General surgery

Front matter

(<i(nTi}>lil.V'

HAND-BOOK

OF

Preface To The First Edition

In the following hand-book of veterinary surgery and obstetrics the general surger}', as well as the operative surgery, forms a separate, independent work. In a sense they serve as an introduction to the following third and fourth volumes of special surgery of the different organs.

Any text-book of general veterinary surgery' must depend on the investigations and text-books of human medicine. While I have kept this point in view in the development of the following plan, I think I have clearly drawn the relations between the general surgery of man and animals. I also admit that in the writing of this book I have followed principally the plans which Billroth, and recently Tillman, have used in their text-books of human and general surgery.

The reader will readily note that the following work is not a mere compilation of the books mentioned on human medicine. In many particulars veterinary surgery, like pathology, pharmacology and therapy, has developed independent lines. Many chapter.s on human surgery have no connection with veterinary surgery ; other divisions that are very important in human surgery are of little or no importance in veterinary science. Tuberculosis of the bones and joints, for example, belongs to one of the most important divisions of human surgery ; in veterinary surgery it is practically never the occasion for surgical interference.

Conversely, actinomycosis and botryomycosis is of great importance in veterinary surgery, the latter is almost unknown in man. In man osteomyelitis is the most important form of inflammation of the bones ; in the horse periostitis is the most important form. Erysipelas, .so frequent in man, appears to be very rare in animals. It is obvious that resection of joints, as well as most amputations of limbs, cannot be employed on

VI Preface.

domestic animals. The aseptic method, which is so important in human surgerj', seems to be of little importance in veterinar}- science because of pureh^ external causes. Even bone-fractures present an entirely different surgical problem in large animals than in men. Firing, and the application of blisters for chronic inflammations of bones, tendons, and joints, are special surgical methods of veterinarians.

On the other hand, the following work is not a compendium of other surgical text-books on veterinary surgery. On the basis of many years of surgical and clinical activity, I think I have had sufiScient experience to elucidate the following subject from my own point of view. In many chapters, namely, those on fractures and tumors, I was in a position to insert my own investigations. I was also careful to arrange the material purely from a veterinary standpoint, and only for the object of veterinary practice. On this basis the reader will find, for example, many references in this book to forensic veterinary science (age of wounds, fractures, fissures, muscular atrophy ; curability or non-curability of bone-fractures in horses and cattle ; abnormal fragility of bones ; prophylaxis of bone-fractures, etc.). Foreign bodies, parasites, and congenital new- formations, which are of great surgical importance, have been given special attention.

General surgery has numerous and important relations to general pathology and pathological anatomy. Unfortunately we have no text-book of general pathology in our veterinary literature. On the other hand we have recently come into the possession of a very important hand-book of veterinary pathological anatomy. I am under great obligations to this excellent book of Kitt's for valuable suggestions and information. General surgery is also closely related to anatomy. I have found a deficiency in the de.scriptions of tendon-sheaths and fasciae in most veterinary text-books on anatomy ; these are very important from a surgical standpoint, the descriptions are usually incomplete and indistinct. With reference to the relation of general surgery to bacteriology, it must be acknowledged that the latter has contributed largely to the problem of suppuration and inflammation, as well as to the combating of

Preface. VII

these processes by means of antiseptics, from a standpoint of both scientific and practical surgerj-. On the other hand, one must not overestimate the importance of bacteriology to general surgery and overlook everything else for bacteria. Many surgical inflammations have nothing to do with bacteria ; this is especially true of the purely traumatic, aseptic inflammations of bones, joints, tendons, tendon-sheaths, and muscles. At suitable places I have considered it my duty to repeatedly refer to this obligation. From a diagnostic standpoint also, bacteriology should not be given too great weight in surgery. Pus-cocci, in particular, are of little practical diagnostic importance ; this is especially true where the candidate, unfortunately, is overenthusiastic concerning the significance of a bacteriological examination, to him the presence of pus-forming bacteria in pus from bones may form the principal evidence for the presence of a bone-fi.stula. The bacteriological confusions that have occurred concerning wound-erysipelas receive attention in the chapter on this subject.

There is no claim of completeness for the bibliography at the end of each chapter. My principal object was to divide the literature on human medicine from that of veterinary- science and, above all, also to indicate to students the fundamental investigations that li ave been made in human medicine : only the most important and recent works have been mentioned.

The book contains no illustrations. I am opposed to the usual custom in veterinary science of appropriating illustrations from works on human medicine, either unchanged or specially modified. I maintain that it is not admissible.

KiSvSiNGEN, August, 1896.

Preface To The Third Edition

The new, third edition of general surgery is improved and enlarged in many respects. The individual changes are as follows : The chapter on the etiology of tumors has been rewritten, and many additions have been made to the casuistry of this group ; unfortunately the recent etiological works on tumors are largely speculations. The chapter on botryomycosis has been newly written to harmonize with the most recent investigations on this subject ; there is hardh' a doubt that in this wound infection we have to deal, not with staphylococci, but with an infectious disease sui generis. Regardless of the objections of critics, the chapter on tuberculosis has been retained and even enlarged ; the motive for following this plan is explained in that chapter. I have supplemented the important chapter on chronic deforming arthritis with the results of recent investigations made in my clinic upon ringbones chronic gonitis, and omarthritis. This is also true of primary infectious osteomyelitis the occurrence of which in the horse, according to our recent investigations, can be no longer doubted. Recent investigations on myositis, neuritis, healing of fractures, necrosis bacilli, pseudo-edema bacilli, and foal-lameness have also been considered. On the subject of asepsis against antisepsis it may be definitely stated that now, even in human therapeutics, all have returned to antisepsis. In the first edition of this book I recommended antisepsis for the veterinary surgeon. Even for the disinfection of fresh wounds the application of pure carbolic acid, as well as the hot iron, has been recently recommended in human surgeries.

What a change within one decade !

Berlin, December. 1904.

Prof. Dr. Frohner.

(VIII)

TRANSLATOR'S PREFACE

The translation of the third edition of Frohners " General Surgery " has been undertaken to supply a well classified presentation of the fundamental principles of surgery. It is hoped that it may assist the beginner in obtaining a clear perspective of the mass of surgical diseases with which he must come in contact.

That portion of the text dealing with bibliography has been omitted in the translation as it is practically unavailable to most English readers. Otherwise the text has been closely followed, no additions or other changes having been made.

The translator of this work is especiall}^ indebted to Professor David Stuart White who has rendered valuable assistance in reading the proof sheets. He is also indebted to Drs. A. D. Fitzgerald and James McI. Phillips for suggestions that have materially reduced the list of errors.

The translator wishes to express his gratitude to the firm of Taylor & Carpenter who have procured the authorization of this translation from the German publishers, assumed all financial responsibility, and shown every possible courtesy and assistance in furthering the progress of the work.

D. H. UDALL.

Columbus, Ohio, July, 1906.

(IX)

PREFACE TO THE THIRD EDITION.

The new, third edition of general surgery is improved and enlarged in many respects. The individual changes are as follows : The chapter on the etiology of tumors has been rewritten, and many additions have been made to the casuistry of this group ; unfortunately the recent etiological works on tumors are largeh^ speculations. The chapter on botryomycosis has been newly written to harmonize with the most recent investigations on this subject ; there is hardly a doubt that in this wound infection we have to deal, not with staphylococci, but with an infectious disease sui generis. Regardless of the objections of critics, the chapter on tuberculosis has been retained and even enlarged ; the motive for following this plan is explained in that chapter. I have supplemented the important chapter on chronic deforming arthritis with the results of recent investigations made in my clinic upon ringbones chronic gonitis, and omarthritis. This is also true of primary infectious osteomyelitis the occurrence of which in the horse, according to our recent investigations, can be no longer doubted. Recent investigations on myositis, neuritis, healing of fractures, necrosis bacilli, pseudo-edema bacilli, and foal-lameness have also been considered. On the subject of asepsis against antisepsis it may be definitely stated that now, even in human therapeutics, all have returned to antisepsis. In the first edition of this book I recommended antisepsis for tlie veterinary surgeon. Even for the disinfection of fresh wounds the application of pure carbolic acid, as well as the hot iron, has been recently recommended in human surgeries.

What a change within one decade !

Berlin, December, 1904.

Prof. Dr. Frohner.

(VIII)

TRANSLATOR'S PREFACE

The translation of the third edition of Frohners " General Surgerj^ ' ' has been undertaken to supph^ a well classified presentation of the fundamental principles of surgery. It is hoped that it may assist the beginner in obtaining a clear perspective of the mass of surgical diseases with which he must come in contact.

That portion of the text dealing with bibliography has been omitted in the translation as it is practically unavailable to most English readers. Otherwise the text has been closely followed, no additions or other changes having been made.

The translator of this work is especially indebted to Professor David Stuart White who has rendered valuable assistance in reading the proof sheets. He is also indebted to Drs. A. D. Fitzgerald and James McI. Phillips for suggestions that have materially reduced the list of errors.

The translator wishes to express his gratitude to the firm of Taylor & Carpenter who have procured the authorization of this translation from the German publishers, assumed all financial responsibility, and shown every possible courtesy and assistance in furthering the progress of the work.

D. H. UDALL.

Columbus, Ohio, July, 1906.

(IX)