1894 Journal of the American Medical Association (JAMA)  
mendation of the Board of Examiners, consisting of the members of the Faculty7 and an equal number appointed by7 the Medical Society. The instruction consisted of didactic and clinical lectures and dis¬ sections during the short winter course. Later, in¬ struction was given during the spring months also, and from time to time the number of instructors was increased. That this dual nature of the school and the method of instruction were wisely planned is shown by the position which the school
more » ... which the school took at once in the medi¬ cal instruction of the time. But changes gradually7 took place in the relations between practitioners and students of medicine, and even greater changes in medicine itself, which demanded a different kind of instruction. This school responded early to this Faculty: Rev. 1. With a small, narrow-bladed, sharp knife make a clean incision through the skin of the necessary length, and with another sweep or two cut through the linea alba, muscle, etc. Lift the peritoneum with your fingers, open it, and enlarge the incision. The use of the forceps to lift the tissues, or the grooved director is unnecessary. 2. In closing the abdominal incision use animal ligature, kangaroo tendon and catgut. First carefully bring together the peritoneum in a running stitch, then the transversalis fascia, and the rectus if the incision is through this muscle. Then carefully bring together, edge to edge, the tendinous insertion of the oblique muscles. The fat and loose cellular tissue above, can ba brought together in one or two tiers, according to thickness. Bring the skin together carefully with Marcy's cobbler stitch, thus burying all your sutures. 3. Then seal with collodion, and if everything connected with the operation has been carefully aseptic, absolute pri¬ mary union will take place, and the different layers of the abdominal wall will have been brought together as near as Downloaded From: by a University of Arizona Health Sciences Library User on 06/03/2015
doi:10.1001/jama.1894.02421190027002 fatcat:nx6lpt3j3jdjjd4jaceptbkpa4