CHAPTER 1 GENERAL CONSIDERATIONS＆BY GUY W．HORSLEY 1
CHAPTER 2 SURGICAL DRAINAGE＆BY GUY W．HORSLEY 7
Biologic Defenses 7
Classification of Surgical Drainage 8
Drainage Material 12
Encapsulated Foreign Bodies in the Peritoneum 13
Criticisms 13
CHAPTER 3 TECHNIC，SUTURES，AND INSTRUMENTS＆BY GUY W．HORSLEY 15
CHAPTER 4 PRINCIPLES UNDERLYING OPERATIONS FOR MALIGNANT TUMORS；TECHNICAL CONSIDERATIONS IN OPERATIONS FOR MALIGNANCY；χ-RAY AND RADIUM BURNS＆BY GUY W．HORSLEY 23
Knowledge of Pathology Needed 23
The Cause of Cancer 24
Cancer Research in the Laboratory 25
Clinical Research 28
The Principles of Prognosis and Treatment 29
Metastases 30
Technical Considerations in Operations for Malignancy 31
Roentgen Ray and Radium Burns 41
CHAPTER 5 INFECTION；SHOCK；HEMORRHAGE；BLOOD TRANSFUSION；FLUID ELECTROLYTE BALANCE＆BY EVERETT I．EVANS 44
Preparation of the Operative Site 44
Preparation of the Surgeon＇s Hands 45
Surgical Infections 45
Shock and Hemorrhage 46
The Sequelae of Prolonged Severe Shock 48
Blood Transfusion in Surgery 48
Fluid and Salt Requirements in Surgery 51
Treatment of Water and Salt Deficit in the Surgical Patient 54
CHAPTER 6 ANESTHESIA＆BY WILLIAMS E．PEMBLETON 59
Preoperative Medication 59
Inhalation Anesthesia 61
Endotracheal Anesthesia 65
Intravenous Anesthesia 66
Resuscitation 67
Spinal Anesthesia 68
Local Anesthesia 72
Curare 73
Intravenous Procaine 75
Choice of Anesthesia for Specific Operations 76
CHAPTER 7 COLLATERAL CIRCULATION；EXPOSURE AND LIGATION OF ARTERIES＆BY I．A．BIGGER 83
Indications for Ligation 83
Technic of Exposure and Ligation of Certain Large Arteries 88
Ligation of the Abdominal Aorta 99
Ligation of the Common Iliac Artery 102
Ligation of the Internal Iliac(Hypogastric)Artery 102
Ligation of the External Iliac Artery 103
Ligation of the Femoral Artery 104
Ligation of the Popliteal Artery 107
CHAPTER 8 BLOOD VESSEL SUTURE；ARTERIAL EMBOLECTOMY＆BY I．A．BIGGER 109
Blood Vessel Suture 109
Arterial Embolectomy 111
CHAPTER 9 ANEURISMS．LIGATION FOR ANEURISMS；ANEURISMORRHAPHY；ANEURISMECTOMY；VEIN IMPLANTS＆BY I．A．BIGGER 115
Wiring and Electrothermic Coagulation 115
Ligation and Compression 116
Matas Operation 119
Excision of Sac 121
Operations on Aneurisms of Special Arteries 122
CHAPTER 10 ARTERIOVENOUS FISTULAS．QUADRUPLE LIGATION AND EXCISION；TRANSVENOUS ARTERIORRHAPHY＆BY I．A．BIGGER 130
CHAPTER 11 VARICOSE VEINS；VENOUS THROMBOSIS；OBSTRUCTION OF THE LYMPHATICS OF THE EXTREMITIES＆BY BENJAMIN W．RAWLES，JR 137
Varicose Veins 137
Venous Thrombosis 147
Obstruction of Lymphatics of Extremities 153
CHAPTER 12 DUPUYTREN＇S CONTRACTURE；INFECTIONS OF THE HAND AND FOREARM＆BY BENJAMIN W．RAWLES，JR 158
Dupuytren＇s Contracture of the Hand 158
Infections of the Hand and Forearm 159
CHAPTER 13 WOUNDS OF SOFT TISSUES；CARBUNCLES；PILONIDAL CYSTS AND SINUSES；TUMORS，BENIGN AND MALIGNANT；MELANOMA＆BY HARRY J．WARTHEN，JR 170
Wounds of Soft Tissues 170
Carbuncles 171
Pilonidal Cysts and Sinuses 171
Tumors，Benign and Malignant 175
Malignant Melanomas 176
CHAPTER 14 GENERAL PRINCIPLES OF PLASTIC SURGERY＆BY HARRY J．WARTHEN，JR 179
Scope of Plastic Surgery 179
General Principles 179
Planning Operations 185
Anesthesia in Plastic Surgery 185
Preparation of Operative Field 188
Instruments，Needles， and Sutures 189
Drains and Dressings 190
Postoperative Care 191
Closure of Defects 192
CHAPTER 15 THE CAUSES OF CONTRACTURES；THE TREATMENT OF SCARS；WEBBED FINGERS；KELOIDS＆BY HARRY J．WARTHEN，JR 198
Causes of Cicatrical Contractions 198
General Considerations in Treatment of Scars 202
Closure of Decubitus Ulcers 210
Syndactylism(Webbed Fingers 211
Keloids 212
CHAPTER 16 TRANSPLANTATION OF FLAPS CONTAINING SKIN＆BY HUNTER S．JACKSON 215
Sources of Grafts 215
Preparation of Source of Graft 216
Dressing of Donor Site 217
Flaps 217
Sources and General Principles 220
Tubed Pedicle Flaps 223
Migrating Pedicle Flaps 226
Crossed Leg Flaps 227
Double Pedicle Flaps 227
CHAPTER 17 FREE GRAFTS OF SKIN AND MUCOUS MEMBRANE＆BY LEROY SMITH 229
Physiologic Properties of Grafts 229
Split Thickness Grafts 231
Full Thickness Grafts 239
Tunnel Grafts 241
Composite Grafts 243
Mucous Membrane Grafts 244
CHAPTER 18 DEEP TISSUE GRAFTS＆BY LEROY SMITH 246
Fat Grafts 246
Fascia Grafts 247
Muscle Graft 249
Cartilage 250
Bone Grafts 251
CHAPTER 19 CLEFT LIP AND PALATE＆BY LEROY SMITH 255
History 255
Repair of Single Cleft Lip 256
Repair of Double Harelip 262
Repair of Cleft Palate 265
Repair of Postoperative Defects 270
Secondary Repair of Postoperative Palate Defects 271
CHAPTER 20 PLASTIC REPAIR OF ACQUIRED DEFECTS OF LIPS，CHEEKS，EYELIDS，AND FOREHEAD＆BY LEROY SMITH 274
The Lips 274
Microstomia 282
Macrostomia 283
The Cheeks 283
Facial Paralysis 285
The Eyelids 286
Ptosis of Eyelids 297
The Eyebrows 298
Forehead Defects 299
CHAPTER 21 PLASTIC OPERATIONS ON NOSE AND EAR＆BY LEROY SMITH 301
Repair of Dorsum of Nose 301
Reconstruction of the Tip of the Nose 304
The Loss of The Ala，Rim， or Columella 305
Total Loss of the Nose 308
Structural Derangement of the Nose 311
Dorsal Hump 315
Hypertrophy of the Tip 318
Subtotal and Total Loss of Ear 319
Congenital Deformities 324
CHAPTER 22 THE SALIVARY GLANDS；BENIGN TUMORS OF THE FACE＆BY HARRY J．WARTHEN，JR 327
Anatomy of the Parotid Gland 327
Operations for Salivary Fistula 327
Operations for Benign Parotid Tumors 330
Operations for Malignant Tumors of Parotid 333
Removal of Salivary Calculi 334
Treatment of Benign Tumors of the Face 334
Treatment of Angiomas 335
Excision of Sebaceous Cysts(Wens 337
Excision of Dermoid Cvsts 337
CHAPTER 23 OPERATIONS FOR CARCINOMA OF THE FLOOR OF THE MOUTH，PALATE，LOWER AND UPPER JAWS＆BY LEROY SMITH 339
Carcinoma of the Floor of the Mouth 339
Carcinoma of the Palate 340
Malignancy of the Mandible 342
Maxilla 345
CHAPTER 24 OPERATIONS ON THE TONGUE，LIPS，AND CHEEKS＆BY HARRY J．WARTHEN，JR 349
Anatomy of the Tongue 349
Operations on the Tongue for Benign Tumors 350
Operations on the Tongue for Carcinoma 350
Treatment of Carcinoma of the Floor of the Mouth 356
Carcinoma of the Lip 356
Operations for Carcinoma of the Lower Lip 359
Operations upon the Upper Lip 361
Carcinoma of the Cheek 362
Facial Carcinoma 362
CHAPTER 25 OPERATIONS ON THE NECK．GENERAL AND ANATOMIC CONSIDERATIONS；DISSECTIONS OF THE NECK＆BY HARRY J．WARTHEN，JR 364
General Considerations 364
Anatomy of the Cervical Lymphatics 365
Suprahyoid Block Dissection of the Neck 368
Complete Unilateral Block Dissection of the Neck 370
Block Dissection of the Upper Cervical Lymphatic-Bearing Tissue 378
Dissection of the Supraclavicular Space and Posterior Triangle of the Neck 379
Wounds of the Thoracic Duct 380
CHAPTER 26 OPERATIONS ON THE NECK(CONTINUED)．PRIMARY TUMORS；CONGENITAL CYSTS AND FISTULAS；TUBERCULOSIS OF CERVICAL LYMPH NODES＆BY HARRY J．WARTHEN，JR 381
Tumors of the Carotid Body 381
Carotid Sinus Syndrome 382
Congenital Cysts and Fistulas of the Neck 383
Locations of Incisions in Neck 389
Tuberculosis of the Cervical Lymphatic Nodes 390
CHAPTER 27 THE THYROID GLAND．HYPERTHYROIDISM；STRUMA；CARCINOMA；ADENOMATOUS GOITER；PARATHYROID ADENOMA＆BY CARRINGTON WILLIAMS 392
Hyperthyroidism 392
Struma 393
Carcinoma 393
Adenomatous Goiter 393
Anesthesia in Thyroid Operations 393
Subtotal Thyroidectomy 394
Total Thyroidectomy 406
Intrathoracic Goiter 410
Aberrant Thyroids 410
The Parathyroid Glands 411
Parathyroid Transplantation 413
Lingual Thyroidectomy．Cervical Approach＆By I．A．Bigger 413
CHAPTER 28 TRACHEA AND LARYNX＆BY PETER N．PASTORE 416
Trachea 416
Larynx 417
CHAPTER 29 THE THORAX＆BY FRANK PHILIP COLEMAN 421
The Surface Anatomy of the Chest 421
Mediastinum 422
Physiology in Relation to Thoracic Surgery 424
Factors Influencing the Development of Thoracic Surgery 427
Fracture of the Ribs and Sternum 428
Soft Tissue Wounds of the Thoracic Wall；Traumatic Pneumothorax；Traumatic Hemothorax 434
Infections of the Soft Tissue，Bony and Cartilaginous Structures of the Thoracic Wall 437
Tumors of the Chest Wall 438
Hernia of the Lung 440
CHAPTER 30 THORACIC INCISIONS；FUNNEL CHEST OR PECTUS EXCAVATUM＆BY I．A．BIGGER 441
Thoracic Incisions 441
Funnel Chest or Pectus Excavatum 443
CHAPTER 31 OPERATIONS FOR LESIONS INVOLVING THE PLEURA AND PLEURAL SPACE．RECURRENT AND CHRONIC PNEUMOTHORAX；ACUTE EMPYEMA；CHRONIC EMPYEMA＆BY I．A．BIGGER 447
Pneumothorax 447
Acute Empyema 449
Chronic Empyema 453
CHAPTER 32 THE LUNGS AND BRONCHI＆BY I．A．BIGGER 461
Repair of Wounds of the Lung 461
Removal of Foreign Bodies 462
Drainage of Lung Abscess 463
Pulmonary Cysts 465
Bronchotomy 468
CHAPTER 33 PULMONARY RESECTION＆BY I．A．BIGGER 470
History 470
Lobectomy by the Tourniquet Technic 471
Pulmonary Resection by Intrahilar Dissection and Individual Ligation Technic 474
Pneumonectomy 475
Technic of Pneumonectomy by Anterolateral Incision 476
Right Upper Lobectomy 480
Middle Lobe Lobectomy 482
Right Lower Lobectomy 483
Bilobectomy 484
Left Upper Lobectomy 485
Left Lower Lobectomy 488
Radical Pneumonectomy 489
CHAPTER 34 SEGMENTAL RESECTION OF THE LUNG＆BY LEWIS H．BOS HER，JR 492
CHAPTER 35 SURGERY FOR PULMONARY TUBERCULOSIS＆BY FRANK PHILIP COLEMAN 503
Operations Upon the Phrenic Nerve 503
Therapeutic Pneumothorax 507
Closed Internal Pneumonolysis 509
Open Internal Pneumonolysis 516
Extrapleural Pneumothorax 517
Thoracoplasty 521
Thoracoplasty With Extrafascial Apicolysis 530
Anterolateral Extrapleural Thoracoplasty 534
Revision Thoracoplasty 536
Drainage of Pulmonary Cavities 536
Pneumoperitoneum 537
Pulmonary Resection 540
CHAPTER 36 THE MEDIASTINUM；THYMECTOMY；THORACIC DUCT INJURIES＆BY I．A．BIGGER 545
Median Sternotomy 545
Drainage of the Superior Mediastinum 547
Operations for Tumors of the Mediastinum 548
Thymectomy for Myasthenia Gravis 550
Thoracic Duct Injuries；Chylothorax 551
CHAPTER 37 PHARYNX AND CERVICAL ESOPHAGUS＆BY FRANK PHILIP COLEMAN 553
Incision 553
Pharyngoesophageal Diverticula 554
Carcinoma of the Cervical Esophagus 558
CHAPTER 38 THORACIC ESOPHAGUS＆BY FRANK PHILIP COLEMAN 566
Physiology and Anatomy 566
Cardiospasm 567
Epinephrenic Esophageal Diverticula 571
Diverticulectomy 572
Esophagoplasty 572
Carcinoma of the Thoracic Esophagus 580
Transpleural Resection of the Esophagus 582
Partial Esophagectomy With Primary Intrathoracic Esophagogastrostomy 584
Resection of the Esophagus for Supra-aortic Carcinoma With Primary Cervical Esophago-gastrostomy 591
Combined Abdominothoracic Approach for Carcinoma of the Esophagus 593
Benign Tumors of the Esophagus 594
CHAPTER 39 CONGENITAL ATRESIA OF THE ESOPHAGUS．PRIMARY ANASTOMOSIS；DELAYED ANASTOMOSIS＆BY I．A．BIGGER 596
CHAPTER 40 DIAPHRAGMATIC HERNIA＆BY I．A．BIGGER 601
CHAPTER 41 PERICARDIUM AND HEART＆BY I．A．BIGGER 609
Pericardicentesis 609
Pericardiostomy 610
Adhesive Pericarditis 611
Pericardiectomy or Decortication of the Heart for Constrictive Pericarditis 611
Operations Upon the Heart and the Adjacent Portions of the Great Vessels at the Base of the Heart 614
Wounds of the Heart and Intrapericardial Portion of the Great Vessels 616
Cardiorrhaphy 618
Operations for Foreign Bodies in the Heart 621
Operations for Coronary Sclerosis and Angina Pectoris 623
CHAPTER 42 RESECTION OF THE AURICULAR APPENDAGES FOR THE PREVENTION OF ARTERIAL EMBOLISM；PULMONARY EMBOLECTOMY；CARDIAC RESUSCITATION；THE SURGERY OF ACQUIRED VALULAR DISEASE 627
Resection of the Auricular Appendages for the Prevention of Arterial Embolism＆By I．A．Bigger 627
Pulmonary Embolectomy＆By I．A．Bigger 628
Cardiac Resuscitation＆By Fred Walls 630
The Surgery of Acquired Valvular Disease＆By Lewis H．Bosher，Jr 633
CHAPTER 43 CONGENITAL ANOMALIES OF THE HEART AND GREAT VESSELS＆BY I．A．BIGGER 638
Closure of Patent Ductus Arteriosus 638
Operative Correction of Coarctation of Aorta 642
Operations for the Relief of Pressure Upon the Esophagus and/or Trachea，the Result of Certain Anomalies of the Aortic Arch 646
Surgery of Pulmonary Stenosis＆By Lewis H．Bosher，Jr 647
CHAPTER 44 THE MAMMARY GLAND＆BY GUY W．HORSLEY 660
Indications for Operations 660
Benign Tumors 661
Cancer of the Breast 664
Mastopexy 672
Excision of Lesions of the Male Breast 675
CHAPTER 45 HERNIA＆BY HERBERT C．LEE 676
General Principles of Hernia Repair 676
Inguinal Hernia 680
Femoral Hernia 705
Umbilical Hernia 707
Incisional Hernia 711