. The principles and practice of surgery. ntraction and reunion of the divided parts,Dr. Bozeman uses an oiled-silk bag stuffed with sponge, which is keptfirm by tying up the mouth, and removed every day to be cleansedwith carbolic acid or with solution of chlorinated soda. The bag itselfgets rough and must be renewed every second or third day. The rawsurfaces are encouraged to cicatrize by brushing them with a solutionof arg. nitr. 3 i. ad aq. 3 i. freely applied, which affords great comfortto the patient. Position of the Patient.—The knee-elbow position, once exclusivelyemployed by Dr. Bozem
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. The principles and practice of surgery. ntraction and reunion of the divided parts, Dr. Bozeman uses an oiled-silk bag stuffed with sponge, which is keptfirm by tying up the mouth, and removed every day to be cleansedwith carbolic acid or with solution of chlorinated soda. The bag itselfgets rough and must be renewed every second or third day. The rawsurfaces are encouraged to cicatrize by brushing them with a solutionof arg. nitr. 3 i. ad aq. 3 i. freely applied, which affords great comfortto the patient. Position of the Patient.—The knee-elbow position, once exclusivelyemployed by Dr. Bozeman, has been renounced by him on account of itsfatiguing both patient and assistants; and the danger incurred in givinganaesthetics while the body is thus inclined forward at an angle of 45°, with the viscera pressing on the diaphragm and lungs. For the knee-elbow Dr. Bozeman has substituted the knee-chest, or right-angle posi-tion upon knees and chest. I have several times seen him demonstratethe advantages of this position. Fig. 449.. Bozemans Knee-chest Position. 1 By this arrangement the patient is made comfortable, and perfectsteadiness is maintained without the aid of assistants. The apparatusis secured to the table A B, by four thumb-screws. When not in use, it folds at the joint C, while the upright thigh-pieces, disengaged fromthe braces, fall forward. The head-support, unbraced, drops, and isturned under the chest-support, to which a hook fastens it; both thenstand back to back, so that the apparatus looks like an ordinary chair.Its weight, fixtures included, is 17 pounds. The patient is no more New York MecUcal Journal, February, 1869. 920 UEINAEY FISTULA. Fig. 448. exposed than for introducing the speculum. An india-rubber clothprotects her dress, as well as the pads and straps. The advantages of this knee-chest apparatus are :— Extension of thevertebral column with relaxation of the abdominal muscles, permittingthe forward gravitation of the viscera; support and