Total price : $ 14.99
contact: 913-593-8774 mike
Monday, July 6, 2009
Wednesday, June 24, 2009
Highspeed Handpiece Maintenance Procedures
Highspeed Handpiece Maintenance Procedures
After each patient it is important to run cleaner through the drive air line before sterilization and
lubricate after sterilization.
Pre-Sterilization:
1. Clean external surface of handpiece by wiping with a damp toothbrush or paper towel.
Do NOT run under water. Wipe dry after clean.
2. Insert bur into chuck.
(Disregard steps 3 – 8 if you have a MaintenanceFree Turbine)
. Spray cleaner into drive air line for 2-3 seconds.
4. Rotate the bur back and forth between your fingers to loosen any debris inside the
handpiece head.
5. Operate handpiece over a paper towel to purge used lubricant and debris.
6. Repeat steps 3 - 5 until expelled fluid is completely clear.
7. Operate handpiece until all cleaner has been expelled.
8. Wipe external surface with a dry towel to remove expelled fluid.
9. Sterilize handpiece according to manufacturer’s instructions.
Post-Sterilization:
1. Allow sterilized handpiece to cool gradually to room temperature.
(Disregard steps 2 – 4 if you have a MaintenanceFree Turbine
2. Verify that the bur is securely in the chuck.
3. Apply 2 drops of lubricant into drive air line, or spray lubricant into drive air line for
2-3 seconds.
4. Operate handpiece for 30 seconds over a paper towel to expel excess lubricant from the
handpiece.
5. Wipe external surfaces with a dry towel.
6. Handpiece is ready for use.
Continued on back…
Quick 3-Hole 4-Hole 5-Hole
Connect
2-Hole
Drive Air Drive Air Drive Air Drive Air
Drive Air
Fiber Optic
6 Hole
Fiber Optic
Drive Air
DO-IT-YOURSELF REPAIR & PARTS
Push Button Chuck Maintenance
Twice a week
1. Remove bur from handpiece
2. Place 2 drops of handpiece oil into the chuck
3. Insert bur into the handpiece.
4. Run handpiece over a paper towel at 35 psi to expel excess lubricant.
If your push button chuck is stiff, after step 2 hold the chuck open and work the bur in and out to flush debris.
External Maintenance Tips
Never use any type of cold sterile, alcohol, or disinfectant on your handpiece.
Do NOT submerge handpiece in running water or ultra sonic cleaner.
1. To remove debris from the outside of the handpiece, use a damp toothbrush, then use a
dry paper towel to wipe off the outside of the handpiece. Discard the paper towel
in a biohazard bin.
2. Clean toothbrush with a cold sterile wipe or in an ultrasonic cleaner for 1 cycle.
3. Rinse toothbrush thoroughly in water before repeating the cleaning process.
4. To sterilize, see Pre-Sterilization instructions (on front page).
5. Check sterilizer temperature. It should be no higher than 276˚F (135˚C).
Other Helpful tips
Air pressure should be set to 30 – 35 psi. If running MaintenanceFree turbines, air
pressure should be set to 40 – 42 psi.
Always insert bur completely into chucks.
Never depress the push button to stop the bur.
Avoid dropping the handpiece.
Do NOT use cold sterile, alcohol or disinfectant on your handpiece.
Check sterilizer temperature. It should be no higher than 276캟/135캜
Before using handpiece or applying a load, be sure to run it for 10-15 seconds.
Use The Smart Cleaner to remove clogs from water lines. Contact us for more
information on The Smart Cleaner.
ProScore
1-800-726-7365
www.ScoreDental.com
Model trimmer saves time, effort, reduces electricity use
Handler has announced the 31UFAST Universal Foot Activated Solenoid Tap (patent pending).
The 31UFAST can save time, effort, and money by reducing electricity use and water consumption. The patented design is simple and can work with a manufacturer's model trimmer.
The 31UFAST allows the user to activate any model trimmer and water flow simultaneously. The 31UFAST comes complete with a small controller with built-in solenoid water valve, switch receptacle, circuit protection, one-fourth inch tubing to connect to water source and momentary foot switch.
Once the 31UFAST is installed, the user walks up and steps on the foot switch. This activates the trimmer and the water, trims each model. The operator then walks away and the trimmer finishes automatically, deactivating the power and water flow to the trimmer.
The trimmer reduces wear on equipment, saves energy, and stops water flow to conserve water. Handler model trimmers are available with the 31UFAST preinstalled or you can connect the 31UFAST to an existing trimmer.
Go to Handler Manufacturing, contact Handler directly at Handler Manufacturing or call (800) 274-2635 for more information.
Buffalo Dental introduces ThermaPlier™ for accentuating and making retentive undercuts on orthodontic appliances and mouthguards
This product reheats the critical retention area allowing emphasis without causing adjacent plastic to distort. You can adjust the temperature to a setting which allows the creation of dimples in the material you are working with but which does not burn the material. You can use the plier to make retentive undercuts on the orthodontic appliances and mouthguards.
For more information on Buffalo Dental or this product
Saturday, June 20, 2009
SURGICAL INSTRUMENTS AND APPLIANCES
INSTRUMENTS
INSTRUMENTS AND APPLIANCES . The purpose of this See also:
ARTICLE (from Lat. articulus, a joint)
article is to give an See also:
ACCOUNT
ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)
account of the more important surgical See also:
INSTRUMENTS
instruments that are now in See also:
GENERAL
GENERAL (Lat. generalis, of or relating to a genus, kind or class)
general use, and to show by what modifications, and from what discoveries in See also:
SCIENCE (Lat. scientia, from scire; to learn, know)
science, the See also:
PRESENT
present methods of an operation have come to be what they are . The See also:
GOOD, JOHN MASON (1764-1827)
good surgeon is easeful to use the right sort and See also:
PATTERN
pattern of See also:
INSTRUMENT (Lat. instrumentum, from insincere, to build up, furnish, arrange, prepare)
instrument, and the See also:
CHIEF (from Fr. chef, head, Lat. caput)
chief fact about the See also:
SURGERY
SURGERY (Fr. chirurgie, from Gr. Xetpoupyfa, i.e. hand-work)
surgery of the present See also:
DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
DAY, JOHN (1574-1640?)
DAY, THOMAS (1748-1789)
day, that it is aseptic or antiseptic, is recorded in the make of surgical instruments and in all the See also:
INSTALLATION
installation of an operating-See also:
THEATRE (BEarpov, " a place for seeing," from OeacOae)
theatre . Take, for instance, a scalpel and a saw that are figured in Ambroise See also:
PARE, AMBROISE (1510-1590)
Pare's (1510-1S9o) surgical writings . The scalpel folds into a handle like an See also:
ORDINARY (med. Lat. ordinarius, Fr. ordinaire)
ordinary See also:
POCKET
pocket-See also:
KNIFE (0. E. cuff, a word appearing in different forms in many Teutonic languages, cf. Du. knijf, Ger. Kneif, a shoe-maker's knife, Swed. knif; the ultimate origin is unknown; Skeat finds the origin in the root of " nip," formerly " knip "; Fr. canif is a
knife, which alone was enough in those days to keep it from being aseptic . The handle is most elegantly adorned with a little winged See also:
FEMALE
female figure, but it does not commend itself as likely to be surgically A B C Frc. r.—See also:
NEEDLE (O. Eng. ncedl; the word appears in various forms in Teutonic languages, Ger. Nadel, Dutch naal, the root being ne-, to sew, cf. Ger. nahen, and probably Lat. nere, to spin, Gr. vi)ats, spinning)
Needle-holders . A, See also:
HAGEDORN, FRIEDRICH VON (1708-1754)
Hagedorn's; B, Macphail's; C, See also:
ALLEN, BOG OF
ALLEN, ETHAN (1739–1789)
ALLEN, GRANT CHARLES GRANT BLAIRFINDIEI, (1848–1899)
ALLEN, JAMES LANE (1850– )
ALLEN, JOHN (1476–1534)
ALLEN, or ALLEYN, THOMAS (1542-1632)
ALLEN, WILLIAM (1532-1594)
ALLEN, WILLIAM FRANCIS (183o-1889)
Allen and Hanbury's, for Hageaorn or ordinary needles . clean . The saw, after the same See also:
FASHION (adapted from Fr. facon, agon, Lat. factio, making, facere, to do or make)
fashion, has a richly chased See also:
METAL
METAL (through Fr. from Lat. metallum, mine, quarry, adapted from Gr. µATaXAov, in the same sense, probably connected with ,ueraAAdv, to search after, explore, µeTa, after, aAAos, other)
metal See also:
FRAME
frame, and, at the end of the handle, a See also:
LION
LION (Lat, leo, leonis; Gr. Mew)
lion's See also:
HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
HEAD, SIR EDMUND WALKER, BART
HEAD, SIR FRANCIS BOND, BART
head in bold See also:
RELIEF
relief, with a See also:
RING (O.E. hring; a word common to Teutonic languages; and probably cognate with the Lat. circus, Gr. KtpKOS or KpLKOS, Skt'. chakra, wheel, circle, cf. also " harangue "); in art, a band of circular shape of varying sizes, made of any material and used f
ring through its mouth to hang it up by . It may be admirable See also:
ART
art, but it would See also:
HARBOUR (from M.E. hereberge, here, an army; cf. Ger. Heer and -beorg, protection or shelter. Other early forms in English were herberwe and haiborow, as seen in various place names, such as Market Harborough.. The French auberge, an inn, derived through
harbour all sorts of germs . If one contrasts with these See also:
ARTISTIC
artistic weapons the Fm . 2.-Tenotomy Knives forged in one piece. instruments of 185o, one finds no such adornment, and for general finish See also:
SAVIGNY, FRIEDRICH KARL VON (1779–1861)
Savigny's instruments would be hard to See also:
BEAT (a word common in various forms to the Teutonic languages; it is connected with the similar Romanic words derived from the Late Lat. battere)
beat; but the wooden or See also:
IVORY (Fr. ivoire, Lat. ebur)
IVORY, SIR JAMES (1765-1842)
ivory handles, cut with finely scored lines like the See also:
CROSS
cross-hatching of an See also:
ENGRAVING
engraving, are not more likely to be aseptic than the handles of Pare's instruments .
At the present See also:
TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
TIME, MEASUREMENT OF
TIME, STANDARD
time, instead of such handles as these, with See also:
BLADES, WILLIAM (1824-1890)
blades riveted into them, scalpels are forged out of one piece of See also:
STEEL, FLORA ANNIE (1847– )
steel, their handles are See also:
NICKEL
NICKEL (symbol Ni, atomic weight 58.68 (0=16))
nickel-plated and perfectly smooth, that they may afford no crevices, and may be boiled and immersed in carbolic lotion without tarnishing or rusting; tha scalpel has become just a single, smooth, See also:
PLAIN (O. Fr. plain, from Lat. plenum)
plain piece of metal, having this one purpose that it shall make an aseptic See also:
WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")
wound . In the same way the saw is made in one piece, if this be possible; anyhow, it must be, so far as possible, a See also:
SIMPLE
simple, smooth, unrusting metal instrument, that can be boiled and laid in lotion; it is a See also:
FOREIGN
foreign See also:
BODY
body that must be introduced into tissues susceptible of infection, and it must not carry infection with it . Or we may take, at different periods of surgery, the various kinds of ligature for the See also:
ARREST (Fr. arrester, arreeter, to stop or stay)
arrest of bleeding from a divided See also:
BLOOD
blood-See also:
VESSEL (O. Fr. vaissel, from a rare Lat. vascellum, dim. of vas, vase, urn)
vessel . In Pare's time (he was the first to use the ligature in amputation, but the existence of some sort of ligature is as See also:
RONTGEN, DAVID
RONTGEN, WILHELM KONRAD (1845– )
Rontgen Rays . old as See also:
GALEN (or GALENUS), CLAUDIUS
GALEN, CHRISTOPH BERNHARD, FREIHERR VON (16o6-1678)
Galen) the ligature was a See also:
DOUBLE
DOUBLE (from the Mid. Eng. duble, the form which gives the present pronunciation, through the Old Er. duble, from Lat. duplus, twice as much)
double See also:
THREAD (0. Eng. praed, literally, that which is twisted, prawan, to twist, to throw, cf. " throwster," a silk-winder, Ger. drehen, to twist, turn, Du. draad, Ger. Draht, thread, wire)
thread, bon flu qui soit en double; and he employed a forceps to draw forward the cut end of the vessel to be ligatured . From the time of Ambroise Fare to the time of See also:
LORD
LORD (O. Eng. hldford, i.e. hldfweard, the warder or keeper of bread, hlIf, loaf; the word is not represented in any other Teutonic language)
LORD, JOHN (1810-1894)
Lord See also:
LISTER, JOSEPH LISTER
LISTER, MARTIN (c. 1638-1712)
Lister no See also:
GREAT
great improvement was made . In the See also:
MIDDLE
middle of last See also:
CENTURY (from Lat. centuria, a division of a hundred men)
century it was no uncommon thing for the See also:
HOUSE
HOUSE (O. Eng. hiss, a word common to Teutonic languages, cf. Dut. huis, Ger. Haus; in Gothic it is only found in gudhiss, a temple; it may be ultimately connected with the root of " hide," conceal)
house-surgeon at an operation to hang a leash of waxed threads, See also:
SILK
silk or See also:
FLAX
flax, through his See also:
BUTTON (Fr. bouton, O. Fr. boton, apparently from the same root as bouter, to push)
button-hole, that they might be handy during the operation . Then came Lord Lister's See also:
WORK
work oa the absorbable ligature; and out of this and much other experimental work has come the present use of the ligature in its utmost perfection—a thread that can be tied, cut See also:
SHORT, FRANCIS JOB (1857– )
short, and See also:
LEFT
left in the See also:
DEPTH
depth of the wound, with See also:
ABSOLUTE (Lat. absolvere, to loose, set free)
absolute certainty that the wound may at once be closed from end to end and nothing more will ever be heard of the ligatures left buried in the tissues . The choice of materials for the ligature is wide . Some surgeons prefer See also:
CATGUT
catgut, variously prepared; others prefer silk; for certain purposes, as for the obliteration of a vessel not divided but tied in its course for the cure of aneurism, use is made of See also:
KANGAROO
kangaroo-tendon, or some other See also:
ANIMAL
ANIMAL (Lat. animalis, from anima, breath, soul)
animal substance . But what-ever is chosen is made aseptic by boiling, and is guarded vigilantly from contamination on its way from the sterilizer into the body of the patient . The old ligatures were a See also:
COMMON
common cause of suppuration .
Therefore the wound was not closed along its whole length, but the ligatures were left See also:
LONG, GEORGE (1800-1879)
LONG, JOHN DAVIS (1838– )
long, See also:
HANGING
hanging out of one end of the wound, and from day to day were gently pulled until they came away . Certainly they served thus to drain the wound, but they were themselves a chief cause of the suppuration that required drainage . Sutures, like ligatures, were a common cause of suppuration in or around the edges of the wound . Therefore, in the See also:
HOPE, ANTHONY
HOPE, THOMAS (c. 1770-1831)
hope of avoiding this trouble, they were made of See also:
SILVER
silver See also:
WIRE (A.S. wir, a wire; cf. Swed. vire, to twist, M.H.G. wiere, a gold ornament, Lat. viriae, armlets, ultimately from the root wi, to twist, bind)
wire, which was inconvenient to handle, and gave See also:
PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
PAIN, BARRY (1867– )
pain at the time of removal of the sutures . At the present time they are of silkworm-gut, catgut, silk or horsehair; they are made aseptic by boiling, and can be left any number of days without causing suppuration and can then be removed without pain . Next may come the See also:
CONSIDERATION (from Lat. considerare, to look at closely, examine, generally taken to be from con-, and the base seen in sidus, sideris, a star, the word being supposed to be originally an astrological or astronomical term)
consideration of surgical dressings . In the days when inflammation and suppuration were almost inevitable, the dressings were usually something very simple, that could be easily and frequently changed—ointment, or wet compresses, to begin with, and poultices when suppuration was established . It is reported of the great See also:
SIR
Sir See also:
WILLIAM
WILLIAM (1143-1214)
WILLIAM (1227-1256)
WILLIAM (1J33-1584)
WILLIAM (A.S. Wilhelm, O. Norse Vilhidlmr; O. H. Ger. Willahelm, Willahalm, M. H. Ger. Willehelm, Willehalm, Mod.Ger. Wilhelm; Du. Willem; O. Fr. Villalme, Mod. Fr. Guillaume; from " will," Goth. vilja, and " helm," Goth. hilms, Old Norse hidlmr, meaning
WILLIAM (c. 1130-C. 1190)
WILLIAM, 13TH
William See also:
FERGUSSON, JAMES (18o8-r886)
FERGUSSON, ROBERT (1750-1774)
FERGUSSON, SIR WILLIAM
Fergusson that he once told his students, " You may say what you like, gentlemen, but after all, there's no better dressing than See also:
COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude
cold See also:
WATER
water." This is not the See also:
PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)
place to try to tell the long See also:
HISTORY
history of the quest after a perfect surgical dressing, and the advance that was begun when Lord Lister invented his carbolic See also:
PASTE (O. Fr. paste, modern pate, Late Lat. pasta, whence also in Span., Port. and Ital., from Gr. 1r&vrrl or 1raara, barley porridge, or salted pottage, ir&ao'ety, to sprinkle with salt)
paste . The work was done slowly in the See also:
INTERNATIONAL, THE
international unity of science during many years . The perfect antiseptic dressing must fulfil many requirements: it must be absorbent, yet not let its medicament be too quickly soaked out of it; and it must be antiseptic, yet not virulent or poisonous . Of the many gauzesnow available, that which is chiefly used is one impregnated with a double See also:
CYANIDE
cyanide of See also:
ZINC
zinc and See also:
MERCURY
MERCURY (MERCU1uus)
MERCURY (symbol Hg, atomic weight = 2oo)
mercury . Its pleasant amethystine tint has no healing virtue, but is used to distinguish it from other gauzes—carbolized See also:
GAUZE
gauze, tinted See also:
STRAW
straw-See also:
COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)
colour; See also:
IODOFORM, CHI3
iodoform gauze, tinted yellow; sublimate, See also:
BLUE (common in different forms to most European languages)
blue; chinosol, See also:
GREEN, A
GREEN, ALEXANDER HENRY (1832—1896)
GREEN, DUFF (1791—1875)
GREEN, JOHN RICHARD (1837—1883)
GREEN, MATTHEW (1696-1737)
GREEN, THOMAS HILL (1836-1882)
GREEN, VALENTINE (1739–1813)
GREEN, WILLIAM HENRY (.1825–1900)
green .
The chinosol gauze is especially used in ophthalmic surgery; for general surgery the cyanide gauze is chiefly employed . The various preparations of absorbent See also:
WOOL, WORSTED AND WOOLLEN MANUFACTURES
wool (i.e. wool that has been freed of its grease, so that it readily takes up moisture) are used not only for outside dressings, but also as See also:
SPONGES
sponges at the time of operation, and have to a great extent done away with the use of real sponges . The gauzes in most cases are used not dry, but just wrung out of carbolic lotion, that their See also:
ANTI, or CAMPA
anti-septic See also:
INFLUENCE (Late Lat. influentia, from influere, to flow in)
influence may See also:
ACT (Lat. actus, actum)
act at once . The whole subject of surgical instruments may be considered in more ways than one . It may be well, for the See also:
SAKE
sake of clearing the ground, to take first some of the more common instruments of general surgery, and then to See also:
NOTE
NOTE (Lat. nota, mark, sign, from noscere, to know)
note the working out, in the operations of surgery, of the three great principles—the use of anaesthetics, the use of antiseptic or aseptic methods, and the surgical uses of See also:
ELECTRICITY
electricity . Of the essential instruments that are common to all operations, we may well believe that they have now become, by See also:
GRADUAL (Med. Lat. gradualis, of or belonging to steps or degrees; gradus, step)
gradual development, perfect . Take, for instance, the ordinary surgical needle . In the older forms the See also:
EYE
EYE (O. Eng. edge, Ger. Auge; derived from an Indo-European root also seen in Lat. oc-ulus, the organ of vision (q.v.)
eye was slit-shaped, not easily threaded, and the needle was often made of a triangular outline, like a See also:
MINIATURE
miniature See also:
BAYONET
bayonet . At the present time the needles used in general surgery are mostly Hagedorn's, which have a full-sized See also:
ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)
round eye, easy for threading, are See also:
FLAT (a modification of O. Eng. flet, an obsolete word of Teutonic origin, meaning the ground beneath the feet)
flat for their whole length and have a See also:
FINE
fine cutting edge on one See also:
SIDE
SIDE (mod. Eski Adalia)
side, near the point . Thus they enter the skin very easily, like a miniature knife, and the See also:
MINUTE
MINUTE (Lat. minutes, small; minuere, to make less)
minute wound they make is not a hole, but a tiny slit that is at once See also:
DRAWN
drawn together and, as it were, obliterated by the tying of the suture . Or, for another simple instrument in universal use, take the catch-forceps that is used for taking hold of a bleeding point till it is ligatured . This forceps is as old as the time of Pare, but he made use of a very heavy and clumsy pattern .
Up to the last few years the artery-forceps was made with broad, curved, fenestrated blades, with the catch set See also:
CLOSE
CLOSE (from Lat. clausum, shut)
CLOSE, MAXWELL HENRY (1822-1903)
close to the blades . At the present time the forceps in general use, named after Dr Nan in See also:
FRANCE
FRANCE, ANATOLE (1844– )
France and after Sir See also:
SPENCER
SPENCER, HERBERT (1820-1903)
SPENCER, JOHN CHARLES SPENCER, 3RD EARL (1782-1845)
SPENCER, JOHNPOYNTZ SPENCER
SPENCER, WILLIAM ROBERT (1769-1834)
Spencer See also:
WELLS
WELLS, CHARLES JEREMIAH (1798?–1879)
WELLS, DAVID AMES (1828—1898)
WELLS, HERBERT GEORGE (1866— )
WELLS, SIR THOMAS SPENCER, 1ST BART
Wells in See also:
ENGLAND
ENGLAND, THE CHURCH OF
England, is made with very narrow grooved blades, and the catch is placed not near the blades, but near the handles: thus it takes a surer hold, and can be set See also:
FREE
free when the ligature is tied by a moment's extra pressure on the handles . Among other instruments in universal use are See also:
DIVERS
divers forms of retractors, for holding gently the edges of a wound: the larger patterns are made with broad, slightly-See also:
CONCAVE
concave, highly-polished surfaces, that they may, so far as possible, reflect See also:
LIGHT
light into the wound . Among tourniquets, the old and elaborate See also:
PETIT, SIR DINSHAW MANECKJI, BART
Petit's tourniquet, which was a See also:
BAND
band carrying a See also:
PAD
pad screwed down over the See also:
MAIN (from the Aryan root which appears in " may " and " might," and Lat. magnus, great)
MAIN (Lat. Moenus)
main artery of the See also:
LIMB
limb, has given place to the elastic tourniquet with See also:
ESMARCH, JOHANNES FRIEDRICH AUGUST VON (1823-1908)
Esmarch's bandage . For example, in an amputation, or in an operation on a See also:
JOINT (through Fr. from Lat. junctum, jungere, to join)
joint or on a vessel or a See also:
NERVE (Lat. nervus, Gr. vevpov, a bowstring)
nerve in a limb, the limb is raised, and the Esmarch's elastic bandage is applied from below upward till it has reached a point well above the site of the operation; then an elastic tourniquet is wound round the limb at this point, the bandage is removed, and the limb is thus kept almost bloodless during the operation . b1G . 7.—Lithotrite (See also:
BIGELOW, JOHN (1817- )
Bigelow's) . It is not possible to describe here the many forms of other ordinary instruments of general surgery—probes, See also:
DIRECTORS
directors, See also:
SCISSORS
scissors, forceps, and many more—nor those that are used in operations on the bones . Nor again can the numerous instruments used in See also:
SPECIAL
special departments of surgery be discussed in detail . But, with regard to the special surgery of the eye, and of the See also:
THROAT (O. Eng. protu, prote or }Prota, possibly from preotan, to press, whence threat, or, with loss of initial s, connected with strut, to swell)
throat and See also:
EAR (common Teut.; O.E. are, Ger. Ohr, Du. oor, akin to Lat. auris, Gr. ovs)
ear, it is to be noted that the chief advance in treatment arose from the invention of the present instruments of diagnosis, and that these are of comparatively See also:
RECENT
recent date . The opthalmoscope was the work of See also:
HELMHOLTZ, HERMANN LUDWIG FERDINAND VON (1821-1894)
Helmholtz . The laryngoscope was invented by See also:
MANUEL, EUGENE (1823–1901)
MANUEL, JACQUES ANTOINE (1775-1827)
MANUEL, LOUIS PIERRE (1751-1793)
Manuel See also:
GARCIA
GARCIA (DEL POPOLO VICENTO), MANOEL (1775-1832)
Garcia in the middle of the 19th century; and the use of a frontal See also:
MIRROR (through O. Fr. mirour, mod. miroir, from a sup-posed Late Lat. miratorium, from mirari, to admire)
mirror, for focussing a strong light on the membrana tympani, in the, examination of the ear, was in use somewhat earlier .
Before the ophthalmoscope it was impossible to study the See also:
INTERNAL
internal diseases of the eye; before the laryngoscope the diseases of the larynx were invisible, and were mainly a See also:
MATTER
matter of guess-work, and of vague and often futile treat- ment . Before the use of the frontal mirror the diseases of the ear were hardly studied, in that sense in which they are studied now . The wonderful advance of the special departments of surgery was, of course, the result of many forces, but one of the chief of these tal/MiNi 1 Fm. lo.—Laryngoscope (See also:
LENNOX
LENNOX, CHARLOTTE (1720-1804)
LENNOX, MARGARET, COUNTESS OF (1515-1578)
Lennox See also:
BROWNE
BROWNE, EDWARD HAROLD (18,1–1891)
BROWNE, ISAAC HAWKINS (1705-1760)
BROWNE, JAMES (1793–1841)
BROWNE, MAXIMILIAN ULYSSES, COUNT VON, BARON DE CAMUS AND MOUNTANY (1705-1757)
BROWNE, PETER (?1665-1735)
BROWNE, ROBERT (1550-1633)
BROWNE, SIR JAMES (1839–1896)
BROWNE, SIR THOMAS (1605-1682)
BROWNE, WILLIAM (1591–1643)
BROWNE, WILLIAM GEORGE (1768-1813)
Browne's) . forces was the invention of proper instruments of diagnosis . The textbooks that were written immediately before those instruments became available were not far in advance of Ambroise Pare, so far as these special departments are concerned . It may be well next to consider in what ways the conduct of an operation is influenced by those two great discoveries of anaesthetics, and the more gradual development of the principles of antiseptic and aseptic surgery; with special reference to the use of the instruments of surgery . The See also:
JUBILEE (or JUBILE), YEAR OF
jubilee See also:
YEAR
year of See also:
ANAESTHESIA
anaesthesia was 1896; the first use of nitrous See also:
OXIDE
oxide was on the 11th of See also:
DECEMBER (Lat. decent, ten)
December 1844; the first operation under See also:
ETHER, (C2H5)2O
ether was on the 3oth of See also:
SEPTEMBER (Lat. septem, seven)
September 1846; the first use of See also:
CHLOROFORM (trichlor-methane), CHC13
chloroform was on the 4th of See also:
NOVEMBER (Lat. novem, nine)
November 1847 . The choice of the anaesthetic, or of some See also:
COMBINATION (Lat. combinare, to combine)
combination of anaesthetics, that is best suited to each particular See also:
CASE
CASE, JOHN (d. 1600)
case, is a matter of careful consideration; but, on the whole, the tendency in England is to keep to the via See also:
MEDIA
media between the more general use of chloroform in See also:
SCOTLAND
SCOTLAND, CHURCH OF
SCOTLAND, EPISCOPAL CHURCH OF
Scotland and the more general use of ether in the See also:
UNITED
United States . Of the methods of administering chloroform there is no need to say much; by some anaesthetists no instrument is used See also:
SAVE, or SAVA (Ger. Sau; Hungarian Szdva; Lat. Savus)
save a See also:
FOLD
fold of See also:
LINT (in M. Eng. linnet, probably through Fr. linette, from lin, the flax-plant; cf. " line ")
lint or some such stuff, or a piece of See also:
FLANNEL
flannel made into a sort of See also:
CONE (Gr. Kwvos)
cone or See also:
MASK (Fr. masque, apparently from med. Lat. mascus, masca, spectre, through Ital. maschera, Span. mascara)
mask . Use is generally made of a modification of " See also:
JUNKER, WILHELM (1840-1892)
Junker's inhaler," whereby the vapour o. chloroform Is administered by means of a See also:
HAND
HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
HAND, FERDINAND GOTTHELF (1786-185r)
hand-See also:
BALL (in Mid. Eng. bal; the word is probably cognate with " bale," Teutonic in origin, cf. also Lat. falls, and Gr. 7raXXa)
BALL, JOHN (1585-1640)
BALL, JOHN (1818-1889)
BALL, JOHN (d. 1381)
BALL, SIR ALEXANDER JOHN, BART
BALL, THOMAS (1819- )
ball . For the See also:
ADMINISTRATION (Lat. administrare, to serve)
administration of ether some See also:
FORM (Lat. forma)
form of See also:
CLOVER
Clover's inhaler is generally used, whereby the ether in a small metal chamber passes as vapour into an indiarubber bag, and there is combined with the patient's breath in See also:
PRO
pro- portions determined by the anaesthetist through-out the operation . The metal chamber is so de-signed that by turning it the exact proportion of ether to See also:
AIR (from an Indo-European root meaning " breathe," " blow ")
AIR, or ASBEN
air is fixed in accordance with the requirements of the case .
Of See also:
LATE
late years, by the use of an See also:
IRON [symbol Fe, atomic weight 55.85 (0=16)]
iron See also:
CYLINDER (Gr. KvAwSpos, from KvXivaety, to roll)
cylinder of nitrous oxide, connected by a See also:
TUBE (Lat. tuba)
tube with a Clover's inhaler, it is possible to begin with nitrous oxide, and to &o on, without interruption, with ether . More recently an admirable method has been devised of administering nitrous oxide with the admixture of air or of FIG . 1z.—See also:
GAS
Gas and Ether Apparatus See also:
OXYGEN (symbol 0, atomic weight 16)
oxygen in such a way (See also:
HEWITT, ABRAM STEVENS (1822-1903)
Hewitt's) . that the anaesthesia pro- duced by the gas may be maintained for time enough to allow of an operation of some length . The See also:
SERIES (a Latin word from serere, to join)
series of discoveries which, in its application to surgery, has brought about the present antiseptic and aseptic methods of operation, is concerned both with the shape or use of the instruments of surgery and with their preparation for use . The See also:
MERE
MERE, ADALBERT (1838-1909)
mere sterilization, by boiling or by steaming, of all instruments and dressings, is enough to ensure their freedom from the ordinary micro-organisms of suppuration; but the surgeon cannot See also:
BOIL
boil or See also:
STEAM
STEAM (0. Eng. steam, vapour, smoke, cf. Du. steam; the origin is unknown)
steam either himself or his patient . The preparation, therefore, of the surgeon's hands, and of the skin over the See also:
AREA
area of operation, is made not only by scrubbing with See also:
SOAP
soap and hot water, but by careful use of antiseptic lotions . Again, ligatures and sutures, which must be kept in stock ready for use, are kept, after careful sterilization, in antiseptic lotion, or are again sterilized immediately before an operation . Again, all towels used at an operation must be prepared, either by sterilization or by See also:
IMMERSION (Lat. immersio, dipping),
immersion in antiseptic lotion . The sterilization of all instruments and dressings is a simple matter: the usual sterilizer is a vessel like a See also:
FISH (O. Eng. fist, a word common to Teutonic languages, cf. Dutch visch, Ger. Fisch, Goth. fisks, cognate with the Lat. piscis)
FISH, HAMILTON (1808-1893)
fish-See also:
KETTLE, SIR RUPERT ALFRED (1817-1894)
kettle, with a perforated metal See also:
TRAY
tray in it, so that the instruments can be immersed in boiling water, and can be lifted on the tray and transferred straight from the sterilizer into vessels containing sterilized water or antiseptic lotion . For the sterilization of dressings an upper vessel is fitted to the sterilizer, so that the steam may permeate the dressings placed in it . In See also:
HOSPITAL (Lat. haspitalis, the adjective of hospes, host or guest)
hospital practice it is used also to sterilize all towels, aprons and the like in a large cylindrical vessel .
Sterilization by boiling or steaming, together with the use of antiseptic lotions, or of water that has been boiled, for all such things as cannot he boiled or steamed, is the essential principle of the surgery of the present day; and practically the antiseptic method and the aseptic method have become one, varying a little this way or that according to the nature and circumstances of the case . Beside anaesthetics and See also:
ANTISEPTICS (Gr. avrl, against, and 6177rrnKor, putrefactive)
antiseptics, there is a third series of discoveries that has profoundly influenced surgery—the use of the forces of electricity . The uses of electricity are fivefold . 1 . The Gaivano-Cautery.—The See also:
ORIGINAL
original form of the cautery, the fer ardent of Pate's time, for the arrest of See also:
HAEMORRHAGE (Gr. atµa, blood, and prryvvvac, to burst)
haemorrhage after amputation, was a terrible affair . Happily for mankind, his invention of the ligature put an end to this use of the cautery, but it was still used in a small number of other cases . Subsequently See also:
CLAUDE, JEAN (1619-1687)
Claude See also:
ANDRE, JOHN (1751-178o)
Andre Paquelin (h . 1836) invented a very ingenious form of cautery, a series of metal blades or points of different shapes and sizes, that could be fitted to a handle: these points were hollow inside, and were filled with fine See also:
PLATINUM [symbol Pt, atomic weight 145.0 (0=16)]
platinum gauze, and, by means of a See also:
BOTTLE (Fr. bouteille, from a diminutive of the Lat. butta, a flask; cf. Eng. " butt ")
bottle and hand-See also:
BELLOWS
BELLOWS, ALBERT F
BELLOWS, HENRY WHITNEY (1814-1882)
bellows they could be kept heated with See also:
BENZENE, C6H6
benzene-vapour . Thus, when they had once been raised to a glowing See also:
HEAT (0. E. haktu, which like " hot," Old Eng. hat, is from the Teutonic type haita, hit, to be hot; cf. Ger. hitze, heiss; Dutch, hitte, heet, &c.)
heat by holding them emie=z over a spirit-See also:
LAMP (from Gr. Xag ras, a torch, Xaµaav, to shine)
lamp, they could be kept at any desired heat . This instrument is still in use for a few cases where very rapid and extensive cauterization is necessary . But for all finer use of actual heat the galvano-cautery alone is used—a series of very minute points of platinum, with a suitable trigger-handle, connected with a See also:
BATTERY (Fr. batterie, from battles, to beat)
battery or (by means of a converter) with the ordinary house See also:
SUPPLY (through Fr. from Lat. supplere, to fill up)
supply of electricity . In this way it is possible to apply a glowing point with a fineness and accuracy of See also:
ADJUSTMENT (from late Lat. ad juxtare, derived from juxta, near, but early confounded with a supposed derivation from justus, right)
adjustment that were wholly impossible with Paquelin's cautery .
2 . See also:
ELECTROLYSIS (formed from Gr. Xbety, to loosen)
Electrolysis.--This method is of great value, in suitable cases, for the arrest or obliteration of small growths . The passage of the electric cur-See also:
RENT
rent between needles introduced into or under the skin brings about a gradual shrinking or cicatrization of the tissues subjected to it, without the See also:
PRODUCTION (Lat. productionem, from producere, to pro-duce)
production of any unsightly scar . 3 . Electro-Motor See also:
POWER [WILLIAM GRATTAN] TYRONE (1797-1841)
Power.—During recent years the use of a small electro-motor See also:
MACHINE
MACHINE (through Fr. from Lat. form machina of Gr. µnxavil)
machine has come into the practice of surgery for certain operations on the bones; especially for the operation for disease involving the mastoid See also:
BONE (a word common in various forms to Teutonic languages, in many of which it is confined to the shank of the leg, as in the German Bein)
BONE, HENRY (1755-1834)
bone . It is, of course, abetter method for the use of a fine See also:
DRILL
drill or See also:
BURR, AARON (1756-1836)
burr, for example, than the" dental See also:
ENGINE
ENGINE (Lat. ingenium)
engine," where the power is generated by a pedal turning a See also:
WHEEL (0. Eng. hweol, hweohl, &c., cognate with Icel. hjol, Dan. hiul, the Indo-European root is seen in Sanskrit chakra, Gr. r in Aos, circle, whence " cycle ")
WHEEL, BREAKING ON THE
wheel, and it will probably come into wide use both for dental surgery and for those operations of general surgery that require very gradual and delicate removal of small circumscribed areas of bone, especially of the See also:
CRANIAL
cranial bones . 4 . The X-Rays.--This, the most unexpected and, as it were, the most sensational See also:
DISCOVERY
discovery that has been bestowed on physicians and surgeons since the discovery of anaesthetics, is now used over a very wide and varied See also:
FIELD (a word common to many West German languages, cf. Ger. Feld, Dutch veld, possibly cognate with O.E. f olde, the earth, and ultimately with root of the Gr. irAaror, broad)
FIELD, CYRUS WEST (1819-1892)
FIELD, DAVID DUDLEY (18o5-1894)
FIELD, EUGENE (1850-1895)
FIELD, FREDERICK (18o1—1885)
FIELD, HENRY MARTYN (1822-1907)
FIELD, JOHN (1782—1837)
FIELD, MARSHALL (183 1906)
FIELD, NATHAN (1587—1633)
FIELD, STEPHEN JOHNSON (1816-1899)
FIELD, WILLIAM VENTRIS FIELD, BARON (1813-1907)
field of practice . Its value does not stop at the detection and localization of foreign bodies; indeed, this is but a small See also:
PART
part of its work . It is used constantly for cases of actual or suspected fracture or dislocation; for cases of congenital or acquired deformity; for cases involving difficulties of diagnosis between a swelling of the bone due to inflammation and a swelling due to a See also:
TUMOUR (Lat. tumor, a swelling)
tumour; and for obscure cases of See also:
SPINAL
spinal disease, See also:
HIP
hip disease and the like . Moreover, it has been found possible, by Dr See also:
HUGH
HUGH, ST
Hugh Walsham, and others to obtain pictures of the thoracic See also:
ORGANS
organs that are a very valuable See also:
GUIDE (in Mid. Eng. gyde, from the Fr. guide; the earlier French form was guie, English " guy," the d was due to the Italian form guida; the ultimate origin is probably Teutonic, the word being connected with the base seen in O. Eng. witan, to know)
guide in many obscure cases of disease of the lungs or of the pleura, and in many cases of thoracic aneurism or of See also:
INTRA
intra-thoracic tumour . Every year the number and the range of the cases where the X-rays are helpful for diagnosis and for treatment become greater; and it is impossible to say at what point the surgical value of this discovery will find its limits .
Beyond these uses, it is probable that the X-rays will maintain and extend the importance that they already have in the See also:
DIRECT
direct treatment of certain cases of disease of she skin (see X-See also:
RAY (Lat. raia)
RAY (or WRAY, as he wrote his name till 1670), JOHN (1628-1705)
RAY TREATMENT) . FIG . I7.—Urethroscope (See also:
FENWICK, SIR JOHN (c. 1645-1697)
Fenwick's), also 5 . The Electric Light.— used for ear, See also:
NOSE (O.Eng. nosu, cf. Dutch neus, Swed. nos, snout; the Aix in Provence. Both at Aix and at Lyons he acquired great connexion with O.Eng. nasu is obscure, cf. Ger. Nase, Lat. pares, distinction by his labours during outbreaks of the plague. In nostrils,
nose, throat, &c . Beside the general superiority of this light to other See also:
LIGHTS, CEREMONIAL USE OF
lights for the routine work of surgery, there are several special uses for it . Of these, the most important is the cystoscope, a long narrow tube, shaped and curved somewhat like a catheter, and having at its end a very minute glow-lamp and reflector, and a small window . Its other end is fitted with a See also:
LENS
LENS (from Lat. lens, lentil, on account of the similarity of the form of a lens to that of a lentil seed)
lens, and is connected by a switch with the main cur-rent . With this instrument, in skilled hands, it is possible to inspect the interior of the See also:
BLADDER (from A.S. blaeddre, connected with bl¢wan, to blow, cf. Ger. blase)
bladder, and in many cases to make an exact diagnosis under circumstances where otherwise it would be impossible . Another instance of the value of the electric lamp in diagnosis is given by the trans-See also:
ILLUMINATION
illumination of the facial bones in cases of suspected disease of the central cavity of the See also:
SUPERIOR
superior maxillary bone . A small glowlalnp is held in the closed mouth, in a darkened See also:
ROOM
room, and by a comparison of the shadows on the two sides of the See also:
FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)
face, thus trans-illuminated, an exact diagnosis can often be obtained as to the presence or See also:
ABSENCE (Lat. absentia)
absence of pus in FIG. i8.—Finsen-Reyn Lamp. this central cavity . Again, a small glow-lamp, duly sterilized, is often of great value in deep operations on the abdominal cavity . The bactericidal properties of light have long been demonstrated by Bie and others .
See also:
PROFESSOR (the Latin noun formed from the verb profiteri, to declare publicly, to acknowledge, profess)
Professor Niels Finsen of See also:
COPENHAGEN (Danish Kjobenhavn)
Copenhagen first used the ultra-See also:
VIOLET
violet rays of See also:
SOLAR, SOLLER (Lat. solarium, Fr.• galetas, Ital. solaio)
solar light in the treatment of skin diseases . notably of See also:
LUPUS (Lat. lupus, wolf)
LUPUS, PUBLIUS RUTILIUS
lupus . He later invented the lamp which bears his name . The original Finsen lamp comprised a voltaic arc of 6o to 8o amperes round which four tubes collected the light by See also:
QUARTZ
quartz lenses, the light being cooled by passing through water and the tubes being surrounded by a water-jacket . The usual exposure was one See also:
HOUR
hour . In the Finsen-Reyn modification now used, a single See also:
COLLECTING
collecting tube fitted on an adjustable stand is placed in front of a scissors arc lamp consuming 20 amperes . The rays are cooled and water-jacketed as in the original . A suitable quartz See also:
COMPRESSOR
compressor with a chamber containing circulating water is pressed upon the skin of the part to be treated and held at right angles to the impinging rays . The time of exposure is now reduced to See also:
FORTY
forty-five minutes . See also:
RADIUM (from Lat. radius, ray)
Radium when used in surgery is applied by means of applicators, either having the fixed salts on square or oblong metallic plates or cloths or by applicators having free radium in sealed metal tubes . These tubes are sometimes buried in the tissues . Sometimes a method of " screening " is adopted in See also:
ORDER
ORDER (through Fr. ordre, for earlier ordene, from Lat. ordo, ordinis, rank, service, arrangement; the ultimate source is generally taken to be the root seen in Lat. oriri, rise, arise, begin; cf. " origin ")
ORDER, HOLY
order to modify the intensity of the See also:
RADIATION, THEORY OF
radiation .
This is done by enveloping the tubes containing the radium in cases of silver, See also:
LEAD
LEAD (pronounced iced)
lead or nickel of various thicknesses . In this, known as the method of Dr Dominici, the a and rays are intercepted by the metal screens and the highly penetrative rays only applied to the morbid tissues . The illustrations in this article are by permission of Messrs Allen & Hanbury, See also:
LONDON
London, and that of the radium applicators , by permission of Messrs See also:
SIEMENS, ERNST WERNER VON (1816-1892)
SIEMENS, SIR WILLIAM [KARL WILHELM] (1823-1883)
Siemens See also:
BROTHERS, RICHARD (1757-1824)
Brothers, London .
End of Article: SURGICAL INSTRUMENTS AND APPLIANCES
INSTRUMENTS AND APPLIANCES . The purpose of this See also:
ARTICLE (from Lat. articulus, a joint)
article is to give an See also:
ACCOUNT
ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)
account of the more important surgical See also:
INSTRUMENTS
instruments that are now in See also:
GENERAL
GENERAL (Lat. generalis, of or relating to a genus, kind or class)
general use, and to show by what modifications, and from what discoveries in See also:
SCIENCE (Lat. scientia, from scire; to learn, know)
science, the See also:
PRESENT
present methods of an operation have come to be what they are . The See also:
GOOD, JOHN MASON (1764-1827)
good surgeon is easeful to use the right sort and See also:
PATTERN
pattern of See also:
INSTRUMENT (Lat. instrumentum, from insincere, to build up, furnish, arrange, prepare)
instrument, and the See also:
CHIEF (from Fr. chef, head, Lat. caput)
chief fact about the See also:
SURGERY
SURGERY (Fr. chirurgie, from Gr. Xetpoupyfa, i.e. hand-work)
surgery of the present See also:
DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
DAY, JOHN (1574-1640?)
DAY, THOMAS (1748-1789)
day, that it is aseptic or antiseptic, is recorded in the make of surgical instruments and in all the See also:
INSTALLATION
installation of an operating-See also:
THEATRE (BEarpov, " a place for seeing," from OeacOae)
theatre . Take, for instance, a scalpel and a saw that are figured in Ambroise See also:
PARE, AMBROISE (1510-1590)
Pare's (1510-1S9o) surgical writings . The scalpel folds into a handle like an See also:
ORDINARY (med. Lat. ordinarius, Fr. ordinaire)
ordinary See also:
pocket-See also:
KNIFE (0. E. cuff, a word appearing in different forms in many Teutonic languages, cf. Du. knijf, Ger. Kneif, a shoe-maker's knife, Swed. knif; the ultimate origin is unknown; Skeat finds the origin in the root of " nip," formerly " knip "; Fr. canif is a
knife, which alone was enough in those days to keep it from being aseptic . The handle is most elegantly adorned with a little winged See also:
FEMALE
female figure, but it does not commend itself as likely to be surgically A B C Frc. r.—See also:
NEEDLE (O. Eng. ncedl; the word appears in various forms in Teutonic languages, Ger. Nadel, Dutch naal, the root being ne-, to sew, cf. Ger. nahen, and probably Lat. nere, to spin, Gr. vi)ats, spinning)
Needle-holders . A, See also:
HAGEDORN, FRIEDRICH VON (1708-1754)
Hagedorn's; B, Macphail's; C, See also:
ALLEN, BOG OF
ALLEN, ETHAN (1739–1789)
ALLEN, GRANT CHARLES GRANT BLAIRFINDIEI, (1848–1899)
ALLEN, JAMES LANE (1850– )
ALLEN, JOHN (1476–1534)
ALLEN, or ALLEYN, THOMAS (1542-1632)
ALLEN, WILLIAM (1532-1594)
ALLEN, WILLIAM FRANCIS (183o-1889)
Allen and Hanbury's, for Hageaorn or ordinary needles . clean . The saw, after the same See also:
FASHION (adapted from Fr. facon, agon, Lat. factio, making, facere, to do or make)
fashion, has a richly chased See also:
METAL
METAL (through Fr. from Lat. metallum, mine, quarry, adapted from Gr. µATaXAov, in the same sense, probably connected with ,ueraAAdv, to search after, explore, µeTa, after, aAAos, other)
metal See also:
FRAME
frame, and, at the end of the handle, a See also:
LION
LION (Lat, leo, leonis; Gr. Mew)
lion's See also:
HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
HEAD, SIR EDMUND WALKER, BART
HEAD, SIR FRANCIS BOND, BART
head in bold See also:
RELIEF
relief, with a See also:
RING (O.E. hring; a word common to Teutonic languages; and probably cognate with the Lat. circus, Gr. KtpKOS or KpLKOS, Skt'. chakra, wheel, circle, cf. also " harangue "); in art, a band of circular shape of varying sizes, made of any material and used f
ring through its mouth to hang it up by . It may be admirable See also:
ART
art, but it would See also:
HARBOUR (from M.E. hereberge, here, an army; cf. Ger. Heer and -beorg, protection or shelter. Other early forms in English were herberwe and haiborow, as seen in various place names, such as Market Harborough.. The French auberge, an inn, derived through
harbour all sorts of germs . If one contrasts with these See also:
ARTISTIC
artistic weapons the Fm . 2.-Tenotomy Knives forged in one piece. instruments of 185o, one finds no such adornment, and for general finish See also:
SAVIGNY, FRIEDRICH KARL VON (1779–1861)
Savigny's instruments would be hard to See also:
BEAT (a word common in various forms to the Teutonic languages; it is connected with the similar Romanic words derived from the Late Lat. battere)
beat; but the wooden or See also:
IVORY (Fr. ivoire, Lat. ebur)
IVORY, SIR JAMES (1765-1842)
ivory handles, cut with finely scored lines like the See also:
CROSS
cross-hatching of an See also:
ENGRAVING
engraving, are not more likely to be aseptic than the handles of Pare's instruments .
At the present See also:
TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
TIME, MEASUREMENT OF
TIME, STANDARD
time, instead of such handles as these, with See also:
BLADES, WILLIAM (1824-1890)
blades riveted into them, scalpels are forged out of one piece of See also:
STEEL, FLORA ANNIE (1847– )
steel, their handles are See also:
NICKEL
NICKEL (symbol Ni, atomic weight 58.68 (0=16))
nickel-plated and perfectly smooth, that they may afford no crevices, and may be boiled and immersed in carbolic lotion without tarnishing or rusting; tha scalpel has become just a single, smooth, See also:
PLAIN (O. Fr. plain, from Lat. plenum)
plain piece of metal, having this one purpose that it shall make an aseptic See also:
WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")
wound . In the same way the saw is made in one piece, if this be possible; anyhow, it must be, so far as possible, a See also:
SIMPLE
simple, smooth, unrusting metal instrument, that can be boiled and laid in lotion; it is a See also:
FOREIGN
foreign See also:
BODY
body that must be introduced into tissues susceptible of infection, and it must not carry infection with it . Or we may take, at different periods of surgery, the various kinds of ligature for the See also:
ARREST (Fr. arrester, arreeter, to stop or stay)
arrest of bleeding from a divided See also:
BLOOD
blood-See also:
VESSEL (O. Fr. vaissel, from a rare Lat. vascellum, dim. of vas, vase, urn)
vessel . In Pare's time (he was the first to use the ligature in amputation, but the existence of some sort of ligature is as See also:
RONTGEN, DAVID
RONTGEN, WILHELM KONRAD (1845– )
Rontgen Rays . old as See also:
GALEN (or GALENUS), CLAUDIUS
GALEN, CHRISTOPH BERNHARD, FREIHERR VON (16o6-1678)
Galen) the ligature was a See also:
DOUBLE
DOUBLE (from the Mid. Eng. duble, the form which gives the present pronunciation, through the Old Er. duble, from Lat. duplus, twice as much)
double See also:
THREAD (0. Eng. praed, literally, that which is twisted, prawan, to twist, to throw, cf. " throwster," a silk-winder, Ger. drehen, to twist, turn, Du. draad, Ger. Draht, thread, wire)
thread, bon flu qui soit en double; and he employed a forceps to draw forward the cut end of the vessel to be ligatured . From the time of Ambroise Fare to the time of See also:
LORD
LORD (O. Eng. hldford, i.e. hldfweard, the warder or keeper of bread, hlIf, loaf; the word is not represented in any other Teutonic language)
LORD, JOHN (1810-1894)
Lord See also:
LISTER, JOSEPH LISTER
LISTER, MARTIN (c. 1638-1712)
Lister no See also:
GREAT
great improvement was made . In the See also:
MIDDLE
middle of last See also:
CENTURY (from Lat. centuria, a division of a hundred men)
century it was no uncommon thing for the See also:
HOUSE
HOUSE (O. Eng. hiss, a word common to Teutonic languages, cf. Dut. huis, Ger. Haus; in Gothic it is only found in gudhiss, a temple; it may be ultimately connected with the root of " hide," conceal)
house-surgeon at an operation to hang a leash of waxed threads, See also:
SILK
silk or See also:
FLAX
flax, through his See also:
BUTTON (Fr. bouton, O. Fr. boton, apparently from the same root as bouter, to push)
button-hole, that they might be handy during the operation . Then came Lord Lister's See also:
WORK
work oa the absorbable ligature; and out of this and much other experimental work has come the present use of the ligature in its utmost perfection—a thread that can be tied, cut See also:
SHORT, FRANCIS JOB (1857– )
short, and See also:
LEFT
left in the See also:
DEPTH
depth of the wound, with See also:
ABSOLUTE (Lat. absolvere, to loose, set free)
absolute certainty that the wound may at once be closed from end to end and nothing more will ever be heard of the ligatures left buried in the tissues . The choice of materials for the ligature is wide . Some surgeons prefer See also:
CATGUT
catgut, variously prepared; others prefer silk; for certain purposes, as for the obliteration of a vessel not divided but tied in its course for the cure of aneurism, use is made of See also:
KANGAROO
kangaroo-tendon, or some other See also:
ANIMAL
ANIMAL (Lat. animalis, from anima, breath, soul)
animal substance . But what-ever is chosen is made aseptic by boiling, and is guarded vigilantly from contamination on its way from the sterilizer into the body of the patient . The old ligatures were a See also:
COMMON
common cause of suppuration .
Therefore the wound was not closed along its whole length, but the ligatures were left See also:
LONG, GEORGE (1800-1879)
LONG, JOHN DAVIS (1838– )
long, See also:
HANGING
hanging out of one end of the wound, and from day to day were gently pulled until they came away . Certainly they served thus to drain the wound, but they were themselves a chief cause of the suppuration that required drainage . Sutures, like ligatures, were a common cause of suppuration in or around the edges of the wound . Therefore, in the See also:
HOPE, ANTHONY
HOPE, THOMAS (c. 1770-1831)
hope of avoiding this trouble, they were made of See also:
SILVER
silver See also:
WIRE (A.S. wir, a wire; cf. Swed. vire, to twist, M.H.G. wiere, a gold ornament, Lat. viriae, armlets, ultimately from the root wi, to twist, bind)
wire, which was inconvenient to handle, and gave See also:
PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
PAIN, BARRY (1867– )
pain at the time of removal of the sutures . At the present time they are of silkworm-gut, catgut, silk or horsehair; they are made aseptic by boiling, and can be left any number of days without causing suppuration and can then be removed without pain . Next may come the See also:
CONSIDERATION (from Lat. considerare, to look at closely, examine, generally taken to be from con-, and the base seen in sidus, sideris, a star, the word being supposed to be originally an astrological or astronomical term)
consideration of surgical dressings . In the days when inflammation and suppuration were almost inevitable, the dressings were usually something very simple, that could be easily and frequently changed—ointment, or wet compresses, to begin with, and poultices when suppuration was established . It is reported of the great See also:
SIR
Sir See also:
WILLIAM
WILLIAM (1143-1214)
WILLIAM (1227-1256)
WILLIAM (1J33-1584)
WILLIAM (A.S. Wilhelm, O. Norse Vilhidlmr; O. H. Ger. Willahelm, Willahalm, M. H. Ger. Willehelm, Willehalm, Mod.Ger. Wilhelm; Du. Willem; O. Fr. Villalme, Mod. Fr. Guillaume; from " will," Goth. vilja, and " helm," Goth. hilms, Old Norse hidlmr, meaning
WILLIAM (c. 1130-C. 1190)
WILLIAM, 13TH
William See also:
FERGUSSON, JAMES (18o8-r886)
FERGUSSON, ROBERT (1750-1774)
FERGUSSON, SIR WILLIAM
Fergusson that he once told his students, " You may say what you like, gentlemen, but after all, there's no better dressing than See also:
COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude
cold See also:
WATER
water." This is not the See also:
PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)
place to try to tell the long See also:
HISTORY
history of the quest after a perfect surgical dressing, and the advance that was begun when Lord Lister invented his carbolic See also:
PASTE (O. Fr. paste, modern pate, Late Lat. pasta, whence also in Span., Port. and Ital., from Gr. 1r&vrrl or 1raara, barley porridge, or salted pottage, ir&ao'ety, to sprinkle with salt)
paste . The work was done slowly in the See also:
INTERNATIONAL, THE
international unity of science during many years . The perfect antiseptic dressing must fulfil many requirements: it must be absorbent, yet not let its medicament be too quickly soaked out of it; and it must be antiseptic, yet not virulent or poisonous . Of the many gauzesnow available, that which is chiefly used is one impregnated with a double See also:
CYANIDE
cyanide of See also:
ZINC
zinc and See also:
MERCURY
MERCURY (MERCU1uus)
MERCURY (symbol Hg, atomic weight = 2oo)
mercury . Its pleasant amethystine tint has no healing virtue, but is used to distinguish it from other gauzes—carbolized See also:
GAUZE
gauze, tinted See also:
STRAW
straw-See also:
COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)
colour; See also:
IODOFORM, CHI3
iodoform gauze, tinted yellow; sublimate, See also:
BLUE (common in different forms to most European languages)
blue; chinosol, See also:
GREEN, A
GREEN, ALEXANDER HENRY (1832—1896)
GREEN, DUFF (1791—1875)
GREEN, JOHN RICHARD (1837—1883)
GREEN, MATTHEW (1696-1737)
GREEN, THOMAS HILL (1836-1882)
GREEN, VALENTINE (1739–1813)
GREEN, WILLIAM HENRY (.1825–1900)
green .
The chinosol gauze is especially used in ophthalmic surgery; for general surgery the cyanide gauze is chiefly employed . The various preparations of absorbent See also:
WOOL, WORSTED AND WOOLLEN MANUFACTURES
wool (i.e. wool that has been freed of its grease, so that it readily takes up moisture) are used not only for outside dressings, but also as See also:
SPONGES
sponges at the time of operation, and have to a great extent done away with the use of real sponges . The gauzes in most cases are used not dry, but just wrung out of carbolic lotion, that their See also:
ANTI, or CAMPA
anti-septic See also:
INFLUENCE (Late Lat. influentia, from influere, to flow in)
influence may See also:
ACT (Lat. actus, actum)
act at once . The whole subject of surgical instruments may be considered in more ways than one . It may be well, for the See also:
SAKE
sake of clearing the ground, to take first some of the more common instruments of general surgery, and then to See also:
NOTE
NOTE (Lat. nota, mark, sign, from noscere, to know)
note the working out, in the operations of surgery, of the three great principles—the use of anaesthetics, the use of antiseptic or aseptic methods, and the surgical uses of See also:
ELECTRICITY
electricity . Of the essential instruments that are common to all operations, we may well believe that they have now become, by See also:
GRADUAL (Med. Lat. gradualis, of or belonging to steps or degrees; gradus, step)
gradual development, perfect . Take, for instance, the ordinary surgical needle . In the older forms the See also:
EYE
EYE (O. Eng. edge, Ger. Auge; derived from an Indo-European root also seen in Lat. oc-ulus, the organ of vision (q.v.)
eye was slit-shaped, not easily threaded, and the needle was often made of a triangular outline, like a See also:
MINIATURE
miniature See also:
BAYONET
bayonet . At the present time the needles used in general surgery are mostly Hagedorn's, which have a full-sized See also:
ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)
round eye, easy for threading, are See also:
FLAT (a modification of O. Eng. flet, an obsolete word of Teutonic origin, meaning the ground beneath the feet)
flat for their whole length and have a See also:
FINE
fine cutting edge on one See also:
SIDE
SIDE (mod. Eski Adalia)
side, near the point . Thus they enter the skin very easily, like a miniature knife, and the See also:
MINUTE
MINUTE (Lat. minutes, small; minuere, to make less)
minute wound they make is not a hole, but a tiny slit that is at once See also:
DRAWN
drawn together and, as it were, obliterated by the tying of the suture . Or, for another simple instrument in universal use, take the catch-forceps that is used for taking hold of a bleeding point till it is ligatured . This forceps is as old as the time of Pare, but he made use of a very heavy and clumsy pattern .
Up to the last few years the artery-forceps was made with broad, curved, fenestrated blades, with the catch set See also:
CLOSE
CLOSE (from Lat. clausum, shut)
CLOSE, MAXWELL HENRY (1822-1903)
close to the blades . At the present time the forceps in general use, named after Dr Nan in See also:
FRANCE
FRANCE, ANATOLE (1844– )
France and after Sir See also:
SPENCER
SPENCER, HERBERT (1820-1903)
SPENCER, JOHN CHARLES SPENCER, 3RD EARL (1782-1845)
SPENCER, JOHNPOYNTZ SPENCER
SPENCER, WILLIAM ROBERT (1769-1834)
Spencer See also:
WELLS
WELLS, CHARLES JEREMIAH (1798?–1879)
WELLS, DAVID AMES (1828—1898)
WELLS, HERBERT GEORGE (1866— )
WELLS, SIR THOMAS SPENCER, 1ST BART
Wells in See also:
ENGLAND
ENGLAND, THE CHURCH OF
England, is made with very narrow grooved blades, and the catch is placed not near the blades, but near the handles: thus it takes a surer hold, and can be set See also:
FREE
free when the ligature is tied by a moment's extra pressure on the handles . Among other instruments in universal use are See also:
DIVERS
divers forms of retractors, for holding gently the edges of a wound: the larger patterns are made with broad, slightly-See also:
CONCAVE
concave, highly-polished surfaces, that they may, so far as possible, reflect See also:
LIGHT
light into the wound . Among tourniquets, the old and elaborate See also:
PETIT, SIR DINSHAW MANECKJI, BART
Petit's tourniquet, which was a See also:
BAND
band carrying a See also:
PAD
pad screwed down over the See also:
MAIN (from the Aryan root which appears in " may " and " might," and Lat. magnus, great)
MAIN (Lat. Moenus)
main artery of the See also:
LIMB
limb, has given place to the elastic tourniquet with See also:
ESMARCH, JOHANNES FRIEDRICH AUGUST VON (1823-1908)
Esmarch's bandage . For example, in an amputation, or in an operation on a See also:
JOINT (through Fr. from Lat. junctum, jungere, to join)
joint or on a vessel or a See also:
NERVE (Lat. nervus, Gr. vevpov, a bowstring)
nerve in a limb, the limb is raised, and the Esmarch's elastic bandage is applied from below upward till it has reached a point well above the site of the operation; then an elastic tourniquet is wound round the limb at this point, the bandage is removed, and the limb is thus kept almost bloodless during the operation . b1G . 7.—Lithotrite (See also:
BIGELOW, JOHN (1817- )
Bigelow's) . It is not possible to describe here the many forms of other ordinary instruments of general surgery—probes, See also:
DIRECTORS
directors, See also:
SCISSORS
scissors, forceps, and many more—nor those that are used in operations on the bones . Nor again can the numerous instruments used in See also:
SPECIAL
special departments of surgery be discussed in detail . But, with regard to the special surgery of the eye, and of the See also:
THROAT (O. Eng. protu, prote or }Prota, possibly from preotan, to press, whence threat, or, with loss of initial s, connected with strut, to swell)
throat and See also:
EAR (common Teut.; O.E. are, Ger. Ohr, Du. oor, akin to Lat. auris, Gr. ovs)
ear, it is to be noted that the chief advance in treatment arose from the invention of the present instruments of diagnosis, and that these are of comparatively See also:
RECENT
recent date . The opthalmoscope was the work of See also:
HELMHOLTZ, HERMANN LUDWIG FERDINAND VON (1821-1894)
Helmholtz . The laryngoscope was invented by See also:
MANUEL, EUGENE (1823–1901)
MANUEL, JACQUES ANTOINE (1775-1827)
MANUEL, LOUIS PIERRE (1751-1793)
Manuel See also:
GARCIA
GARCIA (DEL POPOLO VICENTO), MANOEL (1775-1832)
Garcia in the middle of the 19th century; and the use of a frontal See also:
MIRROR (through O. Fr. mirour, mod. miroir, from a sup-posed Late Lat. miratorium, from mirari, to admire)
mirror, for focussing a strong light on the membrana tympani, in the, examination of the ear, was in use somewhat earlier .
Before the ophthalmoscope it was impossible to study the See also:
INTERNAL
internal diseases of the eye; before the laryngoscope the diseases of the larynx were invisible, and were mainly a See also:
MATTER
matter of guess-work, and of vague and often futile treat- ment . Before the use of the frontal mirror the diseases of the ear were hardly studied, in that sense in which they are studied now . The wonderful advance of the special departments of surgery was, of course, the result of many forces, but one of the chief of these tal/MiNi 1 Fm. lo.—Laryngoscope (See also:
LENNOX
LENNOX, CHARLOTTE (1720-1804)
LENNOX, MARGARET, COUNTESS OF (1515-1578)
Lennox See also:
BROWNE
BROWNE, EDWARD HAROLD (18,1–1891)
BROWNE, ISAAC HAWKINS (1705-1760)
BROWNE, JAMES (1793–1841)
BROWNE, MAXIMILIAN ULYSSES, COUNT VON, BARON DE CAMUS AND MOUNTANY (1705-1757)
BROWNE, PETER (?1665-1735)
BROWNE, ROBERT (1550-1633)
BROWNE, SIR JAMES (1839–1896)
BROWNE, SIR THOMAS (1605-1682)
BROWNE, WILLIAM (1591–1643)
BROWNE, WILLIAM GEORGE (1768-1813)
Browne's) . forces was the invention of proper instruments of diagnosis . The textbooks that were written immediately before those instruments became available were not far in advance of Ambroise Pare, so far as these special departments are concerned . It may be well next to consider in what ways the conduct of an operation is influenced by those two great discoveries of anaesthetics, and the more gradual development of the principles of antiseptic and aseptic surgery; with special reference to the use of the instruments of surgery . The See also:
JUBILEE (or JUBILE), YEAR OF
jubilee See also:
YEAR
year of See also:
ANAESTHESIA
anaesthesia was 1896; the first use of nitrous See also:
OXIDE
oxide was on the 11th of See also:
DECEMBER (Lat. decent, ten)
December 1844; the first operation under See also:
ETHER, (C2H5)2O
ether was on the 3oth of See also:
SEPTEMBER (Lat. septem, seven)
September 1846; the first use of See also:
CHLOROFORM (trichlor-methane), CHC13
chloroform was on the 4th of See also:
NOVEMBER (Lat. novem, nine)
November 1847 . The choice of the anaesthetic, or of some See also:
COMBINATION (Lat. combinare, to combine)
combination of anaesthetics, that is best suited to each particular See also:
CASE
CASE, JOHN (d. 1600)
case, is a matter of careful consideration; but, on the whole, the tendency in England is to keep to the via See also:
MEDIA
media between the more general use of chloroform in See also:
SCOTLAND
SCOTLAND, CHURCH OF
SCOTLAND, EPISCOPAL CHURCH OF
Scotland and the more general use of ether in the See also:
UNITED
United States . Of the methods of administering chloroform there is no need to say much; by some anaesthetists no instrument is used See also:
SAVE, or SAVA (Ger. Sau; Hungarian Szdva; Lat. Savus)
save a See also:
FOLD
fold of See also:
LINT (in M. Eng. linnet, probably through Fr. linette, from lin, the flax-plant; cf. " line ")
lint or some such stuff, or a piece of See also:
FLANNEL
flannel made into a sort of See also:
CONE (Gr. Kwvos)
cone or See also:
MASK (Fr. masque, apparently from med. Lat. mascus, masca, spectre, through Ital. maschera, Span. mascara)
mask . Use is generally made of a modification of " See also:
JUNKER, WILHELM (1840-1892)
Junker's inhaler," whereby the vapour o. chloroform Is administered by means of a See also:
HAND
HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
HAND, FERDINAND GOTTHELF (1786-185r)
hand-See also:
BALL (in Mid. Eng. bal; the word is probably cognate with " bale," Teutonic in origin, cf. also Lat. falls, and Gr. 7raXXa)
BALL, JOHN (1585-1640)
BALL, JOHN (1818-1889)
BALL, JOHN (d. 1381)
BALL, SIR ALEXANDER JOHN, BART
BALL, THOMAS (1819- )
ball . For the See also:
ADMINISTRATION (Lat. administrare, to serve)
administration of ether some See also:
FORM (Lat. forma)
form of See also:
CLOVER
Clover's inhaler is generally used, whereby the ether in a small metal chamber passes as vapour into an indiarubber bag, and there is combined with the patient's breath in See also:
PRO
pro- portions determined by the anaesthetist through-out the operation . The metal chamber is so de-signed that by turning it the exact proportion of ether to See also:
AIR (from an Indo-European root meaning " breathe," " blow ")
AIR, or ASBEN
air is fixed in accordance with the requirements of the case .
Of See also:
LATE
late years, by the use of an See also:
IRON [symbol Fe, atomic weight 55.85 (0=16)]
iron See also:
CYLINDER (Gr. KvAwSpos, from KvXivaety, to roll)
cylinder of nitrous oxide, connected by a See also:
TUBE (Lat. tuba)
tube with a Clover's inhaler, it is possible to begin with nitrous oxide, and to &o on, without interruption, with ether . More recently an admirable method has been devised of administering nitrous oxide with the admixture of air or of FIG . 1z.—See also:
GAS
Gas and Ether Apparatus See also:
OXYGEN (symbol 0, atomic weight 16)
oxygen in such a way (See also:
HEWITT, ABRAM STEVENS (1822-1903)
Hewitt's) . that the anaesthesia pro- duced by the gas may be maintained for time enough to allow of an operation of some length . The See also:
SERIES (a Latin word from serere, to join)
series of discoveries which, in its application to surgery, has brought about the present antiseptic and aseptic methods of operation, is concerned both with the shape or use of the instruments of surgery and with their preparation for use . The See also:
MERE
MERE, ADALBERT (1838-1909)
mere sterilization, by boiling or by steaming, of all instruments and dressings, is enough to ensure their freedom from the ordinary micro-organisms of suppuration; but the surgeon cannot See also:
BOIL
boil or See also:
STEAM
STEAM (0. Eng. steam, vapour, smoke, cf. Du. steam; the origin is unknown)
steam either himself or his patient . The preparation, therefore, of the surgeon's hands, and of the skin over the See also:
AREA
area of operation, is made not only by scrubbing with See also:
SOAP
soap and hot water, but by careful use of antiseptic lotions . Again, ligatures and sutures, which must be kept in stock ready for use, are kept, after careful sterilization, in antiseptic lotion, or are again sterilized immediately before an operation . Again, all towels used at an operation must be prepared, either by sterilization or by See also:
IMMERSION (Lat. immersio, dipping),
immersion in antiseptic lotion . The sterilization of all instruments and dressings is a simple matter: the usual sterilizer is a vessel like a See also:
FISH (O. Eng. fist, a word common to Teutonic languages, cf. Dutch visch, Ger. Fisch, Goth. fisks, cognate with the Lat. piscis)
FISH, HAMILTON (1808-1893)
fish-See also:
KETTLE, SIR RUPERT ALFRED (1817-1894)
kettle, with a perforated metal See also:
TRAY
tray in it, so that the instruments can be immersed in boiling water, and can be lifted on the tray and transferred straight from the sterilizer into vessels containing sterilized water or antiseptic lotion . For the sterilization of dressings an upper vessel is fitted to the sterilizer, so that the steam may permeate the dressings placed in it . In See also:
HOSPITAL (Lat. haspitalis, the adjective of hospes, host or guest)
hospital practice it is used also to sterilize all towels, aprons and the like in a large cylindrical vessel .
Sterilization by boiling or steaming, together with the use of antiseptic lotions, or of water that has been boiled, for all such things as cannot he boiled or steamed, is the essential principle of the surgery of the present day; and practically the antiseptic method and the aseptic method have become one, varying a little this way or that according to the nature and circumstances of the case . Beside anaesthetics and See also:
ANTISEPTICS (Gr. avrl, against, and 6177rrnKor, putrefactive)
antiseptics, there is a third series of discoveries that has profoundly influenced surgery—the use of the forces of electricity . The uses of electricity are fivefold . 1 . The Gaivano-Cautery.—The See also:
ORIGINAL
original form of the cautery, the fer ardent of Pate's time, for the arrest of See also:
HAEMORRHAGE (Gr. atµa, blood, and prryvvvac, to burst)
haemorrhage after amputation, was a terrible affair . Happily for mankind, his invention of the ligature put an end to this use of the cautery, but it was still used in a small number of other cases . Subsequently See also:
CLAUDE, JEAN (1619-1687)
Claude See also:
ANDRE, JOHN (1751-178o)
Andre Paquelin (h . 1836) invented a very ingenious form of cautery, a series of metal blades or points of different shapes and sizes, that could be fitted to a handle: these points were hollow inside, and were filled with fine See also:
PLATINUM [symbol Pt, atomic weight 145.0 (0=16)]
platinum gauze, and, by means of a See also:
BOTTLE (Fr. bouteille, from a diminutive of the Lat. butta, a flask; cf. Eng. " butt ")
bottle and hand-See also:
BELLOWS
BELLOWS, ALBERT F
BELLOWS, HENRY WHITNEY (1814-1882)
bellows they could be kept heated with See also:
BENZENE, C6H6
benzene-vapour . Thus, when they had once been raised to a glowing See also:
HEAT (0. E. haktu, which like " hot," Old Eng. hat, is from the Teutonic type haita, hit, to be hot; cf. Ger. hitze, heiss; Dutch, hitte, heet, &c.)
heat by holding them emie=z over a spirit-See also:
LAMP (from Gr. Xag ras, a torch, Xaµaav, to shine)
lamp, they could be kept at any desired heat . This instrument is still in use for a few cases where very rapid and extensive cauterization is necessary . But for all finer use of actual heat the galvano-cautery alone is used—a series of very minute points of platinum, with a suitable trigger-handle, connected with a See also:
BATTERY (Fr. batterie, from battles, to beat)
battery or (by means of a converter) with the ordinary house See also:
SUPPLY (through Fr. from Lat. supplere, to fill up)
supply of electricity . In this way it is possible to apply a glowing point with a fineness and accuracy of See also:
ADJUSTMENT (from late Lat. ad juxtare, derived from juxta, near, but early confounded with a supposed derivation from justus, right)
adjustment that were wholly impossible with Paquelin's cautery .
2 . See also:
ELECTROLYSIS (formed from Gr. Xbety, to loosen)
Electrolysis.--This method is of great value, in suitable cases, for the arrest or obliteration of small growths . The passage of the electric cur-See also:
RENT
rent between needles introduced into or under the skin brings about a gradual shrinking or cicatrization of the tissues subjected to it, without the See also:
PRODUCTION (Lat. productionem, from producere, to pro-duce)
production of any unsightly scar . 3 . Electro-Motor See also:
POWER [WILLIAM GRATTAN] TYRONE (1797-1841)
Power.—During recent years the use of a small electro-motor See also:
MACHINE
MACHINE (through Fr. from Lat. form machina of Gr. µnxavil)
machine has come into the practice of surgery for certain operations on the bones; especially for the operation for disease involving the mastoid See also:
BONE (a word common in various forms to Teutonic languages, in many of which it is confined to the shank of the leg, as in the German Bein)
BONE, HENRY (1755-1834)
bone . It is, of course, abetter method for the use of a fine See also:
DRILL
drill or See also:
BURR, AARON (1756-1836)
burr, for example, than the" dental See also:
ENGINE
ENGINE (Lat. ingenium)
engine," where the power is generated by a pedal turning a See also:
WHEEL (0. Eng. hweol, hweohl, &c., cognate with Icel. hjol, Dan. hiul, the Indo-European root is seen in Sanskrit chakra, Gr. r in Aos, circle, whence " cycle ")
WHEEL, BREAKING ON THE
wheel, and it will probably come into wide use both for dental surgery and for those operations of general surgery that require very gradual and delicate removal of small circumscribed areas of bone, especially of the See also:
CRANIAL
cranial bones . 4 . The X-Rays.--This, the most unexpected and, as it were, the most sensational See also:
DISCOVERY
discovery that has been bestowed on physicians and surgeons since the discovery of anaesthetics, is now used over a very wide and varied See also:
FIELD (a word common to many West German languages, cf. Ger. Feld, Dutch veld, possibly cognate with O.E. f olde, the earth, and ultimately with root of the Gr. irAaror, broad)
FIELD, CYRUS WEST (1819-1892)
FIELD, DAVID DUDLEY (18o5-1894)
FIELD, EUGENE (1850-1895)
FIELD, FREDERICK (18o1—1885)
FIELD, HENRY MARTYN (1822-1907)
FIELD, JOHN (1782—1837)
FIELD, MARSHALL (183 1906)
FIELD, NATHAN (1587—1633)
FIELD, STEPHEN JOHNSON (1816-1899)
FIELD, WILLIAM VENTRIS FIELD, BARON (1813-1907)
field of practice . Its value does not stop at the detection and localization of foreign bodies; indeed, this is but a small See also:
PART
part of its work . It is used constantly for cases of actual or suspected fracture or dislocation; for cases of congenital or acquired deformity; for cases involving difficulties of diagnosis between a swelling of the bone due to inflammation and a swelling due to a See also:
TUMOUR (Lat. tumor, a swelling)
tumour; and for obscure cases of See also:
SPINAL
spinal disease, See also:
HIP
hip disease and the like . Moreover, it has been found possible, by Dr See also:
HUGH
HUGH, ST
Hugh Walsham, and others to obtain pictures of the thoracic See also:
ORGANS
organs that are a very valuable See also:
GUIDE (in Mid. Eng. gyde, from the Fr. guide; the earlier French form was guie, English " guy," the d was due to the Italian form guida; the ultimate origin is probably Teutonic, the word being connected with the base seen in O. Eng. witan, to know)
guide in many obscure cases of disease of the lungs or of the pleura, and in many cases of thoracic aneurism or of See also:
INTRA
intra-thoracic tumour . Every year the number and the range of the cases where the X-rays are helpful for diagnosis and for treatment become greater; and it is impossible to say at what point the surgical value of this discovery will find its limits .
Beyond these uses, it is probable that the X-rays will maintain and extend the importance that they already have in the See also:
DIRECT
direct treatment of certain cases of disease of she skin (see X-See also:
RAY (Lat. raia)
RAY (or WRAY, as he wrote his name till 1670), JOHN (1628-1705)
RAY TREATMENT) . FIG . I7.—Urethroscope (See also:
FENWICK, SIR JOHN (c. 1645-1697)
Fenwick's), also 5 . The Electric Light.— used for ear, See also:
NOSE (O.Eng. nosu, cf. Dutch neus, Swed. nos, snout; the Aix in Provence. Both at Aix and at Lyons he acquired great connexion with O.Eng. nasu is obscure, cf. Ger. Nase, Lat. pares, distinction by his labours during outbreaks of the plague. In nostrils,
nose, throat, &c . Beside the general superiority of this light to other See also:
LIGHTS, CEREMONIAL USE OF
lights for the routine work of surgery, there are several special uses for it . Of these, the most important is the cystoscope, a long narrow tube, shaped and curved somewhat like a catheter, and having at its end a very minute glow-lamp and reflector, and a small window . Its other end is fitted with a See also:
LENS
LENS (from Lat. lens, lentil, on account of the similarity of the form of a lens to that of a lentil seed)
lens, and is connected by a switch with the main cur-rent . With this instrument, in skilled hands, it is possible to inspect the interior of the See also:
BLADDER (from A.S. blaeddre, connected with bl¢wan, to blow, cf. Ger. blase)
bladder, and in many cases to make an exact diagnosis under circumstances where otherwise it would be impossible . Another instance of the value of the electric lamp in diagnosis is given by the trans-See also:
ILLUMINATION
illumination of the facial bones in cases of suspected disease of the central cavity of the See also:
SUPERIOR
superior maxillary bone . A small glowlalnp is held in the closed mouth, in a darkened See also:
ROOM
room, and by a comparison of the shadows on the two sides of the See also:
FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)
face, thus trans-illuminated, an exact diagnosis can often be obtained as to the presence or See also:
ABSENCE (Lat. absentia)
absence of pus in FIG. i8.—Finsen-Reyn Lamp. this central cavity . Again, a small glow-lamp, duly sterilized, is often of great value in deep operations on the abdominal cavity . The bactericidal properties of light have long been demonstrated by Bie and others .
See also:
PROFESSOR (the Latin noun formed from the verb profiteri, to declare publicly, to acknowledge, profess)
Professor Niels Finsen of See also:
COPENHAGEN (Danish Kjobenhavn)
Copenhagen first used the ultra-See also:
VIOLET
violet rays of See also:
SOLAR, SOLLER (Lat. solarium, Fr.• galetas, Ital. solaio)
solar light in the treatment of skin diseases . notably of See also:
LUPUS (Lat. lupus, wolf)
LUPUS, PUBLIUS RUTILIUS
lupus . He later invented the lamp which bears his name . The original Finsen lamp comprised a voltaic arc of 6o to 8o amperes round which four tubes collected the light by See also:
QUARTZ
quartz lenses, the light being cooled by passing through water and the tubes being surrounded by a water-jacket . The usual exposure was one See also:
HOUR
hour . In the Finsen-Reyn modification now used, a single See also:
COLLECTING
collecting tube fitted on an adjustable stand is placed in front of a scissors arc lamp consuming 20 amperes . The rays are cooled and water-jacketed as in the original . A suitable quartz See also:
COMPRESSOR
compressor with a chamber containing circulating water is pressed upon the skin of the part to be treated and held at right angles to the impinging rays . The time of exposure is now reduced to See also:
FORTY
forty-five minutes . See also:
RADIUM (from Lat. radius, ray)
Radium when used in surgery is applied by means of applicators, either having the fixed salts on square or oblong metallic plates or cloths or by applicators having free radium in sealed metal tubes . These tubes are sometimes buried in the tissues . Sometimes a method of " screening " is adopted in See also:
ORDER
ORDER (through Fr. ordre, for earlier ordene, from Lat. ordo, ordinis, rank, service, arrangement; the ultimate source is generally taken to be the root seen in Lat. oriri, rise, arise, begin; cf. " origin ")
ORDER, HOLY
order to modify the intensity of the See also:
RADIATION, THEORY OF
radiation .
This is done by enveloping the tubes containing the radium in cases of silver, See also:
LEAD
LEAD (pronounced iced)
lead or nickel of various thicknesses . In this, known as the method of Dr Dominici, the a and rays are intercepted by the metal screens and the highly penetrative rays only applied to the morbid tissues . The illustrations in this article are by permission of Messrs Allen & Hanbury, See also:
LONDON
London, and that of the radium applicators , by permission of Messrs See also:
SIEMENS, ERNST WERNER VON (1816-1892)
SIEMENS, SIR WILLIAM [KARL WILHELM] (1823-1883)
Siemens See also:
BROTHERS, RICHARD (1757-1824)
Brothers, London .
End of Article: SURGICAL INSTRUMENTS AND APPLIANCES
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