142. Multiple Chondromas of Phalanges and Metacarpals             488

  143. Skiagram of Multiple Chondromas                              489

  144. Multiple Chondromas in Hand                                  490

  145. Radiogram of Myeloma of Humerus                              492

  146. Periosteal Sarcoma of Femur                                  493

  147. Periosteal Sarcoma of Humerus                                493

  148. Chondro-Sarcoma of Scapula                                   494

  149. Central Sarcoma of Femur invading Knee Joint                 495

  150. Osseous Shell of Osteo-Sarcoma of Femur                      495

  151. Radiogram of Osteo-Sarcoma of Femur                          496

  152. Radiogram of Chondro-Sarcoma of Humerus                      497

  153. Epitheliomatus Ulcer of Leg invading Tibia                   499

  154. Osseous Ankylosis of Femur and Tibia                         503

  155. Osseous Ankylosis of Knee                                    504

  156. Caseating focus in Upper End of Fibula                       513

  157. Arthritis Deformans of Elbow                                 525

  158. Arthritis Deformans of Knee                                  526

  159. Hypertrophied Fringes of Synovial Membrane of Knee           527

  160. Arthritis Deformans of Hands                                 529

  161. Arthritis Deformans of several Joints                        530

  162. Bones of Knee in Charcot's Disease                           533

  163. Charcot's Disease of Left Knee                               534

  164. Charcot's Disease of both Ankles: front view                 535

  165. Charcot's Disease of both Ankles: back view                  536

  166. Radiogram of Multiple Loose Bodies in Knee-joint             540

  167. Loose Body from Knee-joint                                   541

  168. Multiple partially ossified Chondromas of Synovial           542
       Membrane from Shoulder-joint

  169. Multiple Cartilaginous Loose Bodies from Knee-joint          543




MANUAL OF SURGERY




CHAPTER I

REPAIR


Introduction--Process of repair--Healing by primary union--Granulation
    tissue--Cicatricial tissue--Modifications of process of
    repair--Repair in individual tissues--Transplantation or grafting
    of tissues--Conditions--Sources of grafts--Grafting of individual
    tissues--Methods.


INTRODUCTION

To prolong human life and to alleviate suffering are the ultimate
objects of scientific medicine. The two great branches of the healing
art--Medicine and Surgery--are so intimately related that it is
impossible to draw a hard-and-fast line between them, but for
convenience Surgery may be defined as "the art of treating lesions and
malformations of the human body by manual operations, mediate and
immediate." To apply his art intelligently and successfully, it is
essential that the surgeon should be conversant not only with the normal
anatomy and physiology of the body and with the various pathological
conditions to which it is liable, but also with the nature of the
process by which repair of injured or diseased tissues is effected.
Without this knowledge he is unable to recognise such deviations from
the normal as result from mal-development, injury, or disease, or
rationally to direct his efforts towards the correction or removal of
these.


PROCESS OF REPAIR

The process of repair in living tissue depends upon an inherent power
possessed by vital cells of reacting to the irritation caused by injury