scaphoid) Bone[111]
[50.]Dorsal Dislocation of Wrist at Radio-carpal Articulation[113]
[51.]Radiogram showing Forward Dislocation of Navicular Bone[114]
[52.]Extension Apparatus for Oblique Fracture of Metacarpals[117]
[53.]Radiogram of Bennett's Fracture of Base of Metacarpal of Right Thumb[118]
[54.]Splints for Bennett's Fracture[119]
[55.]Multiple Fracture of Pelvis through Horizontal and Descending Rami of both Pubes, and Longitudinal Fracture of left side of Sacrum[123]
[56.]Fracture of Left Iliac Bone; and of both Pubic Arches[124]
[57.]Many-tailed Bandage and Binder for Fracture of Pelvic Girdle[125]
[58.]Nélaton's Line[128]
[59.]Bryant's Line[129]
[60.]Section through Hip-Joint to show Epiphyses at Upper End of Femur, and their relation to the Joint[130]
[61.]Fracture through Narrow Part of Neck of Femur on Section[131]
[62.]Impacted Fracture through Narrow Part of Neck of Femur[132]
[63.]Fracture of Neck of Right Femur, showing Shortening, Abduction, and Eversion of Limb[133]
[64.]Fracture of Narrow Part of Neck of Femur[134]
[65.]Coxa Vara following Fracture of Neck of Femur in a Child[136]
[66.]Non-impacted Fracture through Base of Neck[137]
[67.]Fracture through Base of Neck of Femur with Impaction into the Trochanters[137]
[68.]Non-impacted Fracture through Base of Neck[138]
[69.]Fracture of the Femur just below the small Trochanter, united, showing Flexion and Lateral Rotation of Upper Fragment[140]
[70.]Adjustable Double-inclined Plane[141]
[71.]Diagram of the most Common Dislocations of the Hip[142]
[72.]Dislocation of Right Femur on to Dorsum Ilii[143]
[73.]Dislocation on to Dorsum Ilii[144]
[74.]Dislocation into the Vicinity of the Ischiatic Notch[145]
[75.]Longitudinal Section of Femur showing Fracture of Shaft with Overriding of Fragments[148]
[76.]Radiogram of Steinmann's Apparatus applied for Direct Extension to the Femur[150]
[77.]Hodgen's Splint[151]
[78.]Long Splint with Perineal Band[152]
[79.]Fracture of Thigh treated by Vertical Extension[153]
[80.]Section of Knee-joint showing Extent of Synovial Cavity[156]
[81.]Extension applied by means of Ice-tong Callipers for Fracture of Femur[158]
[82.]Radiogram of Separation of Lower Epiphysis of Femur, with Backward Displacement of the Diaphysis[160]
[83.]Separation of Lower Epiphysis of Femur, with Fracture of Lower End of Diaphysis[161]
[84.]Radiogram of Fracture of Head of Tibia and upper Third of Fibula[163]
[85.]Radiogram illustrating Schlatter's Disease[164]
[86.]Diagram of Longitudinal Tear of Posterior End of Right Medial Semilunar Meniscus[171]
[87.]Radiogram of Fracture of Patella[173]
[88.]Fracture of Patella, showing wide Separation of Fragments[175]
[89.]Radiogram of Transverse Fracture of both Bones of Leg by Direct Violence[178]
[90.]Radiogram of Oblique Fracture of both Bones of Leg by Indirect Violence[178]
[91.]Box Splint for Fractures of Leg[180]
[92.]Box Splint applied[181]
[93.]Section through Ankle-joint showing relation of Epiphyses to Synovial Cavity[186]
[94.]Radiogram of Pott's Fracture, with Lateral Displacement of Foot[187]
[95.]Ambulant Splint of Plaster of Paris[189]
[96.]Dupuytren's Splint applied to Correct Eversion of Foot[190]
[97.]Syme's Horse-shoe Splint applied to Correct Backward Displacement of Foot[191]
[98.]Radiogram of Fracture of Lower End of Fibula, with Separation of Lower Epiphysis of Tibia[192]
[99.]Radiogram of Backward Dislocation of Ankle[195]
[100.]Compound Dislocation of Talus[197]
[101.]Radiogram of Fracture-Dislocation of Talus[198]
[102.]Radiogram of Dislocation of Toes[199]
[103.]Arthropathy of Shoulder in Syringomyelia[203]
[104.]Radiogram of Specimen of Arthropathy of Shoulder in Syringomyelia[204]
[105.]Radiogram showing Multiple partially Ossified Cartilaginous Loose Bodies in Shoulder-joint[205]
[106.]Diffuse Tuberculous Thickening of Synovial Membrane of Elbow[206]
[107.]Contracture of Elbow and Wrist following a Burn in Childhood[207]
[108.]Advanced Tuberculous Disease of Acetabulum with Caries and Perforation into Pelvis[210]
[109.]Early Tuberculous Disease of Right Hip-joint in a Boy[212]
[110.]Disease of Left Hip; showing Moderate Flexion and Lordosis[213]
[111.]Disease of Left Hip; Disappearance of Lordosis on further Flexion of the Hip[213]
[112.]Disease of Left Hip; Exaggeration of Lordosis[214]
[113.]Thomas' Flexion Test, showing Angle of Flexion at Diseased Hip[214]
[114.]Tuberculous Disease of Left Hip: Third Stage[215]
[115.]Advanced Tuberculous Disease of Left Hip-joint in a Girl[216]
[116.]Extension by Adhesive Plaster and Weight and Pulley[220]
[117.]Stiles' Double Long Splint to admit of Abduction of Diseased Limb[221]
[118.]Thomas' Hip-splint applied for Disease of Right Hip[222]
[119.]Arthritis Deformans, showing erosion of Cartilage and lipping of Articular Edge of Head of Femur[225]
[120.]Upper End of Femur in advanced Arthritis Deformans of Hip[226]
[121.]Femur in advanced Arthritis Deformans of Hip and Knee Joints[227]
[122.]Tuberculous Synovial Membrane of Knee[230]
[123.]Lower End of Femur from an Advanced Case of Tuberculous Arthritis of the Knee[231]
[124.]Advanced Tuberculous Disease of Knee, with Backward Displacement of Tibia[233]
[125.]Thomas' Knee-splint applied[236]
[126.]Tuberculous Disease of Right Ankle[239]
[127.]Female Child showing the results of Poliomyelitis affecting the Left Lower Extremity[243]
[128.]Radiogram of Double Congenital Dislocation of Hip in a Girl[249]
[129.]Innominate Bone and Upper End of Femur from a case of Congenital Dislocation of Hip[250]
[130.]Congenital Dislocation of Left Hip in a Girl[251]
[131.]Contracture Deformities of Upper and Lower Limbs resulting from Spastic Cerebral Palsy in Infancy[255]
[132.]Rachitic Coxa Vara[258]
[133.]Coxa Vara, showing Adduction Curvature of Neck of Femur associated with Arthritis of the Hip and Knee[260]
[134.]Bilateral Coxa Vara, showing Scissors-leg Deformity[260]
[135.]Genu Valgum and Genu Varum[265]
[136.]Female Child with Right-sided Genu Valgum, the result of Rickets[266]
[137.]Double Genu Valgum; and Rickety Deformities of Arms[267]
[138.]Radiogram of Case of Double Genu Valgum in a Child[268]
[139.]Genu Valgum in a Child. Patient standing[269]
[140.]Genu Valgum. Same Patient as [Fig. 139], sitting[270]
[141.]Bow-knee in Rickety Child[271]
[142.]Bilateral Congenital Club-foot in an Infant[274]
[143.]Radiogram of Bilateral Congenital Club-foot in an Infant[275]
[144.]Congenital Talipes Equino-varus in a Man[277]
[145.]Bilateral Pes Equinus in a Boy[280]
[146.]Extreme form of Pes Equinus in a Girl[281]
[147.]Skeleton of Foot from case of Pes Equinus due to Poliomyelitis[282]
[148.]Pes Calcaneo-valgus with excessive arching of Foot[284]
[149.]Pes Calcaneo-valgus, the result of Poliomyelitis[285]
[150.]Pes Cavus in Association with Pes Equinus, the Result of Poliomyelitis[286]
[151.]Radiogram of Foot of Adult, showing Changes in the Bones in Pes Cavus[286]
[152.]Adolescent Flat-Foot[287]
[153.]Flat-Foot, showing Loss of Arch[288]
[154.]Imprint of Normal and of Flat Foot[290]
[155.]Bilateral Pes Valgus and Hallux Valgus in a Girl[293]
[156.]Radiogram of Spur on Under Aspect of Calcaneus[295]
[157.]Radiogram of Hallux Valgus[296]
[158.]Radiogram of Hallux Varus or Pigeon-Toe[298]
[159.]Hallux Rigidus and Flexus in a Boy[299]
[160.]Hammer-Toe[300]
[161.]Section of Hammer-Toe[301]
[162.]Congenital Hypertrophy of Left Lower Extremity in a Boy[302]
[163.]Supernumerary Great Toe[303]
[164.]Congenital Elevation of Left Scapula in a Girl: also shows Hairy Mole over Sacrum[304]
[165.]Winged Scapula[305]
[166.]Arrested Growth and Wasting of Tissues of Right Upper Extremity[307]
[167.]Lower End of Humerus from case of Cubitus Varus[309]
[168.]Intra-Uterine Amputation of Forearm[310]
[169.]Radiogram of Arm of Patient shown in [Fig. 168][310]
[170.]Congenital Absence of Left Radius and Tibia in a Child[311]
[171.]Club-Hand, the Result of Imperfect Development of Radius[312]
[172.]Congenital Contraction of Ring and Little Fingers[314]
[173.]Dupuytren's Contraction[315]
[174.]Splint used after Operation for Dupuytren's Contraction[316]
[175.]Supernumerary Thumb[317]
[176.]Trigger Finger[318]
[177.]Multiple Wens[324]
[178.]Adenoma of Scalp[325]
[179.]Relations of the Motor and Sensory Areas to the Convolutions and to Chiene's Lines[330]
[180.]Diagram of the Course of Motor and Sensory Nerve Fibres[333]
[181.]Chiene's Method of Cerebral Localisation[336]
[182.]To illustrate the Site of Various Operations on the Skull[337]
[183.]Localisation of Site for Introduction of Needle in Lumbar Puncture[338]
[184.]Contusion and Laceration of Brain[343]
[185.]Charts of Pyrexia in Head Injuries[348]
[186.]Relations of the Middle Meningeal Artery and Lateral Sinus to the Surface as indicated by Chiene's Lines[353]
[187.]Extra-Dural Clot resulting from Hæmorrhage from the Middle Meningeal Artery[354]
[188.]Depressed Fracture of Frontal Bones with Fissured Fracture[365]
[189.]Depressed and Comminuted Fracture of Right Parietal Bone: Pond Fracture[365]
[190.]Pond Fracture of Left Frontal Bone, produced during Delivery[366]
[191.]Transverse Fracture through Middle Fossa of Base of Skull[368]
[192.]Diagram of Extra-Dural Abscess[374]
[193.]Pott's Puffy Tumour in case of Extra-Dural Abscess following Compound Fracture of Orbital Margin[375]
[194.]Diagram of Sub-Dural Abscess[376]
[195.]Diagram illustrating sequence of Paralysis, caused by Abscess in Temporal Lobe[380]
[196.]Chart of case of Sinus Phlebitis following Middle Ear Disease[384]
[197.]Occipital Meningocele[388]
[198.]Frontal Hydrencephalocele[389]
[199.]Nævus at Root of Nose, simulating Cephalocele[390]
[200.]Hydrocephalus in a Child[391]
[201.]Patient suffering from Left Facial Paralysis[402]
[202.]Skull of Woman illustrating the appearances of Tertiary Syphilis of Frontal Bone—Corona Veneris—in the Healed Condition[408]
[203.]Sarcoma of Orbital Plate of Frontal Bone in a Child at Age of 11 months and 18 months[409]
[204.]Destruction of Bones of Left Orbit, caused by Rodent Cancer[410]
[205.]Distribution of the Segments of the Spinal Cord[417]
[206.]Attitude of Upper Extremities in Traumatic Lesions of the Sixth Cervical Segment[418]
[207.]Compression Fracture of Bodies of Third and Fourth Lumbar Vertebræ[426]
[208.]Fracture-Dislocation of Ninth Thoracic Vertebra[428]
[209.]Fracture of Odontoid Process of Axis Vertebra[429]
[210.]Tuberculous Osteomyelitis affecting several Vertebræ at Thoracico-Lumbar Junction[432]
[211.]Osseous Ankylosis of Bodies (a) of Dorsal Vertebræ, (b) of Lumbar Vertebræ following Pott's Disease[434]
[212.]Radiogram of Museum Specimen of Pott's Disease in a Child[435]
[213.]Radiogram of Child's Thorax showing Spindle-shaped Shadow at Site of Pott's Disease of Fourth, Fifth, and Sixth Thoracic Vertebræ[437]
[214.]Attitude of Patient suffering from Tuberculous Disease of the Cervical Spine[441]
[215.]Thomas' Double Splint for Tuberculous Disease of the Spine[442]
[216.]Hunch-back Deformity following Pott's Disease of Thoracic Vertebræ[443]
[217.]Attitude in Pott's Disease of Thoracico-Lumbar Region of Spine[444]
[218.]Arthritis Deformans of Spine[449]
[219.]Meningo-Myelocele of Thoracico-Lumbar Region[454]
[220.]Meningo-Myelocele of Cervical Spine[454]
[221.]Meningo-Myelocele in Thoracic Region[456]
[222.]Tail-like Appendage over Spina Bifida Occulta in a Boy[457]
[223.]Congenital Sacro-Coccygeal Tumour[458]
[224.]Scoliosis following upon Poliomyelitis affecting Right Arm and Leg[463]
[225.]Rickety Scoliosis in a Child[464]
[226.]Vertebræ from case of Scoliosis showing Alteration in Shape of Bones[466]
[227.]Adolescent Scoliosis in a Girl[467]
[228.]Scoliosis with Primary Curve in Thoracic Region[468]
[229.]Scoliosis showing Rotation of Bodies of Vertebræ, and widening of Intercostal Spaces on side of Convexity[469]
[230.]Diagram of Attitudes in Klapp's Four-Footed Exercises for Scoliosis[473]
[231.]Head of Human Embryo about 29 days old[475]
[232.]Simple Hare-Lip[476]
[233.]Unilateral Hare-Lip with Cleft Alveolus[477]
[234.]Double Hare-Lip in a Girl[478]
[235.]Double Hare-Lip with Projection of the Os Incisivum[479]
[236.]Asymmetrical Cleft Palate extending through Alveolar Process on Left Side[480]
[237.]Illustrating the Deformities caused by Lupus Vulgaris[483]
[238.]Sarcoma of Orbit causing Exophthalmos and Downward Displacement of the Eye, and Projecting in Temporal Region[488]
[239.]Sarcoma of Eyelid in Child[489]
[240.]Dermoid Cyst at Outer Angle of Orbital Margin[490]
[241.]Macrocheilia[492]
[242.]Squamous Epithelioma of Lower Lip in a Man[493]
[243.]Advanced Epithelioma of Lower Lip[494]
[244.]Recurrent Epithelioma in Glands of Neck adherent to Mandible[495]
[245.]Cancrum Oris[497]
[246.]Perforation of Palate, the Result of Syphilis, and Gumma of Right Frontal Bone[498]
[247.]Cario-necrosis of Mandible[510]
[248.]Diffuse Syphilitic Disease of Mandible[512]
[249.]Epulis of Mandible[513]
[250.]Sarcoma of the Maxilla[515]
[251.]Malignant Disease of Left Maxilla[516]
[252.]Dentigerous Cyst of Mandible containing Rudimentary Tooth[517]
[253.]Osseous Shell of Myeloma of Mandible[518]
[254.]Multiple Fracture of Mandible[520]
[255.]Four-Tailed Bandage applied for Fracture of Mandible[522]
[256.]Defective Development of Mandible from Fixation of Jaw due to Tuberculous Osteomyelitis in Infancy[526]
[257.]Leucoplakia of the Tongue[531]
[258.]Papillomatous Angioma of Left Side of Tongue in a Woman[538]
[259.]Dermoid Cyst in Middle Line of Neck[539]
[260.]Temporary Unilateral Paralysis of Tongue[541]
[261.]Series of Salivary Calculi[545]
[262.]Acute Suppurative Parotitis[546]
[263.]Mixed Tumour of Parotid[550]
[264.]Mixed Tumour of the Parotid of over twenty years' duration[551]
[265.]Acute Mastoid Disease showing Œdema and Projection of Auricle[565]
[266.]Rhinophyma or Lipoma Nasi[569]
[267.]The Outer Wall of Left Nasal Chamber after removal of the Middle Turbinated Body[571]
[268.]Congenital Branchial Cyst in a Woman[584]
[269.]Bilateral Cervical Ribs[586]
[270.]Transient Wry-Neck[587]
[271.]Congenital Wry-Neck in a Boy[589]
[272.]Congenital Wry-Neck seen from behind to show Scoliosis[590]
[273.]Recovery from Suicidal Cut-Throat after Low Tracheotomy and Gastrostomy[596]
[274.]Hygroma of Neck[599]
[275.]Lympho-Sarcoma of Neck[600]
[276.]Branchial Carcinoma[601]
[277.]Parenchymatous Goitre in a Girl[606]
[278.]Larynx and Trachea surrounded by Goitre[607]
[279.]Section of Goitre shown in [Fig. 278] to illustrate Compression of Trachea[607]
[280.]Multiple Adenomata of Thyreoid in a Woman[611]
[281.]Cyst of Left Lobe of Thyreoid[612]
[282.]Exophthalmic Goitre[614]
[283.]Radiogram of Safety-Pin impacted in the Gullet and Perforating the Larynx[620]
[284.]Denture Impacted in Œsophagus[621]
[285.]Radiogram, after swallowing an Opaque Meal, in a Man suffering from Malignant Stricture of Lower End of Gullet[626]
[286.]Diverticulum of the Œsophagus at its Junction with the Pharynx[627]
[287.]Larynx from case of Sudden Death due to Œdema of Ary-Epiglottic Folds[637]
[288.]Papilloma of Larynx[641]

MANUAL OF SURGERY

CHAPTER I
INJURIES OF BONES

The injuries to which a bone is liable are Contusions, Open Wounds, and Fractures.

Contusions of Bone are almost of necessity associated with a similar injury of the overlying soft parts. The mildest degree consists in a bruising of the periosteum, which is raised from the bone by an effusion of blood, constituting a hæmatoma of the periosteum. This may be absorbed, or it may give place to a persistent thickening of the bone—traumatic node.