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Show .‘272 aneurnrox or THE THIGH. In doing this, he must carry his eye before the knife, that he may not cut the integuments, of which there is a possi. hility. But if the assistant does his duty, the surgeon can- not do so awkward a thing were he blindfolded; for the as circle of the integuments up. Some surgeons amputate after making the integuments to be merely drawn strongly up, 5. The surgeon now proceeds to tie the arteries : first he pulls the whole flesh upwards, thus :- ("I IIkaLifl‘" nettm‘ «spin to be given in regard to the sawing of the bone, than to car= ry the saw very lightly. During the sawing of the bone, the assistant or pupil, who holds the leg, must keep very steady; if he raises the either side of the bone, he twists the extremities a little, and u 273 sistant taking a slip of linen betwixt his hands, andputting the edge of it close upon the muscles, on the under part of the thigh, he protects, at the same time that he draws the whole without dissecting them from the muscles, or turning them up. 41. When the muscles are cut through, the assistant takes his split cloth, or piece of canvass, and passing the slips on Anrmu AMPUTATION or THE THIGH. , ll _ , I) ' ' ‘ 7 limb he checks the motion of the saw; it he lets it drop, he will splinter the bone. pulls out the femoral artery from its sheath, by the inside of the bone, (if the limb be amputated at the usual place} and ties it. Then, on the outside of the bone, he seeks for the, larger branches of the profunda femoris, and finding these, he requires the tourniquet to be slackened, that the blood may {low and shew the others. r, he considerable branches of the arteries are to be sought for in the cellular interstices of the muscles. Sometimes the main artery shrinks so into the sheath of the triceps, that it does not bleed or shew itself readily, in which case the sheath is to be cut open, when the mouth of the artery is dis,» covered. The number of vessels taken up in general, is from live to eight ; but if the artery has been in high action, or ancuris: mal, many more vessels may require to be tied. In making a deep plunge with the tenaculum, either for the femoral artery or some of the lesser arteries, we have to avoid drawing in the extremities of the nerves. I may say that the nervus cutanous longus, is very often taken in with the femora ar tery. This, if attended with no worse consequences, will certainly occasion many severe and tedious dressings to the patient, and will often destroy the healthy state of the stump. (3. Before we bring down the muscles and integuments; over the end of the bone, we feel if its edges be not rough; if no sharp points project: these we cut oil' by the amputation forceps. The surgeon now clearing the surface of the bone a. little, and pushing up the cloth and soft parts, applies his saw close upon the retracted parts. There is no other precept 7. The tourniquet is now to be entirely removed. The iz‘iteguments being put lightly together, the operation finished, and nothing painful remaining to be done, the patient should have a little cordial, be raised, and encouraged. A delay of 2:. VOL. 1. "\t (2 . - , 7- , 'lVllel M099?! ‘ A |