PREFACE TO THE FIRST EDITION. THE present "Outlines" comprise, for the most part, little more than the notes from which the Author's Lectures have been delivered, somewhat amplified; and they are offered to the Student, in the hope that he may be encouraged to fill in the details from actual observation, and thereby cultivate a habit of self-reliance, instead of depending too much on bookteaching in his early studies. Illustrative notes and cases, thus collected by himself, can scarcely fail to be of lasting value to him in his future practice. Beyond this legitimate aim, the present volume can, of course, have no pretensions in common. with more comprehensive "Systems" of Surgery.. Progress in scientific knowledge leads to generalisation; and, happily, Surgery affords no exception to this rule. Facts usually admit of a rational explanation, by referring them to the few and simple principles with which they are naturally allied. The author trusts that this association has been rendered apparent in the present epitome; and that the abruptness of diction, in which the information is conveyed, will be excused as inseparable from compressed descriptive writing. The concluding Section is designed to compensate, in some measure, for the brevity with which subjects of great practical importance have been treated in the preceding Sections: and it is the wish and intention of the Author, at a convenient opportunity, to supplement these brief "Outlines," by the publication, in a collected form, of illustrative Clinical Lectures. As this volume is intended especially for the Student of Surgery, a few words of general advice may be added. He must bring an earnest spirit to his work, for it demands the cultivation of many qualities of both heart and intellect. His early and close observation of Nature should teach him to appreciate and trust in her resources, and not to over-estimate his own; the sooner this necessary lesson is learned the better. He will perceive that the Art of Surgery is applied chiefly in removing mechanical obstacles to Nature's healing efforts, or in assisting those efforts in accordance with her indications and under her guidance; as, in the treatment of fracture, the relief of stricture, the removal of a sequestrum, or the excision of a joint. The Science of Surgery comprehends the principles which are designed to teach him how and when to exercise his Art, and the equally important, though not less difficult, lesson of judicious forbearance. In pursuing his studies, he must keep this distinction in view, and strive to maintain a healthy balance, as regards the time and value to be allotted to the guiding principles and the practical detail of his art for, sound Principles, if unaccompanied by an acquaintance with their application, will be of little avail in actual Practice: and, on the other hand, the mere treasuring up of precedents for future guidance cannot fail to prove disappointing. It is true that a remedy may be correctly applied, because its success has been witnessed when it was employed by others. scientific knowledge; it is not satisfactory practice: for the apparently similar is often essentially different; and the Practitioner who is satisfied to act on precedent alone will continually find himself at fault, and also be deprived of the pleasure of practising his Profession philosophically, instead of But this is not following it as little better than a trade. Armed with sound principles, and with such familiarity with their practical application as the period of probation permits him to acquire, the student may commence the practice of his Profession with selfreliance, though still a learner, and never relaxing in his desire to enlarge his stock of knowledge. But the foundation will have been laid; and every stone which subsequently comes to hand will find its appropriate place in the superstructure. His pile will thus assume, from the beginning, an architectural character, instead of becoming, as it may be feared is too often the case, a mere heap of fragments, unwieldy and comparatively useless, if not positively perplexing to the accumulator and possessor. TABLE OF CONTENTS. GENERAL EFFECTS OF DISEASE OR INJURY Functional Diseases in the Vascular System, and their Sequences PAGE ABNORMITIES, DISEASES AND INJURIES OF TISSUES. Skin-Hair-Mucous Membrane-Areolar and Adipose Tissues |
