1.byFrancisAdamsITISthebusinessofthephysiciantoknow,inthefirstplace,thingssimilarandthingsdissimilar;thoseconnectedwiththingsmostimportant,mosteasilyknown,andinanywiseknown;whicharetobeseen,touched,andheard;whicharetobeperceivedinthesight,andthetouch,andthehearing,andthenose,andthetongue,andtheunderstanding;whicharetobeknownbyallthemeansweknowotherthings.
2.Thethingsrelatingtosurgery,are—thepatient;theoperator;
theassistants;theinstruments;thelight,whereandhow;howmanythings,andhow;wherethebody,andtheinstruments;thetime;themanner;theplace.
3.Theoperatoriseithersittingorstanding,convenientlyforhimself,forthepersonoperatedupon,forthelight.Therearetwokindsoflight,thecommonandtheartificial;thecommonisnotatourdisposal,theartificialisatourdisposal.Therearetwomodesofusingeach,eithertothelight,orfromthelight(totheside?).Thereislittleuseofthatwhichisfrom(orobliquetothelight),andthedegreeofitisobvious.Astooppositethelight,wemustturntheparttobeoperatedupontothatwhichismostbrilliantofpresentandconvenientlights,unlessthosepartswhichshouldbeconcealed,andwhichitisashametolookupon;thusthepartthatisoperateduponshouldbeoppositethelight,andtheoperatoroppositethepartoperatedupon,exceptinsofarashedoesnotstandinhisownlight;forinthiscasetheoperatorwillindeedsee,butthethingoperateduponwillnotbeseen.Withregardtohimselfwhensitting,hisfeetshouldberaisedtoadirectlinewithhisknees,andnearlyincontactwithoneanother;
thekneesalittlehigherthanthegroins,andatsomedistancefromoneanother,fortheelbowstorestuponthem.Therobe,inaneatandorderlymanner,istobethrownovertheelbowsandshouldersequallyandproportionally.Withregardtothepartoperatedupon;
wehavetoconsiderhowfardistant,andhownear,above,below,onthissideonthatside,orinthemiddle.Themeasureastodistanceandproximityis,thattheelbowsdonotpressthekneesbefore,northesidesbehind;thatthehandsbenotraisedhigherthanthebreasts,norlowerthansoasthatwhenthebreastreposesonthekneeshemayhavethehandsatrightangleswiththearm:thusitisasregardsthemedium;butasconcernsthissideorthat,theoperatormustnotbebeyondhisbebeyondhisseat,butinproportionashemayrequireturninghemustshiftthebody,orpartofthebody,thatisoperatedupon.Whenstanding,hemustmakehisinspection,restingfirmlyandequallyonbothfeet;buthemustoperatewhilesupportinghimselfuponeitherleg,andnottheoneonthesamesidewiththehandwhichhemakesuseof;thekneebeingraisedtotheheightofthegroinsaswhilesitting;andtheothermeasuresinlikemanner.Thepersonoperateduponshouldaccommodatetheoperatorwithregardtotheotherpartsofhisbody,eitherstanding,sitting,orlying;soasthathemaycontinuetopreservehisfigure,avoidsinkingdown,shrinkingfrom,turningaway;andmaymaintainthefigureandpositionofthepartoperatedupon,duringtheactofpresentation,duringtheoperation,andinthesubsequentposition.
4.Thenailsshouldbeneitherlongernorshorterthanthepointsofthefingers;andthesurgeonshouldpracticewiththeextremitiesofthefingers,theindex—fingerbeingusuallyturnedtothethumb;
whenusingtheentirehand,itshouldbeprone;whenbothhands,theyshouldbeopposedtooneanother.Itgreatlypromotesadexteroususeofthefingerswhenthespacebetweenthemislarge,andwhenthethumbisopposedtotheindex.Butitisclearlyadiseasewhenthethumbisimpairedfrombirth,orwhen,fromahabitcontractedduringthetimeofnursing,itisimpededinitsmotionsbythefingers.Oneshouldpracticeallsortsofworkwitheitherofwitheitherofthem,andwithbothtogether(fortheyarebothalike),endeavouringtodothemwell,elegantly,quickly,withouttrouble,neatly,andpromptly.
5.Theinstruments,andwhenandhowtheyshouldbeprepared,willbetreatedofafterwards;sothattheymaynotimpedethework,andthattheremaybenodifficultyintakingholdofthem,withthepartofthebodywhichoperates.Butifanothergivesthem,hemustbereadyalittlebeforehand,anddoasyoudirect.
6.Thoseaboutthepatientmustpresenttheparttobeoperateduponasmayseemproper,andtheymustholdtherestofthebodysteady,insilence,andlisteningtothecommandsoftheoperator.
7.Therearetwoviewsofbandaging:thatwhichregardsitwhiledoing,andthatwhichregardsitwhendone.Itshouldbedonequickly,withoutpain,withease,andwithelegance;quickly,bydespatchingthewithoutpain,bybeingreadilydone;withease,bybeingpreparedforeverything;andwithelegance,sothatitmaybeagreeabletothesight.Bywhatmodeoftrainingtheseaccomplishmentsaretobeacquiredhasbeenstated.Whendone,itshouldfitwellandneatly;itisneatlydonewhenwithjudgment,andwhenitisequalandunequal,accordingasthepartsareequalorunequal.Theformsofit(thebandage?)arethesimple,theslightlywinding(calledascia),thesloping(sima),themonoculus,therhombus,andthesemi—rhombus.Theformofbandageshouldbesuitabletotheformandtheaffectionoftheparttowhichitisapplied.