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Title: Surgical Anatomy

Author: Joseph Maclise

Release Date: January 28, 2008 [EBook #24440]

Language: English


*** START OF THIS PROJECT GUTENBERG EBOOK SURGICAL ANATOMY ***




Produced by Don Kostuch

[Transcriber's Notes]

Thanks to Carol Presher of Timeless Antiques, Valley, Alabama,  for
lending the original book for this production. The 140 year old binding
had disintegrated, but the paper and printing was in amazingly good
condition, particularly the multicolor images.

Thanks also to the Mayo Clinic. This book has increased my appreciation
of their skilled care of my case by showing the many ways that things
could go wrong.

Footnotes are indicated by "[Footnote]" where they appear in the text.
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are numbered.

A few obvious misspellings have been corrected. Several cases of
alternate spelling of the same(?) word have not been modified.

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Transciber's Glossary

[End Transcriber's Notes]

SURGICAL ANATOMY

BY
JOSEPH MACLISE

FELLOW OF THE ROYAL COLLEGE OF SURGEONS.

WITH SIXTY-EIGHT COLOURED PLATES.

PHILADELPHIA:
BLANCHARD AND LEA.
1859.





[Stamped by owner: John D. Warren, Physician & Surgeon.]



I INSCRIBE THIS WORK TO THE GENTLEMEN
WITH WHOM AS A FELLOW-STUDENT I WAS ASSOCIATED AT THE
London University College:

AND IN AN ESPECIAL MANNER, IN THEIR NAME AS WELL AS MY OWN,
I AVAIL MYSELF OF THE OPPORTUNITY TO RECORD, ON THIS PAGE,
ALBEIT IN CHARACTERS LESS IMPRESSIVE THAN THOSE WHICH ARE
WRITTEN ON THE LIVING TABLET OF MEMORY,
THE DEBT OF GRATITUDE WHICH WE OWE TO THE LATE

SAMUEL COOPER, F.R.S., AND ROBERT LISTON, F.R.S.,

TWO AMONG THE MANY DISTINGUISHED PROFESSORS OF THAT
INSTITUTION, WHOSE PUPILS WE HAVE BEEN,
AND FROM WHOM WE INHERIT THAT BETTER POSSESSION THAN LIFE
ITSELF, AN ASPIRATION FOR THE LIGHT OF SCIENCE.

JOSEPH MACLISE.



PREFACE.

The object of this work is to present to the student of medicine and the
practitioner removed from the schools, a series of dissections
demonstrative of the relative anatomy of the principal regions of the
human body. Whatever title may most fittingly apply to a work with this
intent, whether it had better be styled surgical or medical, regional,
relative, descriptive, or topographical anatomy, will matter little,
provided its more salient or prominent character be manifested in its
own form and feature. The work, as I have designed it, will itself show
that my intent has been to base the practical upon the anatomical, and
to unite these wherever a mutual dependence was apparent.

That department of anatomical research to which the name topographical
strictly applies, as confining itself to the mere account of the form
and relative location of the several organs comprising the animal body,
is almost wholly isolated from the main questions of physiological and
transcendental interest, and cannot, therefore, be supposed to speak in
those comprehensive views which anatomy, taken in its widest
signification as a science, necessarily includes. While the anatomist
contents himself with describing the form and position of organs as they
appear exposed, layer after layer, by his dissecting instruments, he
does not pretend to soar any higher in the region of science than the
humble level of other mechanical arts, which merely appreciate the
fitting arrangement of things relative to one another, and combinative
to the whole design of the form or machine of whatever species this may
be, whether organic or inorganic. The descriptive anatomist of the human
body aims at no higher walk in science than this, and hence his
nomenclature is, as it is, a barbarous jargon of words, barren of all
truthful signification, inconsonant with nature, and blindly
irrespective of the cognitio certa ex principiis certis exorta.

Still, however, this anatomy of form, although so much requiring
purification of its nomenclature, in order to clothe it in the high
reaching dignity of a science, does not disturb the medical or surgical
practitioner, so far as their wants are concerned. Although it may, and
actually does, trammel the votary who aspires to the higher
generalizations and the development of a law of formation, yet, as this
is not the object of the surgical anatomist, the nomenclature, such as
it is, will answer conveniently enough the present purpose.

The anatomy of the human form, contemplated in reference to that of all
other species of animals to which it bears comparison, constitutes the
study of the comparative anatomist, and, as such, establishes the
science in its full intent. But the anatomy of the human figure,
considered as a species, per se, is confessedly the humblest walk of the
understanding in a subject which, as anatomy, is relationary, and
branches far and wide through all the domain of an animal kingdom. While
restricted to the study of the isolated human species, the cramped
judgment wastes in such narrow confine; whereas, in the expansive gaze
over all allying and allied species, the intellect bodies forth to its
vision the full appointed form of natural majesty; and after having
experienced the manifold analogies and differentials of the many, is
thereby enabled, when it returns to the study of the one, to view this
one of human type under manifold points of interest, to the appreciation
of which the understanding never wakens otherwise. If it did not happen
that the study of the human form (confined to itself) had some practical
bearing, such study could not deserve the name of anatomical, while
anatomical means comparative, and whilst comparison implies inductive
reasoning.

However, practical anatomy, such as it is, is concerned with an exact
knowledge of the relationship of organs as they stand in reference to
each other, and to the whole design of which these organs are the
integral parts. The figure, the capacity, and the contents of the
thoracic and abdominal cavities, become a study of not more urgent
concernment to the physician, than are the regions named cervical,
axillary, inguinal, &c., to the surgeon. He who would combine both modes
of a relationary practice, such as that of medicine and surgery, should
be well acquainted with the form and structures characteristic of all
regions of the human body; and it may be doubted whether he who pursues
either mode of practice, wholly exclusive of the other, can do so with
honest purpose and large range of understanding, if he be not equally
well acquainted with the subject matter of both. It is, in fact, more
triflingly fashionable than soundly reasonable, to seek to define the
line of demarcation between the special callings of medicine and
surgery, for it will ever be as vain an endeavour to separate the one
from the other without extinguishing the vitality of both, as it would
be to sunder the trunk from the head, and give to each a separate living
existence. The necessary division of labour is the only reason that can
be advanced in excuse of specialisms; but it will be readily agreed to,
that that practitioner who has first laid within himself the foundation
of a general knowledge of matters relationary to his subject, will
always be found to pursue the speciality according to the light of
reason and science.

Anatomy--the  the knowledge based on principle--is the
foundation of the curative art, cultivated as a science in all its
branchings; and comparison is the nurse of reason, which we are fain to
make our guide in bringing the practical to bear productively. The human
body, in a state of health, is the standard whereunto we compare the
same body in a state of disease. The knowledge of the latter can only
exist by the knowledge of the former, and by the comparison of both.

Comparison may be fairly termed the pioneer to all certain knowledge. It
is a potent instrument--the only one, in the hands of the pathologist,
as well as in those of the philosophic generalizer of anatomical facts,
gathered through the extended survey of an animal kingdom. We best
recognise the condition of a dislocated joint after we have become well
acquainted with the contour of its normal state; all abnormal conditions
are best understood by a knowledge of what we know to be normal
character. Every anatomist is a comparer, in a greater or lesser degree;
and he is the greatest anatomist who compares the most generally.

Impressed with this belief, I have laid particular emphasis on imitating
the character of the normal form of the human figure, taken as a whole;
that of its several regions as parts of this whole, and that of the
various organs (contained within those regions) as its integrals or
elements. And in order to present this subject of relative anatomy in
more vivid reality to the understanding of the student, I have chosen
the medium of illustrating by figure rather than by that of written
language, which latter, taken alone, is almost impotent in a study of
this nature.

It is wholly impossible for anyone to describe form in words without the
aid of figures. Even the mathematical strength of Euclid would avail
nothing, if shorn of his diagrams. The professorial robe is impotent
without its diagrams. Anatomy being a science existing by demonstration,
(for as much as form in its actuality is the language of nature,) must
be discoursed of by the instrumentality of figure.

An anatomical illustration enters the understanding straight-forward in
a direct passage, and is almost independent of the aid of written
language. A picture of form is a proposition which solves itself. It is
an axiom encompassed in a frame-work of self-evident truth. The best
substitute for Nature herself, upon which to teach the knowledge of her,
is an exact representation of her form.

Every surgical anatomist will (if he examine himself) perceive that,
previously to undertaking the performance of an operation upon the
living body, he stands reassured and self-reliant in that degree in
which he is capable of conjuring up before his mental vision a distinct
picture of his subject. Mr. Liston could draw the same anatomical
picture mentally which Sir Charles Bell's handicraft could draw in
reality of form and figure. Scarpa was his own draughtsman.

If there may be any novelty now-a-days possible to be recognised upon
the out-trodden track of human relative anatomy, it can only be in
truthful and well-planned illustration. Under this view alone may the
anatomist plead an excuse for reiterating a theme which the beautiful
works of Cowper, Haller, Hunter, Scarpa, Soemmering, and others, have
dealt out so respectably. Except the human anatomist turns now to what
he terms the practical ends of his study, and marshals his little
knowledge to bear upon those ends, one may proclaim anthropotomy to have
worn itself out. Dissection can do no more, except to repeat
Cruveilhier. And that which Cruveilhier has done for human anatomy,
Muller has completed for the physiological interpretation of human
anatomy; Burdach has philosophised, and Magendie has experimented to the
full upon this theme, so far as it would permit. All have pushed the
subject to its furthest limits, in one aspect of view. The narrow circle
is footworn. All the needful facts are long since gathered, sown, and
known. We have been seekers after those facts from the days of
Aristotle. Are we to put off the day of attempting interpretation for
three thousand years more, to allow the human physiologist time to slice
the brain into more delicate atoms than he has done hitherto, in order
to coin more names, and swell the dictionary? No! The work must now be
retrospective, if we would render true knowledge progressive. It is not
a list of new and disjointed facts that Science at present thirsts for;
but she is impressed with the conviction that her wants can alone be
supplied by the creation of a new and truthful theory,--a generalization
which the facts already known are sufficient to supply, if they were
well ordered according to their natural relationship and mutual
dependence. "Le temps viendra peut-etre," says Fontenelle, "que 1'on
joindra en un corps regulier ces membres epars; et, s'ils sont tels
qu'on le souhaite, ils s'assembleront en quelque sorte d'eux-memes.
Plusieurs