Surgical Anatomy Part 2

THE DISTINCTIVE DIAGNOSIS BETWEEN EXTERNAL AND INTERNAL INGUINAL HERNIAE, THE TAXIS, SEAT OF STRICTURE, AND THE OPERATION.

Both herniae compared as to position and structural characters. The co-existence of both rendering diagnosis difficult. The oblique changing to the direct hernia as to position, but not in relation to the epigastric artery. The taxis performed in reference to the position of both as regards the ca.n.a.l and abdominal rings. The seat of stricture varying. The sac. The lines of incision required to avoid the epigastric artery. Necessity for opening the sac.

COMMENTARY ON PLATES 39 & 40

DEMONSTRATIONS OF THE NATURE OF CONGENITAL AND INFANTILE INGUINAL HERNIAE, AND OF HYDROCELE.

Descent of the t.e.s.t.i.c.l.e. The t.e.s.t.i.c.l.e in the s.c.r.o.t.u.m. Isolation of its tunica v.a.g.i.n.alis. The tunica v.a.g.i.n.alis communicating with the abdomen.

Sacculated serous spermatic ca.n.a.l. Hydrocele of the isolated tunica v.a.g.i.n.alis. Congenital hernia and hydrocele. Infantile hernia. Oblique inguinal hernia. How formed and characterized.

COMMENTARY ON PLATES 41 & 42

DEMONSTRATIONS OF THE ORIGIN AND PROGRESS OF INGUINAL HERNIAE IN GENERAL.

Formation of the serous sac. Formation of congenital hernia. Hernia in the ca.n.a.l 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 t.e.s.t.i.c.l.e. Varieties of infantile hernia.

Sacculated cord. Oblique internal inguinal hernia--cannot be congenital.

Varieties of internal hernia. Direct external hernia. Varieties of the inguinal ca.n.a.l.

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 ca.n.a.l. 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 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 PRINc.i.p.aL 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.

Puncturation of the bladder by the r.e.c.t.u.m. The pudic artery.

COMMENTARY ON PLATES 50 & 51

THE SURGICAL DISSECTION OF THE SUPERFICIAL STRUCTURES OF THE MALE PERINAEUM.

Remarks on the median line. Congenital malformations. Extravasation of urine into the sac of the superficial fascia. Symmetry of the parts.

Surgical boundaries of the perinaeum. Median and lateral important parts to be avoided in lithotomy, and the operation for fistula in ano.

COMMENTARY ON PLATES 52 & 53

THE SURGICAL DISSECTION OF THE DEEP STRUCTURES OF THE MALE PERINAEUM; THE LATERAL OPERATION OF LITHOTOMY.

Relative position of the parts at the base of the bladder. Puncture of the bladder through the r.e.c.t.u.m and of the urethra in the perinaeum.

General rules for lithotomy.

COMMENTARY ON PLATES 54, 55, & 56

THE SURGICAL DISSECTION OF THE MALE BLADDER AND URETHRA; LATERAL AND BILATERAL LITHOTOMY COMPARED.

Lines of incision in both operations. Urethral muscles--their a.n.a.logies and significations. Direction, form, length, structure, &c., of the urethra at different ages. Third lobe of the prostate. Physiological remarks. Trigone vesical. Bas fond of the bladder. Natural form of the prostate at different ages.

COMMENTARY ON PLATES 57 & 58

CONGENITAL AND PATHOLOGICAL DEFORMITIES OF THE PREPUCE AND URETHRA; STRICTURES AND MECHANICAL OBSTRUCTIONS OF THE URETHRA.

General remarks. Congenital phymosis. Gonorrhoeal paraphymosis and phymosis. Effect of circ.u.mcision. Protrusion of the glans through an ulcerated opening in the prepuce. Congenital hypospadias. Ulcerated perforations of the urethra. Congenital epispadias. Urethral fistula, stricture, and catheterism. Sacculated urethra. Stricture opposite the bulb and the membranous portion of the urethra. Observations respecting the frequency of stricture in these parts. Calculus at the bulb. Polypus of the urethra. Calculus in its membranous portion. Stricture midway between the meatus and bulb. Old callous stricture, its form, &c.

Spasmodic stricture of the urethra by the urethral muscles. Organic stricture. Surgical observations.

COMMENTARY ON PLATES 59 & 60.

THE VARIOUS FORMS AND POSITIONS OF STRICTURES AND OTHER OBSTRUCTIONS OF THE URETHRA; FALSE Pa.s.sAGES; ENLARGEMENTS AND DEFORMITIES OF THE PROSTATE.

General remarks. Different forms of the organic stricture. Coexistence of several. Prostatic abscess distorting and constricting the urethra.

Perforation of the prostate by catheters. Series of gradual enlargements of the third lobe of the prostate. Distortion of the ca.n.a.l by the enlarged third lobe--by the irregular enlargement of the three lobes--by a nipple-shaped excrescence at the vesical orifice.

COMMENTARY ON PLATES 61 & 62

DEFORMITIES OF THE PROSTATE; DISTORTIONS AND OBSTRUCTIONS OF THE PROSTATIC URETHRA.

Observations on the nature of the prostate--its signification. Cases of prostate and bulb pouched by catheters. Obstructions of the vesical orifice. Sinuous prostatic ca.n.a.l. Distortions of the vesical orifice.

Large prostatic calculus. Sacculated prostate. Triple prostatic urethra.

Encrusted prostate. Fasciculated bladder. Prostatic sac distinct from the bladder. Practical remarks. Impaction of a large calculus in the prostate. Practical remarks.