/^P74> ry/ /^79 COLLEGE OF PHYSICIANS AND SURGEONS LIBRARY — --♦••♦ We take pleasure in informin^^ our friends that our Illustrated Catalogue and Price List with above title, is noiv ready for distribution. Care and expense have not been spared to make this work attractive in appearance and as complete as possible. It numbers j8g pciges^ contains over 2,2j0 first=class original ivood engravings^ and can be obtained ^ handsomely bound in (Russia leather back, cloth sides, ivith gilt title, for the actual cost of Binding, $1.00; postage 35 cents. J\\ (B. — // will be cheaper in many cases to order it sent by express (it weighs a fraction over four pounds'). There will be no deviation or exception from above rule, and, in explanation of possible niisunderstandifig , we wish to make it distinctly understood that we do not charge anything for the Catalogue itself, but merely provide for our friends a fine binding, for which we charge them cost price in order to insure the preservation of the Catalogue. The Arn'iamentarium , apart from being a price list, may justly be regarded as a text book on Surgeons' Instru= ments^ and as such will be a valuable addition to the sur= geons' library. Yours respectfully, GEORGE TIEMANN & CO, 67 Chatham Street, New York. An ABRIDGED CATALOGUE will be sent free upon application. Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/americanarmamentOOgeor GEORGE TIEMANN & CO.'S ARMAMENTARIUM CHIRURGICUM, Messrs. Stohlmann & Pfaere take great pleasure iu offering to the pro- fession the present revised, augmented and supplemented edition of this work. Practitioners of surgery, by consulting the following pages, will be assisted in the choice of the most approved instruments and appliances for the ac- complishment of their purjDoses. Especially will this be the case with those gentlemen engaged in practice at distances remote from the facilities of ob- taining information from personal observation, as well as from intercourse with their brethren of enlarged experience, which populous cities always afford. Moreover, a drawing of an instrument imparts a more accurate conception of its construction, and consequently a clearer idea of its suitableness to the end proposed ; or, the description, however precise, is at times imperfectly comprehended. A drawing often clears the obscurity. In surgical works, the description of many instruments is often necessarily omitted — a mere reference being made to them — which impresses the unin- formed inquirer with the conviction that there are many appliances which he might advantageously employ ; or an ignorance of others, of still more recent introduction, may depiive him of means which, if placed in his hands, would enable hira to effect the desired result. A knowledge of these facts has induced the publication of the present volume, which, it is earnestly hoped, will meet the wants of the profession. It is proposed from time to time to issue a suj^plement to the Aejiamex- TARiuM ; and those physicians and surgeons Avho desire to introduce new instruments are requested to communicate with the publishers, — that the in- ventions may be more thoroughly known, and drawings and descriptions inserted in the supplementary j^ages of the volume. Old Stand, Established 183G. Bkanch Off Geokge Tiemawn & Co., East SSth Street, New Yokk. THE AMEEICAI^ mmmi George Tiemann & Co. 67 CHATHAM STREET, NEW YORK. 3/^t? (j0 4.00 1 Short Catling or Breast Knife .........= 2.00 1 Scalpel, chequered handle 1.00 1 Tenaculum , 0.75 1 Pair fenestrated spring-catch Artery Forceps 2.00 1 Pair Liston's Bone Forceps. • 3.00 1 Elevator with Raspatory , 1-50 1 Brush.. 0.25 1 Hey's Saw .... 1.75 1 Gait's conical Trephine and handle • 4.00 1 Tourniquet .• ■■ 2.00 12 Needles, Silk, Wax, Plastic Pins 1-00 2 Small Scalpels, @ 75 cts , 1-50 1 Bistourie, sharp-pointed 100 1 Bistourie, probe-pointed ^ 1 00 F. A. Stohlmann. Edward PJterre. Part 1. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, AMPUTATING AND TEEPANNINa. Fig. 3. — Metacarpal Saw. P. A. Stohlmann. l\tVAP^U^i-CO Trephines, p. 12-20 ; Elevators, p. 10 ; Tircfond, p. 16. Edward Pfarre.. Part I. 67 CHATHAM-STREET, NEW-YORK. 5 1 Bistourie, finger $1.00 1 Tenotome 1.00 1 Trocar and Canula 2.00 1 Aneurism Needle 0.75 1 Mahogany Case, lined with oil-dyed velvet 10.50 Amount $52.00 BUCK'S G-ENERAL OPEKATINa SET. 1 Liston's long Knife, Hip and Thigh |4.50 1 " medium Knife, Leg and Arm ^ gy 1 Metacarpal Knife, large 2 00 1 Straight Bistourie, ferruled handle. „ . . , -^ 25 1 Curved Bistourie, sharp point -|^ 25 1 Curved Bistourie, probe point , -^ 25 1 Hernia Bistourie 1.25 1 Tenotome j 25 4 Scalpels, assorted sizes, @ $1.25 , , . g qq 1 Tenaculum _ 2^25 1 Pair Crampton's Artery Needles ^ qq 1 Double-pronged Hook , _ ^50 1 Beer's Cataract Knife , -. kq I Desmarre's Scarifying Knife -| qq 1 Straight Eye Needle , , , . . . 1 25 1 Curved Eye Needle ^25 1 Gouge and Spud for removing foreign bodies from the eye , 2 00 1 Folding Probang with silver Bucket 2 50 1 Long Bullet Probe, German silver ^ .50 1 Nelaton's Bullet Probe , q gQ 1 Pair German silver Retractors , , . . , _ ^ 1 50 1 Double silver Trachea Tube ^ _ g 00 1 Curved Rongeur, with spring 3 50 1 Ferguson's Bone-Holding Forceps, lion jaw 3 00 1 Pair Liston's Bone Forceps _ 3 qO 1 Pair Sequestra or Toe-nail Forceps 2 50 1 Small straight Trocar and Canula o qo 1 Ferguson's Bone-holding Forceps, crow-bin 3 00 1 Rectum Trocar and Canula, curved, 3 Oq 2 Gouges @ 11.50 o qo 2 Chissels @ $1 g qq 1 Straight Trocar and Canula, large size, 2 00 1 Pair Lithotomy Forceps 2 50 1 Glass Ear Speculum 50 1 Tourniquet 2 OO 4 Silver Catheters, Nos. 3, 6, 9, 12 § OG 1 Tiemann & Co.'s Bullet Forceps 2 25 1 Steel Director q gO 1 Pair Coxeter's Forceps 1.00 V. A. Stohlmann. Edward Pfarre. Part I. GEO. TIEMAKN & CO.S SURGICAL INSTRUMENTS, AMPUTATINQ, TREPANNING AND MINOR OPERATINa. Yio. 16.— BntcluT's Bow Saw, Avitli two Blades. Double Hook Operating Scalpels. Fig. 21. Fig. 17. 18. 19. 20. Tenotomes. Fig. 22. 23. 24. 25. ft i ^ ^ (T) 1 5 P. A. Stohlmann. Edward Pfarre. 32 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, AETEEIAL. Fig. 104.— Petit's Spiral Touruiquet. Fig. 104^*. — Cliarriere's Tourniquet. Fig 105. Prussian. U. S. A. Field Tourniquets. Fig. 106. Valentine Mott's Tourniquet. Fig. 106&. — Gross' Tourniquet. Fig. 107. — Field Tourniquet. F. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM-STREET, NEW-YORK. 33 1 Pair epring-catch Artery Forceps $1 .50 IHey'sSaw... 1.75 1 Pair Liston's Bone Forceps 3.00 1 Capital Saw 5.00 1 Steel Director 0.60 2 Silver Probes 0.75 12 Needles, Silk, Wax and Plastic Pins 1.00 1 Whalebone Bullet Probe 0.50 1 Rosewood Case, lined with oil-dyed velvet ... 16. 00 Amount $61.85 "No. 1. MINOR OPERATINQ SET. 1 Straight Finger Knife $1.00 1 Curved probe-pointed Bistourie 1.00 1 Curved sharp-pointed Bistourie 1 .00 1 Cooper's Hernia Knife 1.00 3 Scalpels, assorted, @ 75 cts 2.25 1 Tenotome 1.00 1 Aneurism Needle 0.70 1 Tenaculum 0.75 6 Needles, Silk, Iron Wire and Plastic Pins 0.75 1 Pair straight Scissors 1 .25 1 Pair Dressing Forceps 1.50 1 Pair plain Artery Forceps . 0.75 1 Steel Director 0.60 1 Rosewood Case, lined with oil-dyed velvet 4.50 Amount $18.05 No. 2. MINOR OPERATING SET. 1 Straight Finger Knife $1.00 1 Curved probe-pointed Bistourie 1 00 1 Curved sharp-pointed Bistourie 1.00 1 Cooper's Hernia Knife 1.00 3 Scalpels, assorted, @ 75 cts 2.25 1 Tenotome 1.00 1 Aneurism Needle 0.70 1 Tenaculum 0.75 6 Needles, Silk, Iron Wire and Plastic Pins 0.75 1 Pair straight Scissors j 25 1 Pair Dressing Forceps 1 50 1 Pair plain Artery Forceps 75 1 Steel Director 60 P. A. Stohlraann. Edward Pftirre. 34 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, ARTEEIAL. Fig. 108. — Ericlisoii's Arterial Compressor. Fig. 110. — Skey's Arterial Compressor. Fig. 111. — Esmarch's Bandage Clamp. Fig. 1115. — Langenbeck's Bandage Clamps. For Esmarch's Bloodless Method. Esmarch's Tourniquet, see Fig. 184, Part TV. F. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM-STREET, NEW- YORK. 35 1 Compound Catheter, male and female, plated $2.00 1 Pair Spring-catch Artery Forceps, fenestrated 2.00 2 Silver Probes 0.7o 1 Hard-rubber Caustic Holder 1.00 1 Rosewood Case, lined with oil-dyed velvet 5.75 Amount $25.0.5 No. 3. ElSrOS' MIlSrOR OPERATING SET. 1 Double Hook $1.75 1 Curved sharp-pointed Bistourie 1 25 1 Curved probe-pointed Bistourie • 1.25 1 Cooper's Hernia Knife 1.25 4 Scalpels, assorted, @ S1.25 5.00 ' 1 Pair small Polypus Forceps 1-50 1 Tenotome 1.25 1 Tenaculum , 1.25 1 Aneurism Needle 1.25 1 Narrow Metacarpal Saw , » < . . . 1.50 1 Pair plain Artery Forceps 0.75 1 Small Trocar 2.00 1 Pair angular-curved Scissors 1.50 1 Pair slide-catch Artery Forceps 2.50 6 Needles, Silk, Iron and Silver Wire 1.25 1 Steel Director 0.60 2 Silver Probes 0.75 1 Rosewood Case, lined with oil-dyed velvet 6.50 Amount $33.10 No. 4. EVES' MINOR OPERATING SET. 1 Double Hook $2.00 1 Curved sharp-pointed Bistourie 1.35 1 Curved probe-pointed Bistourie , 1.25 1 Cooper'c Hernia Knife 1 25 4 Scalpels, assorted, @ $ 1 .25 5.00 1 Tenotome 1.25 1 Tenaculum 1.25 1 Aneurism Needle 1.25 1 Narrow Metacarpal Saw 1.50 1 Pair plain Artery Forceps 0.75 1 Small Trocar 2.00 1 Pair angular Scissors 1 50 1 Pair Polypus Forceps 2.00 F. A. Stohlmann. Edward Pfarre. 36 Pabt I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, AETERIAL. Fig. 113. Briddon's Artery Compressor. o:b The action of this instrument, made elastic, by running the screws through tense india mbber bands, can be tolerated for a long time, without producing any annoying complica- tions. Pressure can be made, either at two points, the distance between which may be varied according to circumstances, or the instrument may be taken apart and a single compressor used as a tourniquet. A smaller instrument can be made for the upper extremity, a larger one adapted for compression of the abdominal aorta. The hard rubber compressors are attached to the Screws by ball and socket-joints and fitted mto concavo-convex caps of hard wood protected by several layers of buckskin. These additional pads are put on just before screwing down, and should be well powdered each time they are applied. For compression at the groin, a ti'uncated cone of lead, (see Fig. C) is required. This weighs 7 pounds, and tapers, so as to leave a neck two inches long, which terminates in a bulb, an inch and a quarter in diameter, covered with buck-skin. Into the base of this cone an iron stem of ten inches length, and a quarter of an inch thickness is secured. To control the circulation it requires also four or five perforated discs (see Fig D), of one pound each, to string over the stem C, which is maintained in position by a cradle, (see Fig B). F. A. Stohlmann. Edward Pfarre. Pakt I. 67 CHATHAM-STREET, NEW- YORK. 37 1 Pair slide-catch Tortion Forceps , $2.50 6 Needles, Silk and Silver Wire 1 25 1 Steel Director , ..... 0-60 3 Silver Probes 0.75 1 Rosevirood Case, lined with oil-dyed velvet 6.50 Amount $:J3.85 COMPACT MIlSrOR OPERATIlSra SET. With Tlemann <& Co^s Patent Catch Instruments. 1 Metacarpal Saw . .......... $1.20 1 Straight Bistourie . 1.20 1 Curved probe-pointed Bistourie ... 1.20 1 Curved sharp-pointed Bistourie 1.20 2 Scalpels, @ |1.20 . 2.40 1 Tenotome 1.20 1 Tenaculum 1.20 1 Post's Exploring and Director Needle. 1.20 2 Handles, @ |1.60 3.20 1 Compound male and female Catheter and Caustic Holder, made seamless, of sterling silver , 5.00 1 Pair slide-catch Artery Forceps 250 1 Pair straight Scissors o , 1.25 1 Steel Director , , 0.60 2 Silver Probes 0.76 6 Needles, Silk, Wax and Plastic Pins 0.75 i Morocco covered Case, lined with oil-dyed velvet 2 75 Amount $27.60 HOSPITAL MINOR OPERATHSTG- SET. 2 Finger Knives, @ $1 $2.00 2 Straight probe-pointed Bistouries, @ $ 1 2.00 1 Straight Hernia Knife 1.00 2 Curved sharp-pointed Bistouries, @ $1 ..... 2.00 2 Curved probe-pointed Bistouries, @ $1 2.00 1 Curved Hernia Knife o 1.00 1 Abscess Knife 1.00 1 Short straight Bistourie , , 1.00 4 Tenotomes, various shapes, @ $1 4.00 1 Tenaculum , 1.00 1 Pair Nichol's Needle Forceps 1.75 1 Pair Parker's Retractors „ 1 .50 F. A. Stohlmann. Edxvard tPfarre. Part 1. 38 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, AETERIAL. Fig. 113. — May's Tourniquet, for the Treatment of Aneurism. A. Pad of pressure. B. Pad of counter-pressure. C. Ball and socket-joint in the pad of pressure, which is governed by the screw and nut, D. E. Detached liey, by whicli (when fitted on F) tlie pads can be separated or approached. O. FenestrsG, by which the pads can be adjusted. H. Strap and buclile. Fig. 114. — Tiemann & Co.'s Direct Pressure Tourniquet. "Will not easily turn over, nor hem the circulation of the venous blood. Fig. 1145. — Acupressure Pins, for arresting Surgical Hemorrhage, &c. See Needles and Wire, see page 63. P. A. Stohlmann. Edward Pfarre. Pabt 1. 67 CHATHAM-STREET, NEW-YORK 39 18 Assorted Needles, Silk, Silver Wire and Plastic Pins $2.50 12 Yards annealed Iron Wire , o 0.10 3 Serrefines, @ 25 cts „ . . , , 75 1 Straight and 1 curved Tonsil Knife, @ f 1.50 ...... ..o, o 3.00 7 Scalpels, assorted sizes and shapes, @ $1 7.00 1 Green's Double Hook, plain 1.50 1 Pair spring-catch fenestrated Artery Forceps 2.00 1 Pair Coxeter's plain Artery Forceps, small .... 1.00 1 Pair Strabismus Forceps o . . . , 1 25 1 Pair Tiemann & Co.'s Bullet Forceps ...... 2.25 1 Whalebone Bullet Probe 0.50 1 Nelaton's Bullet Probe 0.60 1 Pair Polypus Forceps 2.25 1 Pair Yulcellum Forceps 2.25 1 Pair straight heavy Scissors 1.50 1 Pair Scissors, curved on the flat 1.50 ?. Pair Scissors, angular curve 1.50 1 Trocar and Canula o 2.00 1 German silver Ear Speculum , 2.50 1 Belocq's Sound, for epistaxis, sterling silver 3.00 1 Steel Director. 0.60 1 Rosewood Case, brass-bound and lined with oil-dyed velvet 15.00 Amount $74 80 U. S. A= STAFF SURGEON'S MINOR OPERATING- SET. Regulation Style of October, 1867. 1 Amputating Knife $2.50 1 Long Finger Knife 2.00 IHerniaKnife 1.75 1 Straight sharp-pointed Bistourie 1.75 1 Curved sharp-pointed Bistourie 1.75 1 Curved probe-pointed Bistourie „ 1.75 2 Scalpels, large and small, @ $1.75 3.50 1 Pair slide-catch Artery Forceps 3.00 1 Pair Tiemann & Co.'s Bullet Forceps 2.25 1 Pair Dressing Forceps 1.50 1 Pair Coxeter's Dissecting Forceps, smaU 1.00 1 Pair CEsophageal Forceps, French-joint , _ 2.50 1 Set Mott's Aneurism Needles 2.75 12 Surgeon's and 6 Wire Suture Needles 1.50 1 Pair straight Scissors, French-joint 1..50 1 Pair angular Scissors, French-joint 1.50 1 Pair Scissors, curved on the flat, French-joint , 1.50 1 Tenaculum 1.50 1 Rectum Trocar and Canula 300 2 Double Trachea Tubes, sterling silver, @ $6 12.00 P. A. Stohlmann. Edward Pfarre. 40 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, BULLET. Fig. 115. U. S. A. Bullet Forceps. Fig. 116. Tiemann & Co.'s Bullet Scoop. Fig. 117. Bullet Seeker, burr head, Fig. 118. Mose's Bullet Extractor, w///.'/////,'.'///Mw(y Fig. 119 Tiemann & Co.'s Bullet Screw. Fig. 130. Nelaton's Bullet Probe, porcelain head. Fig. 131. Tiemann & Co.'s Bullet Seeker, flexible. ^^^ Fig. 133. Dr. L. A. Satke's Vertebrated Bullet Probe. P. A. Stohlmann. Edward Pfarre. Pakt I. G7 CHATHAM-STREET, NEW-YORK. 41 1 Belocq's Canula for Epistaxis, sterling silver $3.00 1 Nelaton's Bullet Probe 0.00 1 Director and Porte Meche , O.CO 1 Pair flat and cutting Pliers 2.50 1 Wire Ecraseur with two points 6.50 2 Grooved Staffs, @ $2 4.00 1 Syme's Staffs 2.00 1 Plain Sound 1.25 6 Silver-plated, double-curved Bougies, 9.00 3 Silver Catheters 4.50 3 Gum Elastic Catheters, English, @ 40 cts 2.40 1 Prostate Gland Catheter, sterling silver 4.00 24 Suture Pins 0.50 6 Serrefines @ 25 cts 1.50 6 Yards Silver Sutures 3.00 1 (Esophageal Probang, silver Crochet 3.00 1 Tonsilotome - 14.00 1 Pair Trousseaux Tracheal Forceps 2-00 1 Mahogany Case, brass-bound 25.00 I Leather Pouch T.OO Amount $136.35 No. 1. TWO-FOLD POCKET SET. Two-fold Morocco Case, single-hladed Instruments with Tortoise-shell Ilandles, containing : One Scalpel, one probe-pointed Bistourie, one Tenaculum, one pair of straight Scissors, one pair of Artery Forceps, one Spatula, one Compound (male and female) Catheter, one Direc- tor, one pair of silver Probes, six Needles and Silk ; $10.00 No. 2. TWO-FOLD POCKET SET. Two-fold Morocco Case, single-bladed Instruments with Tortoise-shell Handles, containing : One Scalpel, one probe-pointed Bistourie, one Tenaculum, one pair of straight Scissors, one pair of Artery Forceps, one pair of Dressing Forceps, one hard rubber and silver Caustic Case, one Compound Male and Female Catheter, one Director, one pair of silver Probes, six Needles and Silk $12.00 No. 3. THREE-FOLD POCKET SET. Three-fold Morocco Case, single-bladed Instruments with Tortoise-shell Handles. Contents : One Scalpel, one probe-pointed Bistourie, one Tenaculum, one pair of straight Scissors, one pair of Artery Forceps, one pair of Dressing Forceps, one hard rubber and silver Caustic Case, one Spatula, one sharp-pointed Bistourie, one Gum Lancet, one Compound 3Iale and Female Catheter, one Director, one pair of silver Probes, six Needles and Silk $15.00 No. 4. FOUR-FOLD POCKET CASE Leather Case. Contents : One Male and Female Catheter, one Tenaculum, one hard-rubber Caustic Case, two silver Probes, one Exploring Needle, one Director and Aneurism Needle. P. A. Stohlmann. Edward Pfarre. 42 Pakt I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, Ph M i-J BULLET. Fig. 123.— Geo. Tiemann & Co.'s American Bullet Forceps. It Our Bullet Forceps lias also been introduced into the European Armies during the late Franco- German War ; it is highly- recommended by the Armj^ Surgeons, and styled by them "the American Bullet For- ceps." It is also of ma- terial service in the re- moval of i>ortions of necrosed bone. Fig. 1235.— Gross' Bullet Forceps. ^ P. A. Stohlmann. Edward Pfarre, PAIIT I. 67 CHATHAM-STREET, NEW-YORK. 43 one probe-pointed Bistourie, one pair Dressing Polypus Forceps, one Scalpel, one sharp- pointed Bistourie, one pair of straight Scissors, one pair of curved Scissors, one Thumb Lan- cet, one Spatula, one pair of Dissecting Forceps, one straight Finger Bistourie, one Seton Needle, six Needles and Ligature Silk. The Instruments have Tortoise-shell Handles and are Bingle-bladed $21.00 No. 5. HOSPITAL POCKET SET. Threefold Russia-leather or Morocco Case, single-bladed Instruments with Tortoise-shell Handles, containing : One sharp-pointed Bistourie, one probe-pointed Bistourie, one Scalpel, one Tenaculum, one Abscess Lancet, one Compound Catheter, one pair of straight Scissors, one pair of angular Scissors, one pair of Dressing Polypus Forceps, one pair of plain Artery Forceps, one Spatula, one steel Director, two silver Probes, six Needles and Ligature-Silk $18.00 -No. 6. PARKER'S POCKET SET. Twofold Morocco Case, plain double-bladed Instruments with Tortoise-shell Handles, con- taining : One Scalpel and probe-pointed Bistourie, one Tenotome and sharp-pointed Bistou- rie, one Tenaculum and Gum Lancet, one pair of Dressing Forceps, one pair of Artery Forceps, one pair of Scissors, one Lancet, two silver Probes, one steel Spatula, one steel Director, one plated Compound Catheter and Caustic-Holder, six Needles and Silk $18.00 No. 7. PARKER'S FINE POCKET SET. Contents the same as in No. 6. Tortoise-shell Handle Instruments, either slide or spring- catch, extra fine finished, the Compound Catheter (male and female) is made of sterling silver, the Caustic-Holder seamless, will last much longer than a soldered one. The Case is made of genuine Turkey morocco, with a silver lock, very neat and compact $25.00 No. 8. MULTUM IN PARVO POCKET SET. Turkey morocco Case, silk-velvet lining, silver lock. Instruments Tortoise-shell Handles with spring or slide-catch, double-bladed, containing : One Scalpel and probe-pointed Bistou- rie, one sharp-pomted Bistourie and Tenotome, one Gum Lancet and Tenaculum, one pair of straight Scissors, one pan- of fenestrated spring-catch Artery Forceps, one Female Catheter and Caustic-Case made of sterling silver, one steel Director, two silver Probes, six Needles and Silk $19.00 No. 9. G-UNN'S POCKET SET. Turkey morocco Case, silk-vch^et lining, silver lock. Instruments double-bladed, Tortoise- shell Handles with slide or spring-catch. Contents : One Scalpel and Exploring Needle, one sharp-pointed Bistourie and Tenotome, one probe-pointed Bistourie and one Scalpel, one Seton Needle, one Tenaculum, one pair of Scissors, one screw Probe Director, one pair of Tor- tion Forceps with slide-catch and a long groove, answers also for holding Suture Needles, four Suture Needles, one sharp and two blunt Aneurism Needles, one skein Ligature-Silk. $20.00 P. A. Stohlmann, Edward Pfarre. 44 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MmOE OPERATING. Fig. 129. Plain Artery Forceps. Fig. 130. Coxeter's Artery Forceps. ^^S^9^^^^^mmm^ I Fig. 131. Spring-catcli Artery Forceps. Bull Dog or Plain Teeth. W Fig. 132. Slide-catch Artery or Tortion Forceps. Fig. 135. Exploring Director Lancet Point. P. A. Stohlmann. Edward Pfarre. Part 1. 67 CHATHAM-STREET, NEW-YORK. 45 No. 10. VAN BUKEN'S POCKET SET. Turkey morocco Case, silk-velvet lining, silver lock. Instruments doublc-bladed, Tortoise- shell Handles with slide or spring-catch. Contents : One sharp-pointed Bistourie and Teno- tome, one Scalpel and one probo-pointed Bistourie, one Gum Lancet and Tenaculum, one pair of straight Scissors, one pair of Bulldog Artery Forceps, one steel Director, two silver Probes, one silver Male and Female Catheter of sterling silver and Caustic Case sterling silver seam- less, six Needles and Ligature-Silk $22.00 No. 11. aROSS' POCKET SET. Russia-leather or morocco Case, German silver lock. Instruments double and single-bladed, Tortoise-shell Handles with slide or spring-catch. Contents : One pair mouse-teeth Artery Forceps, delicate, one Scalpel, one pair of Dressing Polypus Forceps, one probe-pointed Bis- tourie and Tenaculum, one sharp-pointed Bistourie and Tenotome, one pair of straight Scis- sors, one Finger Bistourie, one Caustic-holder, plated, one pair Vulcellum Forceps, one Ex- ploring Needle, one Gross' Ear Spoon, one steel Director, six Needles and Ligature-Silk, two silver Probes, one Male and Female Catheter |22.00 No. 12. G-ROSS' FINE POCKET SET. Two-fold Turkey morocco Case, lined with silk velvet, silver lock. Contents the same as in No. 11. The Caustic Case is made of sterling silver, seamless, lasting much longer than a soldered one. The Male and Female Catheter are of sterling silver and the whole of extra fine finish and quality $26.00 No. 13. U. S. A. POCKET SET. Russia leather Case with German silver lock. Instruments all single-bladed, Tortoise-sheU Handles with spring or slide-catch and plain. Contents : One Scalpel, one straight Finger Knife, one curved probe-pointed Bistourie, one curved sharp-pointed Bistourie, one Tenotome, one Gum Lancet, two Thumb Lancets, one small Razor, one pair Artery Forceps, one Aneurism Needle, one Exploring Needle, one Tenaculum, one pair of Scissors, one steel Director, three silver Probes, one silver Caustic Case, one Compound Catheter, six yards Iron Wire, six Needles and Ligature Silk $28.00 No. 14. HEED'S POCKET CASE. Turkey morocco Case, silk-velvet lining, silver lock. Instruments double-bladed. Tortoise shell Handles, slide-catch. Contents : One Scalpel and probe-pointed Bistourie, one sharp- pointed Bistourie and Tenotome, one Gum Lancet and Tenaculum, one pair of straight Scis- sors, one pair Bulldog Artery Forceps with spring-catch, one pair Dressing Polypus Forceps, one Spatula and Elevator, one steel Director, two silver Probes, one Metacarpal Saw, one Thumb Lancet, one Exploring Needle, one Compound Catheter and Caustic Case of sterlinff silver, six Needles and Ligature Silk $27.00 No. 15. HAMILTON'S POCKET SET. Turkey morocco Case, lined with silk-velvet, silver lock. Instruments double-bladed. Tor- toise-shell Handles with spring-catch. Contents : One large Scalpel and Explorinf Needle, P. A. Stohlmann, Edward Pfarre. 46 Pakt I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MINOR OPEEATINa. Fig. 136. Tenaculum. See also Figs. 12. 33. Fig. 137. Small Scalpel. 'G. TIEMANN & CO. Fig. 138. Medium Scalpel. G. TrEMAlNi, & CO. Fig. 139. Curved Probe-poiuted Bistourie. Fig. 140. Cooper's Hernia Eaiife. Fig. 141. Fig. 142. Fig. 143. Curved Large Scalpel. Straight sharp-pointed Finger Knife. Bistourie. J '=n^ <0 "F. A. Stohlmann. Edward Pfarre. FQ fH Part I. 67 CHATHAM-STREET, NEW-YORK. 47 one medium and one small Scalpel, one Tenaculum and aneurism Needle, one sharp and one blunt-pointed Tenotome, one Metacarpal Saw, one pair of Bull-Dog Artery Forceps with spring-catch, one pair of slide-catch Tortion Forceps, one pair of straight Scis.sors, one Thumb Lancet, one set of silver Probes and Nelaton's Bullet Probe, one Male and Female Catheter and Caustic Holder of sterling silver, six Needles and Ligature Silk $.'J2.00 The same without the Catheter and Caustic Case $27.00 No. 16. FINE rOUK-FOLD POCKET CASE. The Contents of this Set are the same as in No. 4. But the Instruments are all of the very best quality and finish ; Tortoise-shell Handles with spring or slide-catch. The Cathe- ters and Probes are of sterling silver. This Set is put up in a very neat Turkey morocco Case with a silver lock $36 00 No. 17 HEG-IMENTAL SURG-EONS' POCKET SET. Russia leather Case with strong German silver lock. Instruments plain, single-bladed. Tor- toise-shell Handles. Contents : One Scalpel, one sharp-pointed Bistourie, one probe-pointed Bistourie, one Finger Bistourie, one Gum Lancet, one Thumb Lancet, one smaU Razor, one pair of Dressing Forceps, one Artery Needle, six Surgeon's Needles, one Exploring Needle, one Tenaculum, one pair of Scissors, one steel Director, three silver Probes, one silver gilt Caustic Holder, one Compound Catheter, three yards of Iron Wire for Sutures, one pair of plain Artery Forceps, one Tenotome, Ligature Silk and Wax |23.00 No. 18. DUG-AS' POCKET SET. Turkey morocco Case lined with silk-velvet, silver lock, and chamois-leather pouch. In- struments have Tortoise-shell Handles with a very firm slide-catch, two strong blades in one handle. Contents: One jointed Porte Caustic for nitrate of silver and sulphate of copper and one Cataract Needle and one male and female Catheter made of sterling silver, one pair of Dissecting, Artery and Needle Forceps, one Thumb Lancet, one pair of delicate Artery Forceps, one Spatula and Elevator, one Belocq's Sound of sterling silver, one pair of curved Scissors, one Ear Spoon and Tumor Hook, one grooved Director of sterling silver, two Eye Probes, two Probes and Director Probe of sterling silver, one Porte Meche, one pair of Po- lypus and Shot Forceps, one Dupuytren's Probang with three silver joints and sii^ er basket, one large and one smaU French Finger Knife, one large and one small straight Bistourie, one straight probe-pointed Bistourie and Tenotome, one Gum Lancet and Exploring Needle, one Tenaculum and Artery Needle, six curved and six straight Needles, Silver Wire and Silk Sutures $56.00 No. 19. DUG-AS' DRESSING CASE. One morocco Case lined with silk velvet, silver lock. Contents : One silver Caustic Case, one Dissecting Artery and Needle Forceps, one Thumb Lancet, one pair of straight Scissors, one grooved Director, one silver Probe with an eye, one silver grooved Probe, one large and one small straight Bistourie, one Tenaculum and Gum Lancet, six Needles and Suture Silk, $18.00 No. 20. J. R. WOOD'S POCKET SET. Morocco Case lined with silk velvet. Instruments double bladcd, Tortoise-shell Handles with spring or slide catches. Contents : One Scalpel and Gum Lancet, one Scalpel and Teno- P. A. Stohlmann. Edward Pfarre. 48 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MINOR OPEEATma. Fig. 144. — Peter's Hernia Director. Fig. 145rr — Hamilton's Dry Dissector. G.TIEMANN 8. CO. Fig. 145i. — Hamilton's I')rv Dissector. G.TIEMANN 8. CO. Fig. 147. Fig. 148. a. b. c. Fig. 14Ga.— Little's large Scalpel. b. — Little's medium Scalpel. c. — Little's small Scalpel. d. — Little's Tenaculum. e. — Little's Aneurism Needle. Fig. 147.— Little's Retractor. Fig. 148a. — Little's sharp-pointed Bistoury. b. — Little's Hernia Knife. c. — Little's probe-pointed Bistoury. d. — Little's straight Bistoury. The extremity of the handles are rounded off and brought to a dull edge to use in dry dis- secting. "P'tg. 149. — Artery Scissors, or for opening other small Canals. F. A. Stohlmann. Ed'ward Pfarre. Pakt I. 67 CHATHAM-STREET, NEW-YORK. 49 tome, one sharp and one probe-pointed Bistourie, one Aneurism Needle and one Explorinp: Needle, one Compound Male and Female C;itheter and Caustic case, one pair of straiglit Scissors, one Pair of Dressing Polypus Forceps, one pair of Hamilton's Artery Forceps, one pail of plain Artery Forceps, one grooved silver Probe and Nelaton's porcelain head in three parts united by screw, one Lancet, two plain silver Probes, one coil silver Suture "Wire, six Needles and Ligature Silk $27.50 No. 21. TIEMAlSriSr & CO.'S PATENT POCKET CASE. PATENT CATCH INSTRUMENTS. See Fig. 185. A very neat and compact Case of Turkey morocco, with silver lock. Contents : Two patent catch Handles, one Post's Explormg Needle, one Tenaculum, one Gum Lancet, one sharp- pointed Bistourie, one probe-pointed Bistourie, one Tenotomy Knife, one large Scalpel, one small Scalpel, one Finger Knife, one Metacarpal Saw, one Lancet, one pair of straight Scis- sors, one pair of Dressing Forceps, one pair of spring-catch fenestrated Artery Forceps one Spatula, one grooved Director and Aneurism Needle, two silver Probes, one Compound Ca- theter of sterling silver, one Caustic Case of sterling silver made seamless, six Needles and Suture Silk, two coils of silver Suture Wire $33.00 No. 22. EXHIBITION POCKET SET, extra size. Five-fold Turkey Morocco Case with one inner and one outside silver lock, containing : Our patent-catch Instruments, two large and two small Tortoise-shell patent catch Handles, one moveable back Saw and one Amputating Knife, both 5 inch blades, one Amputating Scalpel, two assorted Scalpels, one Tenotome, one Gum Lancet, one blunt-pointed straight Bistourie, one curved probe-pointed Bistourie, one curved sharp-pointed Bistourie, one Post's Wire Needle, one Cataract Needle, one Cooper's Hernia Knife, one Tenaculum, one Exploring Lancet, one Aneurism Needle, one Belocq's Sound for epistaxis (silver), one silver Male and Female Catheter with Caustic Case, one Abscess Lancet, one Thumb Lancet, one Weir's Yaccinating Lancet, one Seton Needle, one pair of straight Scissors, one pair of angular Scissors, one fenestrated sprmg-catch Artery Forceps, one Tortion Forceps, one Front's Needle Forceps with slide- catch, one pair of Polypus and Dressing Forceps, combined with Tiemann & Co.'s Bullet Ex- tractor, Uterine and ffisophagus Forceps and Vuloellum Forceps, Ligature, Suture Needles, Plastic Pins, silver and Iron Wire, Serrefines, one pair of fine curved-up Scissors, one Thumb Forceps for extracting splinters, &c., one Exploring Trocar, one Trocar for hydrocele and escites, one set of silver Probes with Nelaton's Bullet Probe, one Director, one Porte Meche, one whalebone Probe, one Artery Constrictor, one Ear-Scoop and Hook to remove foreign bodies, one Spatula with Elevator $100.00 TREPANNING SET. Contents : One Gait's Trephine, one Crown Trephine, one Trephine Handle, one Trepan- ning Scalpel and Raspatory, one Trepanning Elevator, one Hey's Skull Saw, one Brush for cleaning Trephines and Saw. in a Mahogany Case. » $16.00 F, A. Stohlmann. Edward Pfarre, 50 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MINOR OPERATINa. Fig. 150. Angular Operating Scissors. F. A. Stohlmaun Edward Pfarre. Part I. 67 CHATHAM STREET, NEW YORK. 51 No. 23. SAYRE'S POCKET SET. Two-fold morocco Case. One sharp and blunt-pointed Tenotome, one Tenaculum and sharp- pointed Bistoury, one Scalpel and probe-pointed Bistoury, one Finger Knife, one pair plain Artery Forceps, one pair straight Scissors, one Director and Tongue-Tie, one pair silver Probes, one Compound Catheter, silver, one silver Caustic Case, seamless, six Needles, Silk and Wax. $23.50 No. 24. LITTLE'S POCKET SET. Two-fold Russia leather Case, Instruments slide catch, Turtle Shell handles. One Scalpel and sharp-pointed Bistoury, one Tenaculum and probe-pointed Bistoury, one Gum Lancet and Tenotome, one Hernia Bistoury and Finger Knife, one pair angular Scissors, one pair Poly- pus dressing Forceps, one pair fine Thumb Forceps, one Weir's Vaccinating Lancet, one Ex- ploring Needle, one Spatula Avith Tongue-Tie, one Director and Aneurism Needle, one Parker's silver Cnthc+^r ani Caustic Case, two silver Probes, six Needles, Silk and Wax .$25.00 WlLh Thermometer $28.00 TTo. 25. HELMUTH'S POCKET SET. Either two- or three-fold morocco Case. One Tenaculum and Hernia Knife, one Scalpel and Tenotome, one sharp and probe-pointed Bistourie, one Front's Needle Forceps, one pair fenes- trated Artery Forceps, one pair plain Artery Forceps, one pair Dressing Forceps, one pair Scissors, one Uterine Sound, to screw apart, one Thermometer, one Compound Catheter and Caustic Case, plated, one steel Director, two Probes, one Exploring Trocar, one Hook and Ad- juster, six Needles, Silk, Wax $32.00 No. 26. CROSBY'S POCKET SET. One-fold morocco Case. One Scalpel and probe-pointed Bistoury, one Tenotome and sharp- pointed Bistoury, one Tenaculum and Exploring Needle, one pair Artery Forceps, one pair Scissors, one Director and Aneurism Needle, two Probes, six Needles, Silk, Wax $15.00 No. 27. MINOR'S POCKET SET. Two-fold morocco Case. One pair spring-catch Forceps, one pair Hamilton's Arterj'- For- ceps, one Tenaculum and Aneurism Needle, one sharp- and one blunt-pointed Tenotome, one sharp-pointed Bistoury and Scalpel, one silver Probe and Director, one pair Scissors, six Needles, Silk, one silver Catheter and Caustic Case $22.50 F. A. Stohlmann. Edward Pfarre. 52 Part 1. GEO. TIEMANN & CO 'S eURGICAL INSTRUMENTS, MINOE OPEEATma. Fig. 155. Parker's Comijound Catheter and Caustic Holder. Fig. 159. Spatula. Made of Steel or Hard Rubber. TIEMANN i. CO. F. A. Stohlmann. Edward Pfarre. Part 1. 67 CHATHAM STREET, NEW YORK. 53 ISTo. 28. WIG-HT'S POCKET SET. Two-fold Frame Case. One Scalpel and Finger Knife, one Tenotome and sharp-pointed Bistoury, one Scalpel and probe-pointed Bistomy, one Tenaculum and Gum Lancet, one pair Wight's Artery Forceps, one pair Thumb Forceps, one Sand's Needle Holder, one Exploring Needle, one pair straight Scissors, one pair curved Scissors, one Thermometer in hard-i-ubber Case, one Parker's Catheter and Caustic Case, one Director and Aneurism Needle, two silver Probes, one Metacarpal Saw, six Needles, Silk, Wax $37.00 :N"o. 29. WEIR'S POCKET SET. Either two- or three-fold morocco Case. One Aneurism Needle and sharp-pointed Bistoury, one Gum Lancet and probe-pointed Bistoury, one Hernia Knife and Tenaculum, one Tenotome and Scalpel, one pair Scissors, one Director, two Trobes, one Thermometer in silver Case, one pair Thumb Forceps, one pair Dressing Forceps, one Weir's Vaccinating Lancet, one silver Female Catheter and Caustic Holder, one Stimson's Hypodermic Syringe, six Needles, Silk, Wax, Wire $30.00 No, 30. G-AY'S POCKET SET. SPRING-BACK INSTRUMENTS. Morocco Case, 4 inches long oy 2 wide, silver lock. One Tiemann & Co.'s bent Thermo- meter, one patent Hypodermic Syringe, one Scalpel and probe-pointed Bistoury, one Gum Lancet and Tenotome, one Female Catheter and Caustic Case, one Gay's Scissors, both rings open (Fig. 1756), one pair Artery Forceps, plain, one Spatula and grooved Director Probe, steel, one silver Director Probe, one silver Probe, six straight Needles, Silk, Wax $22.00 No. 31. ANDREWS' POCKET CASE. Black hard rubber Case, with nickel-plated mountings, the instruments placed on metallic rests, so as to dispense with velvet lining. One Scalpel, one curved sharp pointed Bistoury, one curved blunt pointed Bistoury, one Tenotome, one Tenaculum, one grooved Exploring Needle, one Abscess Lancet, one pair Scissors, one pair Dressing Forceps, one pair Artery Forceps, toothed, one pair Andrew's toothed bull-dog Forceps, one combined Catheter, one Andrew's pocket case Saw, one ivory card for Ligature, one grooved Director, one Probe, 6 Needles, kept in a little compartment with a metallic, nickeled lid. The first seven instruments each in a thin ivory handle, the length not to exceed 5 inches, these are set up edgewise in the Case. (Figs. 17, 18, &c., page 6) $28.00 F. A. Stohlmann. Edward Pfarre. 54 Part I. GEO. TIEMANN & GO'S SURGICAL INSTRUMENTS, MmOE OPEEATING. Fig. 160. Plain Shell Handle Pocket Instrument. Siuijle bladed. viz : Curved Bistouries, sharp and probe-pointed Scalpels, large and small French Finger Knives, Tenaculums, Gum Lancets, Abscess Lancets, Thumb Lancets, Vaccinnating Lan- cets, &c. Fig. IGL Seton Needle, Fig. 162. Plain double bladed Fig. 163. Tortion Forceps Pocket Instrument. P. A. Stohlmann. Ed-ward Pfarre. Part 1. 67 CHATHAM STREET, NEW YORK. 55 No. 32. WOODWARD'S POCKET SET. (By Dr. Woodward, Surgeon General Marine Hospital Serviee, U. S.) Two-fold red morocco Case, with metal hinge and lo(;k, very flat. One male and female Cathether, silver, one Vaccinating and one Exploring Lancet, concealed inside of the Catliether, one open ring Dressing Forceps, answers for holding needles also ; one pair of Scissors with one open ring, one Tenotome and Scalpel, white handle, spring back; one sharp-pointed and one probe-pointed Bistoury, white handle, spring back ; one Abscess Lancet, one silver Ear Spoon and Probe, one steel Tenaculum and delicate Ear Hook, one Director and Sim's Adjuster, six Needles, Silk and Wax. Price $22.00 No. 33. MASON'S POCKET CASE. Fine two-fold morocco Case. One Scalpel and Gum Lancet, one Scalpel and probe-pointed Bistoury, one sharp-pointed Bistoury and blunt-pointed Tenotome, one Tenaculum and Aneur- ism-Needle, ( all of these Tortoise-shell handles with slide catches) ; one pair Hamilton's Artery Forceps, one pair silver Probes, one German-silver Director, one pair small Thumb Forceps, one pair fine Polypus dressing Forceps, one fine Thumb Lancet, shell handle, one Parker's plated Catheter, one pair straight Scissors, one fine self -registering Thermometer, six Needles, Silk, Wax $30.00 LITTLE'S QENERAL OPERATING- SET. Two Screw Handles, to fit, one large and one small Amputating Knife and one Bow Saw, one pair Phelps' Torsion Forceps, one pair plain Artery Forceps, one pair Bone Forceps, one Spiral Tourniquet, one Nelaton's Probe, one Tiemann & Co.'s Bullet Forceps, one Students' Aneurism Needle, one Director with Tongue-Tie,- silver, one Hernia Director, one Trocar, one pair Polypus Forceps, one pair delicate straight Scissors, one pair strong Scissors, curved flatwise, one pair Cuskoe's Throat Forceps, one plain Trepanning Elevator, one curved Rongeur, one Van Buren's Sequestrum Forceps, one plain Chisel, one plain Gouge, one Pereos- teotome, one Gait's Trephine, three sizes Scalpels, one French Finger Knife, one sharp-pointed Bistoury, one probe-pointed Bistoury, one Hernia Knife, two Retractors, one Tenaculum, one plain Aneurism Needle, one fine silver Probe, two silver Probes, three plated Catheters, one Prostatic Catheter, three steel Sounds, twelve Needles, Silk, silver Wire, Plastic Pins, Wax. Rosewood Case, brass bound, lined with oil-dyed silk velvet $100.00 LITTLE'S MINOR OPERATING- SET. Three sizes Scalpels, one sharp-pointed Bistoury, one probe-pointed Bistoury, one Finger Knife, one Tenaculum, one Hernia Knife, one pair Thumb Forceps, one pair Phelps' Artery and Torsion Forceps, one Aneurism Needle, two Retractors, one Peter's Hernia Director, one Trocar and Canula, one pair angular Scissors, one German silver Director, two silver Probes, one small curved Rongeur, six Needles, Silk, Wax, Wire. Rosewood Case, lined with oil-dyed velvet $37.00 F. A. Stohlmann. Edward Pfarre. 56 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MmoE oPERATma. Fig. 164. Spear-poiuted Thumb Lancet, Fig. 165. Abscess Lancet. Fig. 167. Cooper's Hernia Knife Fig. 166. Broad-pointed Thumb Lancet. Fig. 168. Curved Probe-pointed Bistourie. (U W Fig. 169. Curved sharp-pointed Blstoune F. A. Stoliimanu. Edward Pfarre. Part 1. 67 CHATHAM STREET, NEW YORE. 67 OTIS' U. S. A. COMPACT FIELD SET. TRAY No. 1, G.TlEiViANNaCO Fitting over the compartment A, contains : — One strong Cartilage Knife, one small Ampu- tating Knife, one medium Catling, one medium Amputating Knife, one large Catling, one major Amputating Knife, one straight sharp-pointed Bistoury, one curved shai-p-pointed Bis- toury, one probe-pointed curved Bistoury, one long straight probe-pointed Bistoury, one Tena- culum, one large Scalpel, one small and one very small Knife for dissections and ligations. TRAY Na.a. G.TiEMANN SlCQ Fitting into compartment, B, contains : one Hey's Saw, one Torsion Forceps, one Needle Forceps, one Artery Needle Holder with 4 points and 1 key. GT.Firrti4i'<&CQ F. A. Stohlraann. Edward Pfarre. 58 Part 1. GEO TIEMANN & CO 'S SURGICAL INSTRUMENTS, MINOE OPEEATma. Fig. 170. Pocket-Scalpel Avitli slide catck. Fig. 171. Tenotome Fig. 173. Gum Lancet. Fig. 173. Tenaculum Fig 174. Syme's Abscess Knife and Scalpel. pq % F. A, Stohlmann, Edward Pfarre. Pabt T. 67 CHATHAM STREET, NEW YORK. 59 OTIS' COMPACT FIELD SET. (continued.) Compartment A contains :— One Tourniquet, one large Liston's Bone Forceps, one Rongeur, one Sequestrum Forceps, one Lion Forceps, one conical Trephine, one Trepliine-brusb, two Ger- man-silver Retractors, one Osteotome, handle with 4 points, one Tire-fond, one Oliver's curved Osteotome and Chain-Saw Conductor, one Scissors, one Dissecting Forceps, one Artery Forceps, one silver grooved Director. Compartment B contains : — One major Saw with 2 extra narrower blades, one moveable back Saw, one English No. 6 gum elastic Cathether, one Elevator, one Bullet Forceps (Gross), one Tiemann & Co.'s Bullet Forceps, one long articulated Probe or sonde depoitrine with 2 Nelaton or porcelain tips, one burrheaded Ballsearcher, one Chain-Saw, rotating handles and needle, ten large Serresfines, two coils of annealed iron wire under the moveable back saw ; silk, linen and catgut Ligatures, Wax, silver suture Wire, surgeons' curved Needles, acupressure Pins, two silver Probes. Mahogany Brass-bound Case, lined with oil-dyed velvet $160.00 DARBY'S COMPACT OPERATING- SET. One Amputating Knife, clasp-handle ; one Finger Knife, one Amputating Scalpel, one Aneurism Needle, one Operating Scalpel, one Tenotome, one hard rubber Trachea Tube ; four instruments, consisting of one Gouge and three Pereosteotomes and Levators, fitted into one strong handle ; one folding Tourniquet, three Serres-fines, one Metacarpal Saw, one Hey's Saw, one Trepanning Elevator and Raspatory, one Catling clasp-handle, one Hamilton's spring catch Artery Forceps, one Torsion Forceps, one Darby's Forceps, one Gait's Trephine, 1 small Trephine, 1 Trephine Handle, one Bow-saw with two blades, one Darby's Rongeur and Bone- holder, 1 Chain-Saw and Needle, six Suture Needles, Silk, Pins, Wax, 1 Liston's Forceps. Rosewood Case, lined with oil-dyed velvet , . . . ,$80.00 MASON'S MINOR OPERATING^ SET. IVORY HANDLE INSTRUMENTS WITH FERULES. One Metacarpal Saw, four Scalpels, four Bistouries, one Tenotome, one Tenaculum, one set Fletcher's Aneurism Needles, one pair straight Scissors, one pair angular Scissors, one pair Dressing Forceps, one pair fine Thumb Forceps, one pair fenestrated Artery Forceps, one pair Front's Needle-Forceps, one Hydrocele Trocar, one Exploring Trocar, one German Silver Di- rector, one pair Silver Probes, Needles, Silk, Silver Wire. Mahogany or Rosewood Case, lined with oil-dyed silk velvet $44.00 P. A. Stohlmann. Edward Pfarre. 60 Part 1. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, MINOE OPEEATING. Fig. 175. — Four Bladed Spring-catch Pocket Instrument. M Fig. 175 J. — Gay's Open Ring Scissors. Fig. 176.— Two Bladed Spring-catch Pocket Instruments. P. A. Stohlmanu. Edward Pfarre. Part I. 67 CHATHAM-STREET, NEW-YORK. Fia. 177. Scalpel and Probe-pointed Bistouric 61 Fig. 178. Silver Probes. G. TIEMANN & CO. Fig. 179. Tenaculum and Fig. 180. Post's and Buck's Gum Lancet. Needles. Fig. 181. Sharp-pointed Bistourie and Tenotome Fig. 182. . Director and Aneurism Needle. Fig. 183. Port mecbe. G. TIEMANN & CO. Fig. 184. Director and Tongue Tie. F. A. Stohlmann. Edward Pfarre. 62 Pakt I. GEO. TIEMANN" & CO.'S SURGICAL INSTRUMENTS, MmoE oPEEATma. EiG. 185. — Tiemann & Co.'s Putent-Catcli Pocket Set. ri^-^ F. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM STKEET, NEW YORK. 63 SUTUEE NEEDLES. Fig. 186. — Stimson's Needle Holder and Cutting Forceps. Fia. 188.— Fiill Cnrve Suture Needles. a b c d e f g Fig. 189.— Half Curve Suture Needles. a b G defy Satin Sewing Silk, page 16. Fig. 190.— Wire Suture Needles. a b c d e f g F. A. Stohlmanu. PER COIL. Silver Wire for Sutures $0.50 Iron, annealed , - 02 Price of Needles. EACH. Full Curve, any size ' $0.10 Half Curve, any size 10 Straight flat Needles 10 Wire Suture Needle, triangular 05 Fine Suture Needles for operations on the Eyes and Lids, straight or curved 15 Sim's Needles for Vesico-Vaginal Fistula 15 Bozeman's Needles for Vesico-Vaginal Fistula 40 Emmett's Needles for Vesico-Vaginal Fistula 15 Stohlmann's Wire Needle 50 Greenville Dowell's Needle for Hernia 75 Shrady's open-eyed Needle 25 Piatt's open-eyed Needle 25 Edward Pfarre. 64 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, CUPPING. Fig. 191.— Tiemaiui & Co.'s Patent Scarificator. Fig. 193. Ten-Bladed Scarificator. Fig. 193. Glass and Rubber Cup. ^tiemanm3j m Fig. 194. Twelve-Bladed Scarificator. Fig. 195. — Cupping Pump, Stopcoclc and Cup. Dry Cupping, page 113, Pakt IV. No. 1. CUPPIlSrG SET. Contains : One Brass Cupping Pump, three Stopcoclcs, three Glass Cups, one Ten-BIaded Scarificator, one Mahogany or Black Walnut Case, lined with velvet .$13.00 Kg. 2. CUPPING- SET. Contains : One Brass Cupping Pump, three Stopcoclvs, six Glass Cups, one Twelve- Bladed Scarificator, one Mahogany or Black Walnut Case lined witli velvet $15.00 No 1. Without Scarificator ". $9.00 No. 2. 'Without Scarificator 10.50 Also, Breast Pumps. P. A. Stohlmann. Edward Pfarre. Pakt I. 67 CHATHAM STREET, NEW YORKo 65 LEEOHINa. Fig. 196. — Tieniaiin & Co.'s Pulcnt Arilficiul Loech. The principal feature is the employment of light glass tubes, from which the air is expelled by the vapor of ether, and which imitate very closely the suction of the natural leech as the vapor within them condenses. To expel the air from a tube, a few drops of ether are poured into it, and it is then immersed as far as the mouth in hot water until the ether boils briskly. The mouth of the tube is then ap- plied to the skin, and held for an instant, when it will be found to be firmly attached, and can be left to itself. Each tube will draw about two drachms of Ijlood. For uterine practice they are made long enough to be applied through a speculum. The scarifier is simply a tube |- inch in diameter, straight or curved, having a cutting edge at one extremity. By a simple device this is made to rotate rapidly, making, when applied to the skin, a circular incision, the depth of which is regulated by a gauge. In the cut (a) represents the button, by turning which the instrument is wound up, (d) the trigger, by which the spring is released, (c) the cutting edge, and (b) the gauge for regulating the depth of the incision.. The tubes for general use have the mouth on the side, but some are made straight, as more convenient of application in certain cases. The entire apparatus, including half-a-dozen tubes and a vial for ether, is contained in a small case adapted for the pocket. Price $7.00 Fig. 197. — Heurteloup's Artificial Leech. The Scarifier has a circular cutter, passing through the centre of the Shaft ; the depth of the cut is regulated and set by a thumb-screw. The motive power is a watch-spring, which after having been wound up, is set off by a trigger. After making the incision the blood is drawn by the pump, consisting of a glass barrel and a piston, with a screw arrangement to fix it when drawn up. One Glass Pump and Cutter, contained in a neat Morocco Case $8.00 Reese's Artificial Leech. Fig. 8, Supplement. F. A. Stohlmaun. Edward Pfarre. Part I. 66 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, Fig. 198. Plain Spring Lancet. PHLEBOTOMY. Fig. 199. Tiemann & Go's Spring Lancet. Fig. 200. Button Trigger Spring Lancet. Thumb Lancets, page 56. COUNTEE IREITATIOK Fig. 201. — Baunscbeidt's Lebenswecker. (Baunscheidt's Oil always ou hand.) Jf-l VAOOINATING. Fig. 202. — Tiemann & Go's Vaccinating Scarificator F. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM STREET, NEW YORK. 67 TEANSFUSION. Fig. 210. — Aveling's Apparatus for Immediate Transfusion. In Paper Case $4.50 With one Scalpel and one pair of Forceps, put up in a neat Morocco Case. . . 8.00 MODE OF OPERATION. First place the Apparatus in a basin of tepid water, and while completely under the water, to fill it and ensure its cleanliness, compress the bulb until the air is expelled. The patient having been brought to the side of the bed, and the arm bared, a fold of sl^in over a vein, at the bend of the arm should be raised, transfixed and divided. The flattened vein now brought into view, should be seized with a pair of fine forceps, raised while an incis- ion is made in it, and the bevel-pointed silver tube inserted. In taking this tube out of the basin, it should be kept full of water, by placing the tip of the thumb over its larger opening. While the operator is doing this an assistant should prepare the arm of the blood-donor, as in ordinary bleeding, making an incision direct into the vein, and passing the round pointed tube into it, with its point towards the fingers. This person should then be brought to the bed-side of the patient, and seated in a chair. It is better not to secure the tubes in the veins by liga- tures. B represents the hand of an assistant holding the efferent tube and the lips of the small wound together, and A shows the afferent tube secured in the same manner. The india-rubber portion of the apparatus, filled with water, and kept so by turning the cock at each end of it, is now fitted into the two tubes. The cocks are then turned straight, and the operation com- menced by compressing the india-rubber tube on the efferent side D, and squeezing the bulb C ; this forces two drachms of water into the afferent vein. Next shift tlie hand D to D, and com- press the tube on the afferent side, then allow the tube to expand slowly when blood will be drawn into it from the efferent vein. By repeating this process any quantity of blood can, at any rate, be transmitted, the amount being measured by counting the number of times the bulb is emptied. The advantages of this method of transfusing blood are : 1st. The chances of coagulation are small, because the blood is removed from the action of the living vessels for only a few seconds, and glides smoothly through the india-rubber pipe without being exposed to the air. 3d. The apparatus is effective, simple, portable, inexpensive and not likely to get out of order. 3d. The operation is safe, easy, uninterrupted, and a close imitation of nature. F. A. Stohlmann. Edward Pfarre. 68 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRTOIENTS, TEANSFUSION. Fig. 211. — Fiyer's Transfusion Apparatus. Price $6.50. (Extracted from the Medical Record, April 15, 1874.) A few remarks on the Transfusion of Blood, with a modification of the Appara- tus of Aveling-. By B. E. TKiEU, M. D., Surgeou U. S. Army. To .sliOTv that the subject of transfusion is one which a large portion of the profession has not yet fully ■n-eigliL'd the importance of, nor realized the fact that this measure can frequently ho mailc apiilicalilc'in cases ■niiicli are now quietly otherwise yielded to death, we have onlj- to call fittenti()n to tlic laiity of reiiortcil in- stances in which the operation has been taken advantage of, and refer to the many obvious om-s in whicli it should be made available. Even in threatening dissolutioii from the direct loss of blood,— sucli as from \vmptly act and give the then alnrist only chance of life. "We will biicfly state the kind of cases in which it has occuiicd to us'that transfusion should be had recourse to without hesitation, and they may be conveniently noted under two heads. We would include in the first class those cases in' which a copious blood-loss has occurred and iuimediate death is threatened. As is well known, it is in these mainly that the measure lias lieen applied. It niiglit well be tried in cases of injury accompanied by a more moderate hemorrage, and where it i.s necessary to do an important sur- gical o]ieration, and this operation is delayed (often disastrously) for a reaction by oi iliuary meaus. Moreover, it slioubl lie done before or after necessary surgical measures in the asthenic patieiits, in oriler to avoid pyajmia and its allied evils, especially in operatioiis wliere the peritoneum is involved. After labor, too. where hemorr- age may have been great, but not enough to threaten immediate death, it should be ilone to avoid septicainic ditliculties. For that depression from the loss of blood, &c., is a most direct cause of pya-mia and its iiatliologi- cal associates, those of us who have had to treat large numbers of gunshot and other injuries, aud to operate in these cases, wherehemorrage and other depressing causes had done sad havoc, well know. But we have in the second class a larger number of cases — diseases both acitte and chronic — and here we more commonly meet with opportunities. In such, transfusion has scarcely been thought of; but it is in these, too, it ought to be_. and will be, we think, taken advantage of. Of the acute cases we refer to, those in which natural nutrition is for the time suspended, either from a direct lesion of the blood-making system in one or more -of its di'\'isions, or is indirectly atfected in consequence of some profound systemic impression, where if we can but bridge over a short period by keeping life's machinery going, we nwy tiltimatidy bring about a restorati(m of the healthy nutrition process, and thus save life. To particularize : acute gastric troubles, giving excessive and continuous vomiting; acute diarrlnsas and dysenteries; in peritoneal iuliamniatiotis, in some of the low forms of fevers where waste is excessive and the absorjition of nourislnuent nil. In cliohua it should be doue moT-e generally than it has been. It might be tried, too, in some of the acute diseases of youug ehildicn, ])articu- larly in those wliieh give convulsive movements ami ccmvulsions ]iroper. and which often indicati' to us dimin- ished blond-supply to tlie brain, and tell us that death may come before the return of the parural food absorption can again i)ut the nerve-centres tjnirth/ at work. In chronic cases where tlie blocid-makiug is reduced or nearly destroyed, we mi.ght often prolong life by transfusion. Such cases are not frequent, though we need not eiiumerate them. Wo might well apply the measure even in some cases of phthisis iiulmonalis. In regard to the fluid to ho transfused. As is well kno^vn, human blood is that to be most desired, after this the blood of some of the lower animals may be selected. Dr. Hodder, of Canada, threw into the veins of some of his cholera jiatients fresh milk, and with (".K<'(d]ent restilts. The writer has exiierimeuted with milk injections in the veins of do^s, and though tlu^ expi'riments have not been completed as to a. test of the nourishing i-ffects of the milk so niven. no liad symptoms have become a]ip,ai'ent. If it can be satisfact(uilv ])roveil, that milk may be ■safely aud generally used in transfusion, and witli the desired result . a iireat aihance'will !»■, made in the matter, it bein^ nearly always olitainable, while many of the diiHculties aud ineouvenienees in the use of blood will be avoided. _ A saline .solution (such as that of Mr. Little-) should be tried to saxc life, if nothing else is at hand. The instruments for transfusion are, as is well known, quite numeious. and wliile many of them are very good, we believe that of Aveling, for inniiediate transfusion, to be probably the sinqdest. safest, and mo.st easy of aiijilieation. We have lately mortiou which couples them iu Avoling's apparatus, and we thereby diminish the risk of blood composed of chloride of sodium, 60 grs. ; cliloride of potassium, 6 grs ; phospli^te of soda, 3 grs. ; carbonate of soda, 20 * Mr. Little's solutii . ; -water, 20 ouuccs. F. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM STREET, NEW YORK:. 69 TEANSFUSION. lodging and coagulating; -wliilo wo can, if necessary, compress the whole apparatus more completely. As in Dr. Aveling's iiistriiinciit, lliciv inv no \:i1vch. Tlio inner wall of the whole apiiai'atus is perfectly sniootb, and we have liad Ihe (>|icniui; ridiii liihe to buHis made a gradual )jloi)e, thua altogetlier doing away with corners in which the blood niiiiht lie iiiicslcd and form a clot. The instruniciit of Av|iarati[,s. The manner of using the instriiiiK.nt is very similar to Aveling's. The canula marked Ji is placed in the giver's vein, tliat niai-l tulie is t(j be i]i],|ied tightlv between the lingers, close to the giver's or etfeivnt end. and then the linlbniaikeil 1 is to be (■(iiii|nissed, and tlie Idood of course forced on towards the receiver. W'liih^ this liulb is still held c()ni])ressed, thi' tiilie at the, giver's side is tf) be re- laxed, and that ])ortion of it between the bulbs is to lie ]iip|ie(l ; bnlli 1 is rela^ceil. ami Xo. 2'eompressed and lield ; then the tube at the receiver's side is to be seized ainl ladd to ] ii-e\-en I legurgitation, and the whole apparatus allowed to refill. The same ojieration to be repeated till sulHcient blood is transfused. Assugu;ested h.v Dr. Aveliug, a few drops of ammonia sidution may be injected into the bulbs now ami then, by a fine pointed h.ypo- dennic syringe, in order to more efl'eetuallv prevent coagulation. It will bo found that considerable force is necessary in sending blood or other fluids into the veins. This we discovered while doing transfusion twice in a case after hemorrage from gun.shot injury, and we have also found it in our experimenis on tln' lower animals. It is a fact that we have not seen noted in connection with transfnsion, and one well wort h icinembeiing. In order to use the apparatus as a mediate transfuser, the vess(d marked A in tlie cut receives the blood, the tube is to be ayiplied, and the instrument used as before directed. If the blood is not iletiluinated and strained, three or four drops of ammonia solution to each ounce are added, in order to avoid coagulation. The in.strument is made by Messrs. Geokge Tiemann & Co., 67 Chatham Street. Kew York. "We would suggest to those who may become interested in transfusion, that though the operation is a simple one, it requires care, and it should first be practised once or twice on the lower animals; no dilficulty will then be had in doing it on man when occasion requires. EiG. 212. — GarrigLie's Mediate Transfusion Apparatus. Price. ...$4.00. Draw eight or ten oitnces of blood from a healthy person into a clean vessel, Avhilst it is accumulating whip it with a silver fork, a stick of wood or a bunch of straw, then strain it through a piece of cleanly washed linen into a vessel placed within another containing warm water (about 105 C.) "Warm the syringe, put the suction end A into the blood, compress the bulb, and when- it flows through the canitla, turn the stopcock C. Having bared the patient's arm, raise a fold of skin over a vein at the bend of the elbow, divide it and pass a probe or thread under the vein thus brought into view. This is now held with a pair of forceps or tenaculum and an in- cision made with a lancet or j^air of fine pointed scissors, carefully avoiding to wound its posterior wall. Now introduce the canula D, open the stopcock and inject slowly. The bulb contains about three fluid drachms, but by moderate compression about two only are expelled. In most cases it suflices to inject from four to six ounces. If resistance, not due to external j^ressure be felt, or dyspnoea, or any other untoward symptom appear, the operation has to be interrupted or ended. Dress the wound as after phlebotomy. After use, the instrument must be thoroughly cleansed, which is best done by separating all the parts and washing them in wann water. F. A. Stohlmann. Edward Pfarre. Pakt I. GEO. TIEMAjSTX & CO.'S SURGICAL INSTRUMENTS, HYPODERMIC MEDICATION. Ftc. 213. — ITypodormic Syringe. No. 0. Graduated Glass Barrel, with Fenestrated Metal Guard, 2 steel Needles attachable by Screw or Slide. With A'ial and Wires for cleaning the Needles, in a neat Morocco Case $3.00 EiG. 214. — Hj'podermic Syringe. No. 1. Graduated Glass Barrel, with Bi-Fenestrated Metal Guard, 2 Needles attachable by Slide or Screw, made of tempered cast steel, nickel-plated, and much finer than those usually employed an advantage in lessening pain on the introduction of the same. "With Yial and Wires, in a neat Morocco Case $4.00 Fig. 215. — Hypodermic Syringe. No. 2. Graduated Piston, Hard Rubber Barrel, 2 steel nickel-plated Needles attachable by Slide or Screw. With Vial and Wires for cleaning the Needles, in a neat Morocco Case $0.00 Fig. 216. — Hypodermic Syringe. No. 3. Graduated Piston, Glass Barrel, 2 fine steel nickel-plated Needles attachable by Screw or Slide. With Vial and Wires for cleaning the Needles, in a neat Morocco Case $2.50 P. A. Stohlmann. Edward Pfarre. Part I. 67 CTIATIIAM STREET, NEW YORK. 71 HYPODERMIC MEDICATION. Fig. 217. — Hypodermic Syringe. No. 4. Graduated Glass Barrel, smootli Piston Rod, 2 fine steel nickel-plated Needles attachable by Screw or Slide. With Vial and Wires for cleaning the Needles, in a neat Morocco Case |2.o0 Hypodermic Syringe. No. 5. Graduated Glass Barrel with Screw Piston, 2 fine steel nickel-plated Needles attachable by Screw or Slide. With Vial and Wires for cleaning the Needles, in a neat Morocco Case $3.00 Fig. 218. — Stimson's Hypodermic Syringe. No. 6. . IlEMANN~Cb The accompanying cut represents a convenient form of hypodermic syringe, to be carried in the pocket-case. The point, inclosing the wire cleaner, fits into a hollow graduated piston. The barrel is an ordinary silver tube, the size of a No. 10 catheter, and is about three inches long. Price $3.00 Fig. 219. — Vance's Hypodermic Syringe. No. 7. Two Gold (14 carats) Needles, a small bottle with a glass stopper (retained by a metallic shield,) and a small wire. In a neat Morocco Case $4.50 Morocco Hypodermic Syringe Cases each, $0.^0 Metal, nickel-plated Hypodermic Syringe Cases, to fit Nos. 1, 3, 4 and 5 Syringes, " .73 P. A. Stohlmann. Edward Pfarre. 72 Part I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, HYPODEEMIC MEDICATION. Greene's Hj'podermic Case. It contains four four-draclim vials, and five two-drachm vials, which each physician can fill to suit his fancy or requirements ; a double fenestrated hypodermic syringe (No. 1, page 70), and three points or needles, all of the most improved pattern. They are of diffei-ent sizes: one, the smallest and most delicate ever manufactured in the world, another, a size larger, and the third one of the ordinary size and make. Wires for keeping them clean and open, a small hone or stone of the finest quality for sharpening the points, a twenty-four minim glass measure per- fectly exact, a Self-Registering Pocket Thermometer, very superior, contained in a neat vulcan- ized rubber case, and warranted perfectly correct. And last but not least, contains a thumb- lancet, also of the best manufacture. Price of complete Case $12.00 Fig. 220. — Geo. Tiemann & Co.'s Patent Hollow Piston Hypodermic Syringe, with a Gold Needle. No. 8. The larger cut shows the instrument closed ; the other one, the same syringe, barrel filled and needle mounted on the end of the piston (ready for use), and the cap, to cover the instru- ment. The barrel of this syringe is of glass, graduated, and is protected by a German silver or nickel-plated fenestrated case. It is very compact, and may be conveniently carried in t!:G vc::t pocket. For this purpose the needle is unscrewed and put, point foremost, into the cavity of the piston ; this is pushed home and the cap screwed on. In this way, it is perfectly protected from harm, and very portable. Price .$3.50 Fig. 221. — Extra Needles for Hypodermic Syringes. r,. TIEMANN ^ CO Gold $1.00 Steel 50 Steel, gilt 75 Steel, nickel-plated 65 Needles made of Gold do not oxydize, but will not take a good edge nor keep it long. Steel Needles pierce best, but are apt to rust if not properly taken care of. Steel Needles, gilt, are compartively rust-proof. The Steel nickel-plated Needles answer as well as any others, and are even preferred by some. In ordering extra Needles, please state which of the above you desire, and how the attach- ment to the syringe is to be effected — i. e., by sc7'ew or slide f ^^ If 3'ou desire Needles for syringes not of our manufacture, it is necessary to send your syringe to fit them. r. A. Stohlmann. Edward Pfarre. Paut r. 67 CHATHAM STREET, NEW YORK. 73 HYPODEEMIO MEDICATION. Fig, 222. — Geo. Tiemann & Co.'s Hypodermic Hyringe Bottle. Patented October 9th, 1877. Great inconvenience is often experienced iiv filling a hypodermic syrin.!.;e from tlie ordinary bottle, because of its narrow neck and its liability to upset. The narrow neck prevents tlie insertion of the end of the syringe, or, if the syringe is screwed upon the bottle, a partial vacuum is liable to be formed, so that the piston returns when re- leased and often some of the fluid re-enters the bottle. The liability to spill the contents of the bottle is increased by the fact that it has to be removed from the case and stood upright. All these difficulties are overcome by the above improvement, the bottle having the mouth at a right angle to its body and made sufficiently large to admit the nozzle end of the sj^ringe. It need not be removed from the case for the purpose of charging the syringe. You merely turn the neck upward, remove the stopper, insert the syringe into the fluid, and draw upon the piston until the desired quantity of medicine has entered the barrel. The case is made to hold the bottle tightly in any position, so that both may be left on the table during the operation, without fearing for the safety of the glass or its contents. After having operated and replaced the needle and syringe in the case, the bottle is corked and turned back to its former position. Price §0.25 When desired with Kos. 0, 1, 2, 3, 4, 5 Hypodermic Syringes, no extra charge is made. REPAIRING HYPODERMIC SYRINGES. If your glass cylinder is broken, and you want a ncAv one, always send us your fittings. If any other part of the syringe is wanted, send what you have left, and it will be easy to supply the missing portions. dt^" To prevent confusion and loss, parties sending parcels to us are requested to enclose ilieir card in the same, as otherwise they cannot be identified. P. A. Stohlmann. Edward Pfarre. 74 Part I. GEO. TIEMAKN" & CO.'S SURGICAL INSTRUMENTS, HYPODEEMIO MEDICATION. Fig. 233. — Pinkliam's Graduated Measure. For making solution, especially of morphia, at the time of using it, it is found most convenient to carry powders of the sulphate of morphia, contain- ing half a grain of each. One of these is placed in the glass and twenty minims of w^arm water are thrown upon it from the syringe. If the powder remains undissolved, the contents of the glass can be taken in the syringe, and thrown back repeatedly until a perfect solution is obtained. The glass is so graduated (see wood-cut) that any desired portion of its contents can be easily determined and taken up for use. Price $0.50 Fig. 324.— Tiemann & Co.'s Air-tight Hypodermic Bottle. A small graduated glass bottle is so arranged that it is hermetically sealed by means of a hard rubber stopper. When you wish to fill the syringe the nozzle is placed in the side hole of the stopper, the glass is then turned up and rotated until it stops. Communication between the syringe and bottle is now open. Draw the piston back and the liquid follows, without any ad- mixture of air. Turn the glass back again and the bottle is hermetically closed. To fill the bottle, turn the stopper half-way round, and there being a slot or indentation, it is easily pulled out. Bottles arranged for the sliding or for the screw syringes, as may be desired. Price $0.75 DIAGNOSTIC. See Index for the following : Endoscopes, Laryngoscopes, Otoscopes, Ophthalmoscopes, Probes, Sounds, Specula, Anal, Aural, Nasal, Oral, Ophthalmic, Uterine, Vaginal. CLINICAL THERMOMETERS. (Extracted from "Lessons in Physical Diagnosis" by Alfred L. Loomis, M. D.) The thermometer is now regarded an indispensable mechanical aid in the diagnosis of disease. I prefer, and Avould recommend to you, the straight, self -registering, clinical thermometer, re- presented in Fig. 335, No. 1. This themiometer consists of a glass stem six inches in length, having on it a graduated scale varying from 85° to 115° Fahr., exhibiting .5° Fahr. The upper extremity of the stem is closed: at the lower end there is a bulb of mercury as thick as the diameter of the stem. Within the stem is a bit of mercury detached from the column of mercury in the bidb called ths index : this index is set by taking the bulb and stem of the instrument firmly in the hand, when, by repeated sudden blows of the waist upon the knee, the index is brought down the stem to a point just below the lines which indicate the degrees. After the index has thus been set, the bulb of the instrament may be applied to the axilla, between tlie thiglis, in the mouth, rectum or vagina, or to any part where it can be completely covered. Before introducing the bulb it is well to hold it in the closed hand until the mercury shows ;i temperature of 98°. Neglect of this precaution is apt to lead to an under statement of temperature. When the instrument has been in perfect contact with the parts for five or seven minutes, gently remove it, and the top of the index will denote the maximum temperature of the part. P. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM STREET, NEW YORK. 75 o o o o IC o JO iO C? CO CO "^ .3 - 4 :: 'i* lO o ^ PI S 0? ^ o > .a ^ J ^ G :3 '^ cc X !S V 'S > 'S 1— 1 s w s ca ;C o cu 3 g w 3) C TJ -r; o o '3 o "C -^ >> ^ _o ^ c n ^ c D n ,^ o ^ X 7B, a "E i m 'O o S3 ^ 13 fcJD C > 1 O X -* a F. A. Stohlmann. Edward Pfarre. Part I. 76 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, DIAGNOSTIC. Pig. 225. — Clinical Thermometers. O a, a « f3 P r I ,^ r/( c fcn p d 324.— Tripod Ilcud-Rcst. W a, Fig. 326.— Braiu Knife. Fig. 327. — Eiiterotome. Fig. 328.— Calvarian Hook. Fig. 329.— 1 Posl-mortem Saw, 1 Kuife and 1 Handle. F. A. Stohlmann. Edward Pfarre. 96 Pa-rt I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, DISSEOTma SETS. No. 1 Dissecting Set. Price, $S.oo. I Steel Handle Cartilage Knife.' 4 Ebony Handle Scalpels, assorted. I Steel Handle Dissecting Hook. I German Silver Blowpipe. I pair of Straight Dissecting Scissors. I pair of Dissecting Forceps. I set of Chain Hooks. I Chisel. I Mahogany or Rosewood Case, with lock and key, nfeatly arranged, lined with velvet. No, 2 Dissecting Set, Price, $7.00. I Steel Handle Dissecting Hook. 4 tbony Handle Scalpels, assorted. I Steel Handle Cartilage Knife. I set of Wire Chain Hooks. I pair of Dissecting Forceps. I pair of Straight Dissecting Scissors. I German Silver Blowpipe. I Mahogany Case, lined with velvet. No. 3 Dissecting Set. Price, $6.25. I Steel Handle Dissecting Hook. 3 Ebony Handle Scalpels, assorted. I Steel Handle Cartilage Knife. I set of Wire Chain Hooks. I pair of Dissecting P'orceps. I pair of Straight Ijissecting Scissors. I German Silver Blowpipe. I Mahogany Case, lined with velvet. No. 4 Dissecting Set. Price, $6.00. I Steel Handle Cartilage Knife. 3 Ebony Handle Scalpels, assorted. I Steel Handle Dissecting Hook. I set of Wire Chain Hooks. I pair of Dissecting Forceps. I pair of Straight Dissecting Scissors. I Mahogany Case, lined with velvet. No. 5 Dissecting Set. Price, $5.50. 1 German Silver Blowpipe. 2 Ebony Handle Scalpels. I Steel Handle Dissecting Hook. I Steel Handle Cartilage Knife. I pair of Dissecting Forceps. I pair of Straight Dissecting Scissors. I set of Wire Chain Hooks. I Mahogany Case, lined with velvet. No. 6 Dissecting Set. Price, $5.25. 2 Ebony Handle Scalpels. I Steel Handle Dissecting Hook. I Steel Handle Cartilage Knife. I pair of Dissecting Forceps. I pair of Straight Scissors. I set of Wire Chain Hooks. I Mahogany Case, lined with velvet. Darling's Dissecting Set. Price, $5.75. 3 Darling's Scalpels, ebony handles, assorted. I set of Adjustible Chain Hooks. I pairof Coxeter'sDissecting Forceps, I pairofCiirved lip Dissecting Scissors. I Mahogany Case, lined with velvet. Microscopic Dissecting Set, Price, $15.00. I Needle Holder. 6 Needle Points. I Section Knife. I Fine Lacerating Needle. I Heavy Lacerating Needle. 3 Ebony Handle Microscopic Scalpels, assorted. I pair of Straight and Delicate Micro- scopic Dissecting Forceps. I pairof Curved, Delicate Microscopic Dissecting Forceps. I pair of Straight, Delicate Scissors. I pair of Delicate Scissors, curved on the flat. I Neat Rosewood Case, lined with silk velvet. Our Patent Dissecting Case. Price, $3.50. I Steel Handle Cartilage Knife. 3 Ebony Handle Scalpels. I Steel Handle Dissecting Hook. I set of Wire Chain Hooks. I pair of Dissecting Forceps. I pair of Straight Dissecting Scissors. I Blowpipe. ** I Strap to sharpen the scalpels. I Black Walnut Case. POST MOETEM SETS. No, 1 Post Mortem Set. Price, $28.00. I Hammer. I Costotome (Rib Shears'). 1 Ebony Handle Cartilage Knife. 2 Ebony Handle Scalpels, assorted. I Steel Handle Dissecting Hook. I pair of Coxeter's Dissecting Forceps. I Enterotome. I set of Heavy Chain Hooks. I pair of Straight Scissors. I Saw. I Amputating Knife. I Handle to fit the Saw and Knife. I Chisel. 1 Reamer. 2 Needles, Thread and Wax. I Mahogany Case, with a slide or lock, lined with velvet. No, 2 I Hutchison' s> Post Mortem Set, Price, $24.00. I Amputating Knife. I Saw. I Handle to fit the above. 1 Chisel. I pair of Straight Dissecting Scissors. I set of Chain Hooks. I pair of Dissecting Forceps. I Aneurism Needle. I Metacarpal Saw. 3 Ebony Handle Scalpels, assorted. I Steel Director. I Probe-pointed Bistoury. I Hammer. I Steel Handle Dissecting Hook. I large Ebony Handle Cartilage 1 German Silver Blowpipe. [Knife. 2 Needles, Silk and Wax. I Rosewood Case, with lock and key, lined with velvet. No, 3 Post Mortem Set, Price, $22.00. I Hammer. I Costotome Chisel. I Steel Handle Cartilage Knife. 3 Ebony Handle Scalpels, assorted. I Steel Handle Dissecting Hook. I pair of Plain Dissecting Forceps. I Enterotome. I set of Heavy Chain Hooks. I German Silver Blowpipe. I Plain Chisel. I pair of Straight Dissecting Scissors. I Amputating Knife. I Saw. 1 Handle to fit the Knife and Saw. 2 Needles, Thread and Wax. I Mahogany Case, with a slide or lock, lined with velvet. Finnel's Post Mortem Set. Price $12.50 I Amputating Knife. I Saw. I Handle to fit the above. 3 Ebony Handle Scalpels, assorted. I Steel Handle Cartilage Knife. I pair of Straight Dissecting Scissors. I Ebony or Steel Handle Tenaculum. I set of Heavy Chain Hooks. I German Silver Blowpipe. 1 pair of Dissecting Forceps. 2 Needles and Thread. I Chisel. I Rosewood Case, with lock and key, lined with velvet. F. A. Stohlraann. Edward Pfarre. Pakt I. 67 CHATHAM STREET, NEW YORK. 97 POST MOETEM. Fig. 330. — Post Mortem naramer. FtCt. 332. — Pinnell's Knife, Saw and Handle. Fig. 333. — Double Rachitome. PHYSIOLOaiOAL EXPEEIMENTS. Flint's Armamentarium for Physiological Experiments. Contents of complete set in case : i Portal Vein Ligator. Fig. 384. 1 pair Bone Forceps, for opening spinal canal. Fig. 335. 1 Hey's Saw, for opening spinal canal. Fig. 336. 1 pair Forceps, for extirpating the spinal accessory nerve. Fig. 337. 1 Drill for breaking up medulla oblongata. Fig. 338. 1 pair Bone Forceps, shear handles. Fig 339. 3 Blunt Hooks, for hooking up roots of spinal nerves. Fig. 340. (Continued on nest page.) "F. A. Stohlmann. Edward Pfarre. 98 Part 1. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, PHYSIOLOGICAL EXPERIMENTS. Flent's Armamentarium for Physiological Experiments. (C'o?itm^ied.) 2 Knives, for intra-cranial division of the root of the fifth nerve. Fig. 341. 2 Picjues, for irritation of the floor of tlie fourth ventricle. Fig. 342. 1 Bull-dog Forceps, for drawing out tlie stomach in making a gastric fistula. 2 Gastric Fistula Tubes. Fig. 344. 1 Catheter, for catheterizing the right side of the heart. Fig. 345. 2 Dissecting Tenacula, steel liandles. Fig. 315. 1 pair long-pointed Dissecting Forceps. Fig. 346. Fi-. 343 Fiff. 349. Fiff. 351. pair medium Dissecting Forceps. Fig. 347. pair sliort Dissecting Forceps. Fig. 348. Enterotome. Fig. 327. Blowpipe, with mouth-piece, stop-cock and 2 points. Lifting-Back Saw, 9 inches long. Fig. 352. 1 Lifting-Back Saw, 7)^ inches long. Fig. 352. 1 pair Scissors — one probe-point, the other sharp. 2 pair Pointed Scissors. Fig. 351. 3 Langenbeck's Steel Serresfines. Fig. 103d. 1 Heavy Cartilage Knife. Fig. 350. 3 Scalpels, assorted sizes. Figs. 17, 18, 19. 1 Probe-pointed Bistour3^ Fig. 27. 3 Microscopic Needles, each in handles. Fig. 306. 1 Tenotome. Fig. 22. 1 Artery Needle. Fig. 32. 1 Mahogany Case, lined with oil-dyed velvet $70.00 Fig. 334.— Portal Vein Ligator. Fig. 335. Bone Forceps, for opening spinal canal. Fig. 339. Bone Forceps Fig. 336.— Hey's Saw. ^--^ Fig. 337. — Forceps, for extirpating the spinal accessory nerve. Fig. 338. — Drill, for breaking up medulla oblongata. r. A. Stohlmann. Edward Pfarre. Part I. 67 CHATHAM STREET, NEW YORK. 99 PHYSIOLOQIOAL EXPEEIMENTS. Fig. 340. — Blunt Hooks, for hooking up roots of spinal nerves. Fki. 344. rjiistric Fistula Tubes. Fig. 341. — Knives, for intru-cianial division of the root of the fifth nerve. Fig. 342. — Piques, for irritation of the floor of the fourth ventricle. Fig. 343. — Bull-dog Forceps, for drawing out the stomach in making a gastric fistula. Fig. 352. — Lifting-back Saw (see also fig. 58, Part I.) F. A. Stohlmann. Edward Pfarre. 100 P.UIT I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, ELEOTEO-THEEAPEUTIO. Fig. 353. — Stoehrer's Galvanic Battery (Constant Current). {Abi-idged from Beard & RockweWs work on Medical and Surgical Electricity.) ^" <^^^ ^71] How THE Battery is Cokstrtjcted otss*^ t'^ - -fill ''^^ Used. — This battery is composed ^^>;^\ y^~~ "^J^^ /iiillll °-^ plates of zinc and carbon in a solution W ^ /ifillliliilllil of bichromate of potass, sulphuric acid, and water. The solution is contained in glass jars that are raised up to the plates of zinc and cai'bon by the keys at the G. TiEMANN & CO IIIIIIIIIIIIIIIIIIIIIIHIIIIIIIIIIIIIIIlllllllllllllllllllllllllllllllll'll 111ITI""JI^F' ^^^^ '^^ *^^ ^'^^- When the jars are raised by the keys to the top of the box, ^ ^ ^_ turn the keys at right angles and the jars ■' mJ^^ will stay in position, and the battery is ready for use, if the jars are properly filled with the solution. By means of llllllllllllllllllllllillli^=' *^*^ slide on the top, the current can be increased two cells at a time, as indicated by the graduated plane at the side. When the battery is not in use the jars should be let down from the plates by means of the keys. If allowed to remain immersed day after day the battery will rapidly lose its strength. How TO Charge the Battery. — The solution is made in about the following proportions : sulphuric acid, 1 oz. ; bichromate potass, 1| oz. ; water, 10 oz. The best way to make the solution s to dissolve the bichromate of potass in cold water and then add the sulphuric acid. The mingling of the water and sulphuric acid causes great heat. Do not use the solution until it is cool. Lift out the plates by the middle piece to which they are attached, lift up the jars by the keys and fill each jar with two, or three, or three and a-half ounces of the solution. They should be filled pretty uniformlj'^, and care should be taken that no more should be put in than the jar will hold after the plates are immersed. How TO Clean the Battery and Amalgamate the Zincs. — Every few weeks or months, according to the extent to which the battery is used, it Avill be necessary to wash the plates and scrape off the incrustations and renew the solution, or, at least, to add more acid or water, and amalgamate the zincs. A good Avay to amalgamate the zincs is, take a strip of zinc, dip it in k solution of sulphui'ic acid and water, then dip it in mercury ; the mercury will adhere to and run over it; then rub it up over the surface of the zincs of the battery until all are well covered with mercury. During the process of amalgamation the zincs should be kept well moistened with a solution of sulphuric acid and water. The brass work of the battery should be kept dean and bright, so that the current may flow readily. How to Tell the Strength op the Current. — Those who have no galvanometer can tell whether the current is running and how strong it is by putting one pole in the hollow of the hand, and the other between the thumb and forefinger. The poles should be of sponge, wet with salt-water or simple warm Avater. Those who have been accustomed only to the noisy and violent Faradic (induced) current, will be disappointed to find that this galvanic current causes only a slight burning sensation, with no shocks, except when interrupted. A current that is scarcely felt when applied in the hand, maj^ be too strong to apply to the head, or face, or neck. Th^e greatest mistakes are made by using the galvanic current too strong. How to Distinguish the Poles. — The current is felt strongest at the negative pole. When both poles are dipped in a solution of Iodide of Potassium, the brown color of the iodine appears at the positive pole. Stoehrer's 8 Cell Battery $20.00 " 16 " " 30.00 32 " " 55.00 Each with a pair of Handles and the Conducting Cords. P. A. Stohlmann. Edward Pfarre. Part 1. 67 CHATHAM STREET, NEW YORK. 101 ELECTEO-THEP.APEUTIC. Fig. 354. — Gaiffe's Battery (Fai-radif. CJiirrent). It gives: 1. The primary current ; 3. The secondary current ; 3. The current of the two first, combined in intensity ; 4. Shocks, slow or fast, according to the use either of the contact breaker or tlie lever. Admitting that the three currents produce the same physiological effects, they give a series of results increasing in intensity. The battery working this instrument consists of a small rectangular cell of hard rubber divided in the middle, each part containing a carbon plate and also one of zinc. Each is charged with bi-sulphate of mercury and water, producing no fumes or smell whatever. To prepare the apparatus for use : remove the zincs a a from the gutta percha reservoir b b, place a few grains of bi-sulphate of mercury on the carbon plates contained in same reservoir and mix with a little water. Replace the zincs a a. Should the apparatus refuse to work, give the vibrator c an impulse with your finger. The power of the apparatus is regulated by pulling out the tube d more or less, and increased by adding to the dose of bi-sulphate of mercury. By placing the conducting wires in their sockets A B, we have the primary, in A C the extra, and in A D the primary and secondary currents. To produce sliocks press on the button e. After use, clean out the reservoirs, wash and dry them. To keep the apparatus in repair : a. Oxide often forms on the platina of the vibrator c, clean it by rubbing it softly with a small smooth file. b. The same may happen to the springs // which touch the platinum wires emerging from the reservoir; clean them in like manner, and as they serve the double purpose of holding in place the reservoirs and forming the connection with the instrument — it is necessary to rebend them, should they cease to touch the wires. c. The ends of the conducting wires and their sockets A B GB should also be kept clean, which may be done with powdered pumice stone and a rag, the holes cleaned out with pumice stone and a piece of wood. Accessories to the Battery: 1. A pair of Sponge Holders. 2. An olive shaped Excitor. 3. A spherical Excitor. 4. A metallic Brush. Price of Apparatus |13.00 Same, nickel-plated 14.00 Extra Troughs, each 1.75 Extra Zinc Plates, each 20 Bi-sulphate of Mercury, per oz 25 P. A. Stohlmann. Edward Pfarre. Part I. 103 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, ELEOTRO-THERAPEUTIO. O qH « O ^ ri:^ b g ^ >^;=i rf <:s ::3 w ^ ^ & ^ oz. Vials, Glass Stoppers, Russet Leather, Patent Leather Flaps. 20 13^ oz. Vials, Glass Stoppers, Russet Leather, Patent Leather Flaps. 24 11^ oz. Vials, Glass Stoppers, Russet Leather, Patent Leather Flaps. Fig. 422. Saddle Bag. Box Pattern, with Trays to lift out. 16 1 oz. Ground Stop Bottles. 20 1 " " - " 24 1 « P. A. Stohlmanu. Sdward Ffarre. ISO Pakt I. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, OSTEOLOaiOAL. Fig. 433. Human Skeleton. SKELETONS. Articulated by means of brass screws. Grades: 1, 3, 3. SKULLS. Plain and disarticulated. FEMALE PELVES. W ithout ligaments. With ligaments. FEET. Stmng on catgut. HANDS. Strung on catgut. BRASS SCREWS AND HINGES. For joining slieletons. AUZOUX'S ANATOMICAL MODELS Imported to order. F. A. Stohlmann. Edward Pfarre. Pakt 1. 61 CHATHAM STREET, NEW YORK 131 ASPIRATORS. A descriptive pamphlet on Aspirators may be had on application, together with directions how to Iteep tliem in order. Fig. 434. Dieulafoy's Aspirator. Fig. 425. Hospital Aspiratoj-. The largest Aspirator in general use. Its arrangement is such as to leave both hands of the operator free to perform any manipulation which may be found necessary. The rack-and- pinion movement, by increasing the power, admits of the piston being more tightlj' packed, and hence a more perfect vacuum is obtained for exhausting, and enables to wash out the cyst, without the necessity for removing the needle. The syringe and needles are exquisitely fitted and finished. P. A. Stohlmann. Edward Pfarre. 13^ IPart 1. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, ASPIEATOES. A descriptive pamphlet on Aspirators may be had on application. Fig. 426. Steurer's Aspirator. Fig. 427. Emmett's Aspirator. F. A. Stohlmann. Edward Pfarre. Part I. 67 CriATHAM STREET, NEW YORK. 133 ASPIEATOES. A descriptive pamphlet on Aspirators may l)e luul on application. Fig, 428. Tiemann & Co.'s Aspirator. Fig. 429. Higgins' Aspirator and Injector. Fig. 430. Codman's Aspirator and Injector. P. A. Stohlmann. Edward Pfarre. 134 Part I. GEO. TIEMAKK & CO.'S SURGICAL INSTRUMENTS, ASPIEATOES. Descriptive pamphlet may be had on application. Fig. 431. Fitch's Handy Aspirator. THEEMO-OAUTEEY. Fig. 432. Paquelin's Thermo-Cautery. The apparatus consists of a hollow handle, insulated with wood, to protect the hands from the heat. It is furnished with three movable holloAV platinum cauteries ; into these, after thej^ have been heated to blackness in a flame of a spirit lamp, a blast of benzine vapor is introduced by means of a Richardson's spray bellows, which at once rises to and maintains them at a state of vivid incandescence. The heat thus produced can be kept up for an indefinite time by slightly compressing the bellows occasionally. The apparatus, in a morocco case, imported directly from the manufacturer in Paris $50 . 00 P. A. Stohlmann. Edward Pfarre. Part II. Politzer's Acoumeter. Please do :h''OT MUTILATE this Book, In ordering, merely state the Fart of the Armamen- tarium, the JVumher of the Figure, and the JSTame of the article desired. Instruments not mentioned in our Frice List will he furnished' at the lowest market rates. When GOODS FOR REFAIR are directed to us, the Owner's Xame and Address should accoinpany them. This will enable us to return them to the proper place and person. Parties finding it convenient to order through dealers are requested to insist upon receiving our manufacture, as otherwise inferior goods are frequently substituted. All instruDxents of our make have our name stamped Pakt II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, No. (i7 Chatham Street; IBrancli ©tore, TVo. lOT' East T>v-en.ty-elg:lxtli. Htreet, NEW-YORK. W% IMiTEUMllfT! INSTRUiVIENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 1 Fig. 2. Fig. 3. Fig. 4. Fig. 6. Jaeger's Plate Lid-Holder. Pakt II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparke. I¥l IW iTEUMlHTS, INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 7. Henry's Depilating Forceps. e.TIEMANU = CO.HY. Fig. 8. Fig. 9. Cilia Forceps. Fig 11. Prout's Entropium Forceps Fig. 12. Fig. 13. Knapp's Entropium Forceps. Pakt II. 67 CHATHAM STREET, NEW-YORK. 3 Branch Store, _ 107 East 28th St., N. Y. SETS OF EYE INSTRUMENTS IN CASES. SET OF EYE INSTRUMENTS No. 1. 1 Beer's Knife, $1 50 1 Curved Needle, 1 25 1 Iris Needle, . . . . . . ^ 1 25 1 Pair of Forceps, 1 50 1 Pair of Scissors, curved on the flat, fine points, ... 1 50 1 Plain Wire Speculum, 1 00 1 Strabismus Hook, 1 25 1 Dix's Spud for removing foreign bodies, .... 1 25 1 Silver Probe, 38 3 Suture Needles, fine silk, 75 1 Tyrrell's Sharp Iris Hook, 1 25 1 Daviel's Curette, . . . 1 50 1 Morocco Case, lined with silk velvet, . . . . . 2 75 Amount, . . $17 13 Set No. 1 in a Rosewood Case, $19. SET OF EYE INSTRUMENTS No. 2. 1 Beer's Knife, . ... . . $1 50 1 Keratome, or Artificial PupU Knife, 1 50 1 Dix's Spud for removing foreign bodies, 1 26 1 Curved Needle, 1 25 1 Straight Needle, . 1 25 1 Pair of Straight Iris Scissors, 1 50 1 Pair of Strabismus Scissors, . . . ^ . . . 1 50 1 Strabismus Hook, . 1 25 1 Parker's Fistula Lachrymalis Knife, 1 75 1 Plain Wire Speculum, 1 00 1 Tyrrell's Blunt Hook, 1 25 1 Silver Probe, 38 1 Critchet's Lens Scoop, . . . . . . . . . 1 75 1 Pair of Forceps, . . 1 25 6 Suture Needles, fine silk, 1 25 1 Rosewood Case, lined with silk velvet, 4 50 Amount, . . $24 13 Part II. GEO. TIEMANN & CO.'S SURGICAL mSTRUMENTS, F. A. Stohlmanx. Edwakd Ppakre. i^iMLmi liO INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 14. Galante's Eye Speculum. Fig. 145. Liebreicli's Eye Speculum. Figs. 21, 23. Desmarre's Eye-lid Retractors. Paet n. 67 CHATHAM STREET, NEWYOllK, Branch Store, • 107 East 2«tii St., N. Y. SETS OF EYE INSTRUMENTS IN CASES. SET OF EYE INSTRUMENTS No. 3. 1 Graefe' s Linear Knife, $1 .50 1 Parker's Fistula Lachrymalis Knife, .... 1 Beer' s Cataract Knife, 1 Desmarre's Scarificator, 1 Straight Keratome, for artificial pupil, .... 1 Angular Keratome, for artificial pupil, . 1 Strabismus Hook, 1 Small Scalpel, for operating upon the lids, 1 Large Curved Needle, Couching, . . . 1 Small Curved Needle, 1 Straight Iris Needle, 1 Cystotome, for lacerating the capsule, .... 1 Tyrrell's Blunt Hook, . . . . . . . . 1 Tyrrell's Scoop, 1 Plain Wire Speculum, , . 1 Pair of Cilia (or Eye-lash) Forceps, .... 1 Pair of Strabismus Forceps, 1 Pair of Iridectomy Forceps, 1 Pair of Straight Iris Scissors, ...... 1 Pair of Iris Scissors, curved on the flat, . . . 1 Anel' s Silver Probe, . . . - 6 Suture Needles and Fine Silk, 1 Rosewood Case, lined with silk velvet, .... Amount, . . $34 63 1 75 1 50 1 50 1 50 1 75 1 25 1 50 1 25 1 25 1 25 1 50 1 25 1 75 1 00 1 00 1 25 1 50 1 50 1 50 88 1 25 4 75 SET OF STRABISMUS INSTRUMENTS No. 4. 1 Pair of Strabismus Scissors, $1 60 1 Pair of Strabismus Forceps, 1 25 1 Double Hook, for fixing the eye, 1 50 1 Strabismus Hook, . . . 1 25 1 Plain Wire Speculum, . 1 00 1 Morocco Case, 1 75 Amount, . . $8 25 Part II. GEO. TIEMANN & CO.'S SUBGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 29. Agnew's Lachrymal Syringe e, TIF MANN 8^ CO Fig. 30. Galezowsky'a Canalicula Dilator Fig. 305. Anel's Probe. Fig. 31. Bowman's Director; and Nos. 1, 2, 3, 4, 5, 6, 7, 8, Probes. 6. TIEMANN St, CO. Part II. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28th St., N. Y. 1¥1 INBTEUMlN'l'S, INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 32. William's Set of Lachrymal Probes. a, h. Probes. c. Dilator. d, e. Styles. Fig. 34. Liebreicli's Probe and Fistula Knife. nE MONN S, C O Fig. 35. Manfredi's Speculum. Fig. 35/;. Test Drum, to try the edges of Eye Instruments. SMALL SET OF EYE INSTRUMENTS. No. 5. 1 Curved Couching Needle, $1 25 1 Strabismus Hook, 1 25 1 Beer' s Cataract Knife, . . . - . - . . . . . 1 50 1 Double Hook, for fixing tlie eye-ball, 1 60 1 Pair of Plain Curved Forceps, 1 25 1 Pair of Strabismus Scissors, ^ 1 50 1 Plain Wire Eye Speculum, 1 00 1 Morocco Case, lined with silk velvet, . . . . . 2 50 Amount, . . $11 75 Part II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, R A. Stohlmann. Edward Pfakre. 1¥1 IHSimUMlirTS. INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 37. Bowman's Canalicula Knife. (Director Fig. 31.) Fig. 88. Geusoul's Canula for Cauterizinsr the Nasal Duct. Fig. 47. Noves' Plain Canalicula Knife. Fig. Parker's Fistula Laclirvmalis Knife. Part II. 67 CHATHAM STREET, NEW-YORK, Branch Store, _ 107 East 28tji St., N. Y. SETS OF EYE INSTRUMENTS IN CASES. COMPLETE SET OF EYE INSTRUMENTS No. 7. 2 Graefe's Linear Knives, $1.50, $3 00 1 Beer's Cataract Knife, 1 50 1 Pair of Straight Iris Forceps, 1 50 1 Pair of Curved Iris Forceps, 1 50 1 Pair of Strabismus Scissors, . . . , . . . 1 50 1 Cystotome and Daviel's Curette, 2 50 1 Gouge, for removing foreign bodies, . . . . . . 1 50 1 Silver Lens Scoop, 2 00 1 Straight Keratome, . 1 50 2 Angular Keratomes, large and small, $1.75, . . . . 8 50 1 Pair Cilia Forceps, . 1 25 1 Steel Blunt Spatula, . ' . . 1 25 1 Tyrrell' s Blunt Hook, soft shank, 1 25 1 Tyrrell's Sharp Iris Hook, . . . . . . . 125 2 Strabismus Hooks, $1.25, 2 50 1 Curved Needle, for removing foreign bodies, . . . . 1 25 2 Straight Delicate Scalpels, $1.50, . 3 00 1 Liebreich's Best Ophthalmoscope, 6 50 2 Desmarre's Lid Retractors, $1.75, . . . . . .3 50 2 Desmarre's Eye Specula, right and left, with set-screw, $2.25, 4 50 1 Weber's Graduated Dilator, . 1 00 1 Set of Bowman' s Silver Probes, Nos. 1 to 8, . . . . 3 00 1 Pair of Straight, Spring-catch, Fixation Forceps, . . . 2 50 1 Pair of Slide-catch Fenestrated Artery Forceps, . . . 3 00 1 Pair of Desmarre's Entropium Forceps, . - . . . . 3 00 2 Pairs of Snellen's Right and Left Entropium Forceps, $3.00, . 6 00 1 Anel' s Hard-rubber Syringe, 2 silver gilt j)oints, ... 5 50 1 Brush and Caustic-holder, . 2 50 1 Jaeger' s Plate Lid Holder, 1 00 6 Suture Needles and Fine Silk, 1 25 1 Hard-rubber Spatula, to apply ointment, .... 75 2 Bowman's Stop Needles, $1.60, 3 00 1 Paracentesis Needle, . , 1 75 1 Straight Broad Needle, 1 25 1 Delicate Shell Spoon, 1 75 1 Double Hard-rubber Curette, 1 50 1 Stilling' s Canalicula Knife, . 1 50 1 Graefe's Tractor, 1 50 1 Pair Delicate Bone-gouging Forceps, 3 00 1 Rosewood Brass-bound Case, lined with silk velvet, . . 16 00 Amount, , . $107 00 Part II. 10 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, r. A. Stohlmann. Edwakd Pfarre. i¥l IH iTKUMlW Ti. INSTRUMENTS FOR OPERATING ON THE LIDS AND LACHRYMAL DUCTS. Fig. 49. Jaeger's Bistoury Cache for the CanaUcula. < £ Fig. 50. Beaumont's Concealed Canalicula Knife. Fig. 51. Asnew's Canalicula Knife. Fig. 57. Styles and Lach- rymal Canula. ft O (In cb Fine Suture Needles, Suture Silk (white and black), fine Silver wire. Page 63, Part I. Styles made of gold, silver, aluminium, hard rubber and lead, solid and canulated ; also lead wire. Pakt II. 67 CHATHAM STREET, NEW-YORK, U Branch Store, 107 East 28tii St., N. Y. ^^ , Fig. 58. Girard Teulon's Canalicula Instrument. NOYES' SET OF EYE INSTRUMENTS No. 8. 2 Desmarre's Eye-lid Retractors, large and small, $1.75, . . $3 50 1 Plain Wire Speculum, 1 00 1 Noyes' Plain Canalicula Knife, 1 75 1 Set of Bowman's Probes, Nos. 1 to 8, 3 00 Some Lead Wire, Nos. 4 to 8, 60 1 Small Scalpel, 1 50 1 Hard-rubber Dental Syringe, . . . . . . . 1 00 2 Strabismus Hooks, large and small, $1.25, . . . . 2 50 1 Pair of Straight Iris Scissors, 1 50 1 Pair of Curved Iris Scissors, . . . . . . . 1 50 1 Pair of Fixation Forceps, . . ... . . . 2 00 1 Pair of Plain Dissecting Forceps, ...... 75 1 Dix' s Spud, for removing foreign bodies, . . . . . 1 25 1 Spatula, 1 25 1 Straight Iridectomy Knife ( Keratome), ... . . . 1 50 1 Angular Iridectomy Knife, . 1 75 1 Short Iris Forceps, . . . . ... . . . 1 50 1 Large Curved Iris Forceps, 1 50 1 Tyrrell's Blunt Hook, . . . . . . . . . 1 25 2 Straight Discission Needles, $1.25, . . . . . . 2 50 1 Graefe's Linear Knife, wide pattern, ... . . . 1 50 1 Small Sharp Iris Hook, 1 25 1 Pan- of Front's Entropium Forceps, 4 00 1 Cystotome and Curette, . . 2 50 1 Sand' s Needle Forceps, 4 50 6 Small Curved and 3 Straight Suture Needles, and fine Silk, . 2 00 2 Graefe' s Linear Knives, narrow pattern, $1.50, . . . . 3 00 1 Hard-rubber Spoon, . . ... . . . . 75 1 Critchett's Lens Scoop, . 1 75 1 Rosewood Brass-bound Case, lined with silk velvet, . . 12 00 Amount, . . $66 25 Part II. 12 GEO. TEIMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. ITl IF/iTEiriilWT 'iO STRABISMUS INSTRUMENTS. Part II. 67 CHATHAM STREET, NEW-YORK. 13 Branch Stoiie, 107 Eart 28Trr Street. Fig. 70. Liebreich's Oplithuinioscope. AG-NEW'S SET OF EYE INSTKUMENTS No. 9. 1 Agnew's Glass Syringe, metal mounted, with two silver points (for lachrymal disease), 1 Set of Bowman's Probes, N'os. 2 to 8, 1 Agnew's Knife, modified, longer than Weber's, and temper taken out of a quarter of an inch of the shank, . 2 Strabismus Hooks, $1.25, 1 Pair of Strabismus Forceps, 1 Pair of Straight Scissors, small, rounded points, . 1 Pair of Scissors, curved on the flat, delicate, . . . 1 Pair of Iris Forceps, delicate, ....... 1 Graefe's Linear Cataract Knife, 1 Liebreich's Linear Cataract Knife, narrow, 1 Cystotome, 1 Small Cataract Xeedle, . 2 Stop Needles, $1.50, 1 Small Sharp Hook, . . « 1 Graefe's Spring Speculum, . 1 Paracentesis Needle, Desmarre's, ...... 1 Iridectomy Knife, angular, . . . . . 1 Pair of Fixation Forceps, spring-catch, ..... 1 Pair of Prout' s Needle Forceps, ....... 6 Fine, Curved Suture Needles, and Fine Silk, 1 Double Lid Elevator, with hinge so as to shut up on itself, 1 Beer's Cataract Knife, . . . . . . . 1 Pair of Large Straight Scissors, 1 Pair of Large Scissors, curved on the flat, for enucleation, . 1 Rosewood Case, lined with silk velvet, Amount, . . $57 75 $5 00 3 00 1 75 2 50 1 25 1 50 1 50 1 50 1 50 1 50 1 25 1 25 3 00 1 25 2 50 1 75 1 75 2 50 3 50 2 00 3 00 1 50 1 50 1 50 8 50 Paet II. 14 GEO. TIEMAKN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfabre. OPHTHALMOSCOPES. FiCt. 70A. Loring's Student Ophthalmoscope. o _ Part II. 67 CHATHAM STREET, NEW-YORK. 15 Branch Stobe, 107 East 28tii St., N. Y. ON THE USE OF THE OPHTHALMOSCOPE. BY JONATHAN HUTCHINSON, Esq., Surgeon to the London Hospital. Some of the simplest applications of optics to the observation of the eye, and the detection of diseased conditions, depend upon the fact that the transparent structures still reflect some light, and more when diseased than when healthy. Thus : Firstly . We examine the reflecting efficiency of the surface of the cornea, in order to determine its transparency. In cases in which there is no large opacity, but simply a case of general steaminess caused by an uneven surface, it may be difficult to detect it by dkect inspection, but if we expose the eye to the light, and look at the image of the window-frame produced, we shall see directly that this image is blurred and indistinct, like that from a greasy mirror. Secondly". We use what is called the catoptric test to determine the presence or absence of the lens. This depends upon the fact that the surfaces of the lens reflect images. Dilate the pupil well with atropia. Hold a small taper in front of the pupil in a dark room. You will observe, if the lens be present, three images : an anterior one, bright, distinct and erect — ^from the front surface of the cornea ; a middle one, inverted, small, fairly distinct — from the concave posterior surface of the lens capsule ; a posterior one, erect, indistinct — from the anterior surface of the lens capsule. Thirdly. Again, the surfaces of the crystalline lens easily become visible, by the light which they reflect, whenever we can see them obliq ae- ly. When the lens is in its normal position it is difficult, unless by oblique illumination, to see its surface ; but if it is malplaced, as wq sometimes find it, by congenital imperfection, or from mjuries, then its surfaces, being oblique, become easily visible. Any one not aware of this fact would at once declare that the malplaced lens was also slighdy opaque, and erroneous observations to that effect are to be found in some records of such cases. In former days the catoptric test used to be much employed to deter- mine the transparency, or otherwise, of the crystalline lens. !N'ow, how- ever, it has been wholly superseded by another discovery, which in its every-day usefulness is second only to that of the ophthalmoscope itself. I allude to oblique illumination. To accomplish this is the easiest matter possible, and by its aid any one of the slightest skill can, in almost all cases, determine at a glance the condition of the patient' s pupil and of his crystalline lens. The smallest dots of pigment on the capsule, the least possible streaks of an incipient cataract, become by its aid conspicu- ously definite. We have no longer any need for the curious, but very disappointing, catoptric test (which fails us just Avhen most needed, /.in'il''|i r i|,, , ii ' I I I ii I' „!'■ ,11'' 1 ■ ■ ■! |l,ill{|li:;|ji||jljl|iil,1,i|li!iii|jji,i,|l/,,li^^^ ii;pi> I < ' . , ■ ii . . I .1 'I, I I ,.ll|l'.„''l'' ■ N'i'' w'":/ muLii/^ / ,/ Fig. 73c. Knapp's Metric System Opthalmoscope. Part II. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28Tn St., N. Y. ^3 ;¥1 IMBTEUMlNtB. Fig. 74. Knapp's Single Disk Ophthalmoscope. Fig. 75. Pupillometer. Part 11. 24 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. KNAPP'S SET OF EYE INSTRUMENTS. 2 Strabismus Hooks, . $1 25, . $2 50 1 Beer's Cataract Knife, 1 50 1 Graef e' s Knife, for Linear Extraction, 1 50 1 Small Scalpel, '. . 1 50 1 Knapp's Foreign-Body Hook, silver, 2 00 1 Discission Needle, . 1 25 1 Foreign-Body ISTeedle, 1 25 1 Cystotome and Daviel' s Spoon, 2 50 1 Spatula Hook, . . . . 1 25 1 Angular Iridectomy Knife, *. . 1 75 1 Bowman' s Laclirymal Knife, . 1 75 1 Pair of Fixation Forceps, spring-catch, . . . . . 2 00 1 Pair of Strabismus Scissors, curved, 1 50 2 Desmarre's Lid-Holders, $1 75, . 3 50 1 Porte Caustic, liard-rubber and silver, , . . . . . 1 00 1 Hard-Rubber Copper-Holder, . . . . , . . 1 50 1 Pair of Sand's Needle Forceps, 4 50 1 Pair of Lidectomy Forceps, plain, 1 50 1 Pair of Iridectomy Scissors, 1 50 1 Pair of Knapp' s Entropium Forceps, . . ' . . . 4 00 1 Hard-Rubber Spatula, broad, 1 00 1 Pair of Cilia Forceps, . . . . . . . . 1 25 ^ Doz. Suture Needles and Silk, 1 25 1 Bowman' s Probe, Nos. 3 and 4, ... . '. . 75 1 Morocco Case, pocket size, 6 00 Amount, . . $50 00 Witli 1 Liebreicli' s Oplitlialmoscope, $54 00 1 Knapp' s Ophthalmoscope (see Figs. 73) instead of Liebreich's, . . . $85 00 Pat?t II. 67 CHATHAM STREET, NEW-YORK. 25 Branch Store, 107 East 28Tir St., N. Y. 1¥1 raBiTE,UM;iKTS.. FIXATION INSTRUMENTS, TO STEADY THE EYEBALL FOR AN OPERATION. Fig. 78. Ball's Double Hook, lor Extirpation. Fig. Pamard's Pique, for Fixing the Eye. ^^ Fig. 83. Jaeger's Ophtlialmostate. Fig. 84. Noyes' Ophtlialmostate. Part II. 26 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. Fig. 855. Carron de Villard's Lid Forceps, Right and Left. KNAPP'S COMPLETE EYE SET No. 11. 2 Knapp's Eye Specula, right and left, . 2 Desmarre s Elevators, ... 2 Fixation Forceps, .... 1 Beer's Cataract Knife, 1 Graefe's Cataract Knife, concave, 1 Liebreich's Cataract Knife, concave, 1 Cystotome, with Daviel's Curette, 2 Iris Forceps, large and small, . 1 Iris Scissors, curved on the flat, delicate, 1 Strabismus Scissors, 1 Large Silver Scoop, .... 2 Angular Iridectomy Knives, 1 Weber's Canalicula Knife, . 1 Bowman's Stop Needle, straight, 1 Sickle Needle without Stop, 1 Foreign Body Needle, curved, 1 Knapp' s Foreign Body Hook, silver, . 1 Tyreir s Blunt Hook, soft shank, 4 Bowman's Probes, „ , , . 2 Strabismus Hooks, . „ . . 1 Ferguson's Needle and Artery Forceps, ■ 2 Knapp' s Entropium Forceps, neutral right and left, one for operation on the outside, one for inner side, 1 Jaeger' s Lid Holder, hard rubber, 1 Agnew's Glass Syringe, 2 Bistouries, 1 Cilia Forceps, 6 Suture Needles and China bead Silk, 1 Test Drum, 1 Knapp's Caustic Holder, .... 1 Camels-hair Brush, mounted on one side with a piece of sulphate of copper, 1 Baader's Tattoeing-Needle, 1 Morocco-covered Case, lined with silk velvet. Amount, . $5 00 3 60 4 00 1 50 1 50 1 50 2 50 3 50 1 50 1 50 2 00 3 50 1 50 1 25 1 25 1 25 2 25 1 25 3 00 2 50 3 00 8 00 1 00 4 50 3 00 1 25 1 00 50 1 00 25 2 00 7 00 $78 25 Part II. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y. 1¥1 niiTEUMlMTB. INSTRUMENTS FOR REIVIOVING FOREIGN BODIES FROIVl THE EYE-BALL AND ORBIT. Fig. 86. Dix's Spud. =-^C Fig. 87. Couchins? Needle. -=c Fig. 88. CarroQ de Villard's Needle. Fig. 89. Anfjulav Needle. Fig. 90. Gouge. Fig. 91. Spatula. Fig. 92. Daviel's Curette. Fig. 93. Hard Rubber Spoon. a. O 27 Fig. 94. Knapp's Foreign Body Hook. G .Tl EM AN N- CM Fig. 95. Agnew's Eye Douche. Fig. 95c. Eye-Bath Glass. Fig. 95^». Stopcock for Eye Douche. Part II. 28 GEO. TIEMANN & OO.'S SURGICAL INSTRUMEKTS, F. A. Stohlmann. Edward Pfarre. SNELLEN'S COMPLETE EYE SET No. 12. 1 Agnew' s Canaliciila Knife, $1 75 1 Angular Keratome, 1 75 1 Straight Keratome, 1 50 3 Graef e' s Linear Knives, . . 4 50 1 Small Strabismus Hook, 1 25 1 Large Strabismus Hook,, 1 25 1 Knapp' s Foreign Body Hook, -. 2 00 1 Silver Lens Scoop, 1 50 1 Hard Rubber Lens Scoop, 75 1 Agnew" s Lachrymal Syringe, 2 points, . . . . . 5 00 1 Test Drum, . 50 1 Bowman' s Grooved Director, 50 1 Set Bowman' s Probes, button-pointed, . . . . . 3 00 1 Anel' s Probe, . 50 1 Weber's Graduated Probe, 1 00 1 Hard Rubber Probe, 10 1 Skein black Eye Silk, 15 1 Dozen Eye Needles, . 1 50 1 Beer's Knife, 1 50 1 Agnew' s Tattoeing-Needle, 2 00 1 Curved Needle, 1 25 4 Straight Needles, 5 00 1 Tyrrell's Sharp Hook, .... . . . . . 125 1 Tyrrell's Blunt Hook, . 1 25 1 Bowman' s Stop Needle, 1 25 1 Spud, 1 25 1 Daviel's Curette and Cystotome, flexible shank and angular bend, bayonet, 2 50 1 Graef e' s Angular Iris Forceps, 1 75 1 Wecker's Iris Scissors, . . . . . . . . 10 00 1 Cilia Forceps, 1 25 1 Graef e' s spring-catch Fixation Forceps, ordinary, . . . 2 00 1 Graef e' s spring-catch Fixation Forceps, very slender shank, . 2 00 2 Desmarre' s German Silver Retractors, 3 50 1 Jaeger's Hard Rubber Lid Holder, 1 00 1 Caustic Holder, 1 00 2 Knapp' s Entropium Forcejjs, . . . . ... 8 00 1 Manoir' s Canalicula Scissors, . 1 50 1 Straight Iris Scissors, 1 50 1 Sand' s Needle Forceps, 4 50 1 Enucleation Scissors, curved on flat, ..... 1 60 Part II. 67 CHATHAM STREET, NEW-YORK Branch Store, 107 Eaht 28tii Street. 29 1 Iris Forceps, straight, very fine, . ' . . . . 1 Strabismus Scissors, straight, batton-pointed, 1 Iris Scissors, curved on flat, 1 Iris Forceps, curved, 1 ISToyes' Eye Speculum, Fig. 17, regular size, 1 Noyes' Eye Speculum, small size, 1 Morocco-covered Case, with tray in the bottom for eye instru ments, and tray in the top for scissors and forceps, Amount, . . $1 50 1 50 1 50 1 50 4 50 4 50 . W 00 $115 25 INSTRUMENTS FOR OPERATING ON THE CONJUNCTIVA. Fig. 96. Scissors Curved on the Flat. O "p. c Q pq Q [See also Double Hook, Figs. 78 to 80 ; Scalpels, Figs. 54, 55, 56 ; Forceps, Figs. 80 to 85 ; Rubber Spatula for the application of Ointment ; Hard Rubber and Silver, Silver and Platina Caustic Cases ; Camel's-Hair Brushes, for applying Caustic Solutions, etc.] ' 1^ INSTRUMENTS FOR PARACENTESIS CORNE/E. Fig. 98. Desmarre's Paracentesis Trocar. Fig. 99. Broad Paracentesis Needle. Fig. 101. Very Broad Paracentesis Needle. 30 Part II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfarre. i¥l m iTEUMllfTS^ IRIS INSTRUMENTS. FOE ARTIFICIAL PUPIL, IRIDECTOMY, DISLOCATING THE NATURAL PUPIL, AND INCISION. Fig. 102. Jaeger's Straight Keratome. Fig. 103. Jaeger's Angular Keratome. Fig. 105. Welker's Iridectomy Instrument. T /EMftNI\/-CG, Fig. 105&. De la Rosa's Iris Needle. Many other patterns of Iris Hooks on hand, such as Weber's Capsular Hooks, single and double, right and left curves Part II. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28th Stiikkt, N. Y. 31 i¥i nfiTMUMiiiTe ^« INSTRUMENTS USED IN OPERATIONS FOR CATARACT. Figs. 113, 114, 115. Beer's Cataract Knives, three sizes. *a!:l!iJ«iii:!llli|llin«ill!llllll"}l"«'|iF ^-^'■'■'IllV'll! " Jas Fig. 116. Cystotome, for Lacerating the Capsule. Fig. 117. Knapp's Cystotome. 3 'pb Fig. 118. Graefe's Linear Knife. Fig. 119. Graefe's Tractor. Fig. 120. Graefe's Lens Scoop. Fig. 121. Hard-Rubber or Shell Lens Spoon. Fig. 122. Critchet's Hooked Needle. ^€ Fig. 123. Luzardi's Hooked Needle. Fig. 124. Silver Lens Scoop and Cystotome Fig. 125. Fenestrated Lens Scoop. Fig. 125b. Critchet's Flat Lens Scoop. Fig. 125c. Critchet's Concave Lens Scoop. Paut II. 32 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoulmanx. Edward Pfaurk. EYE raSTRlTMEMTS. INSTRUMENTS USED IN OPERATIONS FOR CATARACT. Fig. 136. Knife-Needk. ^= Fig. 137. Noyes' Iris Scissors. Fig. 138. Wilde's Cauulated Needle. M P^ Fig. 139. Wilde's Canulated Forceps, Scissors, and Forceps-Needle, in one Handle. N Fig. 140. Wilde's Canulated Forceps (Lithotriptor-like). Part II. 67 CHATHAM STREET, NEW-YOEK. Branch Stoke, 107 East 38tii St., N. Y. ¥1 INSTmTOIlN/T HO INSTRUMENTS USED IN OPERATIONS FOR CATARACT. Fig. 148. Tattoeins: Needle (for the Coloring of White Spots in the Cornea). Ftg. 149. Baader's Tattoeins Needle. ^ S. riEMANN =CC. 1 Fig. 150. Agnew's Tattoeine NeedV. 1 G. 1 lEIVIB'MN-CO. Fig. 151. Blanehet's Instrument for Exhausting Soft Cataract. Fig. 153. Bowman's Instrument for Exhausting Soft Cataract. 34 Pakt II. GEORGE TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoulmann. Edward Pfarre. ^A 4\ 5irr\T ffMlNI Fig. 153. Ear Piercer, to Perforate the Lobe for the Insertion of Ear-rings. INSTRUMENTS FOR THE EXAMINATION OF THE EXTERNAL MEATUS. Pakt it. 67 (CHATHAM STRP:ET, NEW-YORK. Branch Store, 35 107 East 28tu St., N. Y. MR raB^TEUMlHTS. INSTRUMENTS FOR THE EXAMINATION OF THE EXTERNAL MEATUS, Fig. 1(30. Clark's Otoscope. Fig. 162. Gruber's Specula of Hard Rubber. Fig. 161. Knapp's Ear Specula. o O O Fig. 163. Toynbee's Ear Specula. Fig. 164. Simrock's Otoscope, with Lens. Fig. 165. Speir's Self-retaining Ear Speculum. Fig. 1655. Milikin's Self-retainino; Ear Speculum Pakt II. 30 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfakre. EAE INSTRUMENTS IN CASES. POLITZEK'S COMPLETE SET OF EAR INSTRU- MENTS. 1 Reflector, with handle and headband, $6 50 3 Hard-Rubber Ear Specula, . 1 50 1 Hard-Rubber Curette, . . . 1 00 1 Daviel's Curette, German silver, 1 50 1 Hook, for removing foreign bodies, 1 00 1 Polypus Knife, 1 25 1 Tympanum Perforator, angular, . . .' . . . . 1 50 1 Wilde' s Angular Forceps, spring, 1 50 1 Pair of Polypus Forceps, . . . . . . . . 2 50 1 Wilde's Polypus Snare, . . . ... . . 3 50 1 Pair of Eyelet Forceps and eight Eyelets (Politzer' s), for insertion into the perforated tympanum, 3 75 3 Hard-Rubber Eustachian Catheters, 3 00 1 German Silver Eustachian Catheter, . . . . . 1 50 1 Diagnostic Tube and Explorer, . . . . . . . 2 50 1 Tuning Fork, 1 25 1 Ear Syringe, hard rubber, 1 25 1 Morocco-covered case, lined with velvet, 5 00 Amount, . . $40 00 Fig. 166. Hassenstein's Otoscope. Pakt II. 67 CHATHAM STREET, NEW-YOHK, 37 Branch Store, 107 East 38th St., N. Y. IMM roSTEUMlHTS. INSTRUMENTS FOR OPERATING ON THE MEMBRANA TYMPANI, ETC. Fig. 167. Toynbee's Artificial Tympanum. Fig. 168. Gruber's Sickle-shaped Polypus Knife. Fig. 169. Simrock's Scissors, for Operating on the Tympanum and Small Bones of the Ear. Pig. 170. Politzer's Tympanum Perforator, Angular. Fig. 171. Politzer's Tympanum Perforator, Straight. Fig. 172. Politzer's For- ceps, for Introduc- ing Eyelets into c> the Perforated Tympanum. Fig. 174. Pomeroy's Fig. 173. Bonafont's Eustachian Catheter- Eustachian Catheter-Holder. Kramer's Holder. G.TIEMAhN = CO, Fig. 174&. Wire Nose Clamps for holding the Eustachian Catheter Fig. 175. Politzer's Meatus Knife. ^ -^ 3.TIEMAI\IN&CQ. Fig. 176. Eustachian Catheter, Hard Rubber or Silver. 88 Pakt it. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F, A. Stohlmann. Edward Pparre. EAR INSTRUMENTS IN CASES. POLITZER'S SMALL SET OF EAR INSTRUMENTS. 1 Troeltsch' s Mirror, with handle, $3 50 3 Hard-Rubber Ear Specula, 1 50 1 Hard-Rubber Curette, .... . . . . . 1 00 1 Curette and Hook, steel, . . 1 00 1 Polypus Knife, steel, "75 1 Pair of Angular Forceps, 1 50 1 Wilde's Polypus Snare, 3 50 2 Hard-Rubber Eustachian Catheters, 2 00 1 Diagnostic Tube and Explorer, 2 50 1 Hard-Rubber Syringe, . . 1 25 1 Morocco-covered Case, lined with velvet, 3 50 Amount, . . $22 00 Pakt II. CHATHAM STREET, NEW-YORK. 39 Branch Store, 107 East 28tu St., N. Y. lAE IFfSTEUMllTT'S, NSTRUMENTS FOR THE EUSTACHIAN CANAL, Fig. 179. Politzer's Air-Bag, for Inflating the Eustachian Canal. Fig. 180. Politzer's Air-Bag with Roosa's Attachment, for Treating Diseases of the Middle Ear. Fig. 181. Buttle's Inhaler, and for Forcing Medicated Vapors into the Eustachian Canal. Knapp's, Simrock's, Allen's, and other Nozzles for Politzer's Air-Bags. Kramer' s Air-Press to Order. 40 Pa-rt 11- GEO. TIEMANN & CO.S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparke. EAR INSTRUMENTS IN CASES. TURNBULL'S SET OF EAR IlSrSTRUMENTS. 1 Troeltsch' s Ear Mirror, with handle and headband, 1 Set of (B) Rhinoscopic Mirrors, to fit one handle, 1 Set of (3) Gruber' s Tubular Specula, German Silver, in a case, to be carried in the vest-pocket, ..... 1 Tuning Fork, to test the condition of the auditory nerve, . 1 Explorer and Diagnostic Tube, pair, 1 Eustachian Catheter, hard rubber, small size, 1 Politzer' s Apparatus, attachable to, 1 Capillary Spray, for injecting the middle ear, ... 1 Ear Syrmge, hard rubber, 1 Turnbull's Curette, soft silver, 1 Turnbuir s Angular Forceps, for removing foreign bodies, 1 Turnbuir s Sickle-shaped Knife and Curette, for opening furun- culous abscess in the external meatus, 1 Ear Spout, 1 Clarke' s Douche, f or'the ear and eye, 1 Wilde' s Polypus Snare, 1 Probe. . . . . . . . 1 Pair of Polypus Forceps, Politzer' s, . . . 1 Gruber's Tenotome, Fig. 177 (3 blades), . 1 Politzer' s Tympanum Perforator, .... 1 Catarrhal Syringe, posterior nares, 1 Pair Thudichum's Nasal Specula, r. and 1., . 1 Rauchfuss' Powder Blower, .... 1 Drill, for perforating mastoid cells, 1 Morocco-covered case, lined with velvet, . Amount, $6 50 4 50 3 50 1 25 2 50 1 00 2 00 3 00 1 25 1 75 1 75 2 50 1 50 2 50 3 50 35 3 00 5 00 1 50 1 50 1 50 2 50 8 00 6 00 $68 00 Part II. 67 CHATHAM STREET, NEW- YORK. Branch Store, 107 East 28tii St., N. Y. 41 MM mSTWGMSmTS, NSTRUMENTS FOR THE EUSTACHIAN CANAL. Fig. 183, Fullgraff's Eustachian Spray. Fig. 184. Hackley's Instrument for Spraying the Eustachian Canal, Part II. 42 GEO. TIEMANN & CO.'S iSURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Ppakee. HOOSA'S SET OF EAR INSTRUMElSTTa 1 Troeltsch' s Ear Mirror, with handle, and Roosa' s Head-band, . $6 50 1 Set of three Wilde's Tubular Specula, plated, . . . 3 00 1 Pail' of Wilde' s Angular Forceps, 1 75 1 Scalpel and Daviel' s Curette, , , 2 50 1 Holcomb's Cotton Probe, 60 1 Eustachian Catheter, silver, 1 50 1 Eustachian Catheter, hard rubber, . . . . . . 1 50 1 Posterior IS'ares Syringe, hard rubber, 1 50 1 Ear Syringe, hard rubber, 1 25 1 Roosa' s Iodine Apparatus, . . . . . . . 2 50 6 Toynbee's Artificial Tympanii, 30c., 180 1 Diagnostic Tube and Explorer, . 2 50 1 Tuning Fork (C), . 1 25 1 Siegle' s Pneumatic Otoscope, 5 00 1 Small Powder-Blower, hard rubber, 1 25 1 Set of Blake' s Ear Snares and Paracentesis Needle, . . 5 50 1 Morocco-covered Case, lined with velvet, 3 50 $43 40 And 1 Politzer's Apparatus, in a separate paper box, . . $2 00 Fig. 184!>. Ely's Modification of Siegle's Otoscope. Pakt II. 67 CHATHAM STREET, NEW-YORK. 43 Branch Store, 107 East 28th St., N. Y. lAE DfBT'EUMra'TB. DIAGNOSTIC INSTRUMENTS. Fig. 185. Ear Probe, Steel, Angular. Fig. 186. Politzer Ear Manometer ipART II. 44 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, E. A. Stohlmann. Edward Pfarbb. lAE Ilf eTmUMlIf IT'S. Fig. lO". Blake's Inner-Ear Mirror. i Dr. Albert H. Buck's Ear Instruments. (Fig. 194.) /. Silver Probe. g. Blunt-pointed Curved Bistoury. Ti. Maryngotome. i. Furuncle Knife. k. Sharp-pointed Curved Bistoury. For Buck's Case of Ear Instniments. (See page 46.) . Curette. h. Cotton Holder, c. Silver Probe. d. Mastoid Process Knife, 6. Port-Acid Glass. Part IT. ♦ 67 CHATHAM STREET, NEW- YORK. 46 Branch Store, 107 East 28tii St., N. Y. :^m\ >io INSTRUMENTS FOR REMOVING FOREIGN BODIES, FLAKES OF EPIDERMIS, WAX, HAIRS, POLYPI, FLUID SECRETIONS, ETC. Fig. IMl. Politzer's Hard-Rubber Ear Spoou. UJJEMANtl^Ca. Fig. 195. Allen's Polypus Forceps, and for Removing Foreign Bodies. Part II. 45 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfabre. BUCK'S SET OF EAR INSTRUMENTS. 2 Curettes, 75c., 4 Cotton Holders, 50c., 1 Silver Probe (c), . . . .- 1 Mastoid Process Knife, 1 Port Acid Glass, 1 SHver Probe (/), 1 Blnnt-pointed Curved Bistoury, 2 Maryngotonies, $1.00, . .■ 1 Furuncle Knife, . . ' 1 Sliarp-pointed Curved Bistoury, 2 Drills for Mastoid Process, 1 Mirror, 2| inch diameter, and Head-Band, .... 1 Wild' s Ear Forceps, very delicate, 1 Blake's Snare, silver canula, only one hole to receive No. 37 wire doubled, 1 Set of 4 Wild's Ear Specula, silver, 1 Fine Morocco Case, silk velvet lining, Amount, . $1 50 2 00 60 1 50 15 75 1 50 2 00 1 50 1 50 3 00 5 00 1 50 3 00 4 50 5 00 $35 00 INSTRUMENTS FOR REMOVING FOREIGN BODIES. Fig. 203. Angular Ear Hook. Fig. 205. Elsbersi's Angular Screw-Hook. Ftg. 206. Gross' Ear Spoon and Hook. S.TIEMP.NN &CD- Part II. 67 CHATHAM STREET, NEW YORK. Bkanch Store, 107 East 28th St., N. Y. 47 mm INBTEUMIHTS. Fig. 207b. Hinton's Double-jointed Fig. 207c. Fig. 207. Hinton's Polypus Forceps. Polypus Forceps. ' Pomeroy's Ear Forceps. Fig. 207d. Tiemann & Co.'s Ear Forceps and Reflector. Fig. 207e. Tiemann & Co.'s Universal Ear Forceps. Fig. 207/. Avery's Ear Forceps. Part II. 48 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, r. A. Stohlmann. Edward Pfarre. SPEIK'S SET OF EAR INSTRUMENTS. 1 Tympanum Perforator, $1 50 1 Eustachian Cauterizer, 1 50 1 Spec's Ear Scoop (Curette), 1 00 1 Virgin Silver Eustachian Catheter, .... . 2 00 1 Hook for Removing Foreign Bodies, 1 50 1 Speir's Self -retaining Ear Speculum, . - . . . . 4 50 1 Hard Rubber Ear Syringe, 1 25 1 Wilde's Angular Forceps, *. ' 1 75 1 Wilde's Ear Polypus Snare, . . ^ 3 50 1 Pair of Plain Slender Forceps, . . ' . . . . 1 00 1 Lens and Frame, 2" focus, 2 00 1 Speir' s Ear Cleaner, 75 1 Pair of Small, Straight Scissors, 1 50 1 Tympanum Manometer, 2 50 1 Speir's Aural Reflector, ■ 4 50 1 Ear Probe, 60 6 Toynbee's Artificial Tympana, 30c., 1 80 1 Glass Brush, . 40 1 Coil of Silver Wire, 50 2 Atropine Glasses, 20c., 40 1 Morocco Case, lined w^ith silk velvet, . . . . . 6 00 Amount, . . $40 45 TOYNBEE'S SET OF EAR INSTRUMENTS. 3 Silver Ear Specula (Toynbee's), $5 50 1 Pair of Rectangular Forceps, ....... 1 Metallic Syringe with two Rings (or hard rubber), 1 Ear SjDout, . . . - . 1 Wilde's Polypus Snare, 1 Pair of Ring Polypus Forceps, . . . • . 4 Artificial Tympana, 1 Otoscope (Diagnostic Tube) and Exx)lorer, 1 Eustachian Catheter, hard rubber, . . 1 Morocco-covered Case, lined with velvet, .... Amount, . . $23 20 1 75 1 50 1 50 3 50 2 00 1 20 2 50 1 00 2 75 Part II. 67 CHATHAM STKEET, NEW YORK. Bbanch Store, 107 East 28Tn St., N. Y. 49 lAM mST-EUMlHTS. Fig. 210. Lucae's Eeflux Ear Douche Fig. 208. Eiterbecken (Pus Basin), Brass. Fig. 209. Pns Basin, Hard Rubber or Tin. Fig. 210&. Bonder's Ear Spout. Fig. 211. Up de Graff's Ear Spout. 50 Part II. GEO. TIEMAN?^" & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pparre. Fig. 215b. Hosiier's Ear Spout Fig. 215. Sexton's Ear-Douche. FOR PERFORATING THE MASTOID PROCESS AND FOR THE REMOVAL OF NECROSED BONE. Fig. 216. Drill with Guard, for Perforating the Mastoid Process. O Ph ffi Fig. 2165. Buck's Drills. Sfc also Osteotomy Instruments, Part I. Part II. 67 CHATHAM STREET, NEW- YORK. 51 Branch Store, • 107 East 2Stu St., N. Y. 1AM TEUMPETB, A DESCRIPTION OF MECHANICAL APPLIANCES FOR IMPROVING THE CON- DITION OF THE DEAF, BY ENABLING THEM TO HEAR MORE DISTINCTLY THE HUMAN VOICE, MUSIC, AND SOUNDS GENERALLY. In view of the very limited remarks on Ear Trumpets, even by the best authors on Aural Surgery^ and in answer to the many inquiries respect- ing tliem, we will attempt to describe in these pages the most useful kinds, hoping thereby to meet the wishes of many of our friends who have ad- dressed us on that subject. Fig. 319, U.riEMANN&CO.N.Y The smallest auricular or Hearing Instruments are Silver Cornets, Fig. 219, a, h. They will prove efficient in cases of obstruction of the meatus auditorius, by reason of contraction, or the presence of polypii. Keeping the canal open, and admitting air to the tympanum, they will sometimes start its dormant functions. As they come in contact with inflamed or otherwise diseased structures, they ought to be made of gold or silver, and never of inferior metal. Fig. 219, c, represents an ARTIFICIAL TY'MPANUM. In order to diminish the evil results occurring from perforation of the drum, it has been recommended by Toynbee, of London, to insert an arti- ficial one, and thus close the opening. The instrument consists of a thin plate of vulcanized India-rubber, about one centimeter in diameter, in the centre of which a line silver wire, about an inch long, is fastened. This wire has a ring on its outer end, by which it can be easily removed. This artificial membrane is pressed against the remains of the natural one, caus- ing sometimes truly a magical effect. (Yide Toynbee on Diseases of the Ear, Philadelpliia ed., page 191 and others.) Patients should never apply them, before they are properly instructed by their physicians. Fig. 320 EAR TRUMPETS. So called on account of their similarity in form to the well-known mu- sical instrument, but, in principle, the very reverse ; for, whilst the latter produces and emits sound (air waves), the Ear Trumpet, on the contrary, absorbs, concentrates, and conducts it. They are made in various forms, and may be said to consist of three parts : 52 Pakt II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfakre. lAE TEUMPlT'e, Fig. 221. The montli, the neck, and the ear piece. The mouth, or large opening, is turned toward the speaker. The larger this part of the instrument is, the greater its power will be. The neck, conical in shape, connects the mouth to the ear-piece. Fig. 222. e.TIEMAHI\IS.CO.N.Y: The neck may be made of various lengths ; in a straight line, also in curves, or angles, without impairing the power of the instrument. The Ear-piece is simply the small, well-rounded open extremity, of proper size to fit the auditory canal. THE DIPPER TRUMPET, Fig, 225, is the most powerful instrument, best adapted to hear public lec- tures, or sermons, and will be found efficient where the smaller-sized trum- pets have failed. Fig. 225. Fig. 226. S. TIEMANN & CO. N.Y. G.TIEMANN&CO.Nh; They differ from the ordinary Trumpet in shape and construction. The mouth-piece is closed by a perforated metal plate. The neck is at a right angle to it and reaches clear inside, in a curved line, nearly striking the bottom. Air waves passing through the little apertures of the mouth- piece, will touch the bottom, which, being in form of a parabola, reflects them toward a common centre. This common centre is the neck of the in- strument. All of the waves being forced into this channel and conducted to the ear, will operate with increased j)Ower. Like the common Trumpet, they are made in various forms to suit the fancy of the patient. (Figs. 225, 226, 227.) The power of the instrument is not dependent on its form, but bears minute relations to size, increasing or dinainishing with the other. Patit it. 67 CHATHAM STREET, NEW- YORK. 53 Branch Store, 107 East 28Tn St., N. Y. .;AE TEUMPlTe Fig. 227. ■t^S!asi£l AMD -ffiBOPMA- nis^ TONSIL INSTRUMENTS. fe Pakt II. 67 CHATHAM STREET, NEW YORK. 65 Branch Store, ■ 107 East 28Tir St., N. Y. TONSIL INSTRUMENTS. Fig. 283^^. Mackenzie's Tonsilotome. Fig. 284. Tonsil Scissors, Curved on tlie Flat. Fig. 285. Hamilton's Tonsilotome. Pakt II. 66 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, E. A. Stohlmann. Edward Pparre. QEALi WiTEUMlHTI ^ STAPHYLORRHAPHY AND URANISCOPLASTIC INSTRUMENTS. Ph «^ o S p Pm Fi&. 295. Whitehead's Spu-al Needle, for Sutures. Fig. 296. "Whitehead's Gum Knife. Fig. 298b. Rio-ht and Left Cheek Retractors. « O 'o tn t>=e PI'S ft [11 5 0^ 1 <■ o Ph ■ii be C m ^ H J Part II. 67 CHATHAM STREET, NEW YORK. Bkanch Store, 107 East 38tii St., N. Y. 67 ^ LAE¥lf(ilAlL/ AHB SSOPl [A« STAPHYLORRHAPHY AND URANISCOPLASTIC INSTRUMENTS. Fig. 298 c to I. Langenbeck's Knives, Tenaculum, Retractor and Suture Holder. ( Pakt II. 68 G^EO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pparke. OEAL, IL'AMTireiAL AMD ffiSOPHA- MAL: 'IA.M =lL ^^i) LARYNGOSCOPIC INSTRUMENTS. Fig. 306. Roe's Modification of Tobold's Laryngoscope. Fig. 307. Henry's BuU's-Eye Illuminator. Fig. 308. Laryngoscopic Mirrors. Part II. 67 CHATHAM STREET, NEW-YORK. 69 Branch Store, • 107 East 28Tir St., N. Y. Fig. 309. Tiemann & Co.'s La,ryng()Sco])e, with Head-Band. Fig. 310. Application of Tiemann & Co.'s Laryngoscope. Tlie Laryngeal Instniments represented on the following pages are de- signed by distingnislied Laryngoscopists of Enrope and America, and re- commend themselves, on account of their great simplicity, for general use. Before using the Laryngeal Mirror (to prevent deposits of moisture), warm it over a spirit lamp, as the immersion in hot water, recommended by some, favors the decomposition of the silver coating of the glass. Sponge-holders are preferable to Probangs, because the same piece of sponge need not be used twice. Solid Nitrate of Silver is best applied by means of Lente's or other Probes, the extremity of which is dipped into some Nitrate of Silver fused over a spirit lamp, in either a porcelain or platinum cup. In thisway a coating of the nitrate adheres firmly to the probe, and the application is safe. The pistons of all Syringes used for the application of solutions should be kept in proper order, by frequent oiling, and by renewing the leathei' packing whenever it becomes too loose. Pakt II. 70 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. ON THE USE OF THE LARYNGOSCOPE. BY DR. E. H. SIEVEKING, Physician in Ordinary to the Prince of Wales, and to St. Mai'y^s Ilosjntal, Before speaking of laryngeal pathology as exhibited by the laryngo- scope, let me say a few words anent the apparatus to be employed, the method of using it, and the points to be observed. What do you want to do i In plain English, you want to look round a corner into a dark hole. This sounds paradoxical, but the paradox is solved by the laryngoscope. The light, either of the sun or of a lamp, is received on a mirror attached to the observer's forehead, from which it is reflected on to a small muTor which is introduced into the fauces of the patient, and from this mirror again the light is thrown down upon and into the larynx. The angle of incidence being equal to the angle of reflection, you have merely to place your mirrors in such a relation to one another, as to secure the proper du-ection of the rays of light, and a perfect and distinct image of the parts illuminated will be visible on the small mirror. The sun can not be relied upon at any hour of the day ; and patients would not, even if the sun were always shining, present themselves when his rays penetrated a given locality. We therefore And it much more convenient to trust to artificial light altogether, and accordingly have recourse to a gas moderator, or a paraffin oil lamp, which are not amen- able to the caprices of the weather. It is well to darken the room in which you make your examination ; but even this is not absolutely necessary if the light is protected by a convex mirror on one side, and concentrated by one or more lenses on the other. Various apparatuses have been devised for the purpose of inten- sifying the light. The lamp should be placed close to the patient' s head, on either side most convenient to the observer, and so that the lamp and the patient's and observer's heads are in the same horizontal plane. The patient, sitting erect, should push his head back so as to straighten the neck, and facilitate the introduction of the small mirror. Before attempting to do this, the observer should first ascertain that the reflector is properly adjusted. If he finds that the mouth is fully illuminated, he may fairly conclude that he will be able to throw the light upon the fauces. Beginners generally find a little difficulty in adjusting the reflector, but this is speedily surmounted. Whether you place your muTor on your forehead, or whether you prefer to use it fixed to a lamp, is a matter of little moment Try both ways, and adopt the one you like best. The mirror I employ has a central uncovered spot. It is an im- provement upon the original mirror employed by the father of laryngo- scopy, Professor Czermak. I admit that with Professor Czermak's instru- ment I had a difficulty in seeing through the central orifice, but with this modification I find it advantageous first to adjust the reflector so that Part H. 67 CHATHAM STREET, NEW-YOliK, 71 Branch Store, _ 107 East 28tii St., N. Y. I am enabled to see the fauces through, the opening, with the eye covered with the reflector, and then I am certain to liav(3 tii(^ proper axis for botli eyes. After you have satished yourselves that tlie lamp and th(^ ]elle(;to]' (wliich is hxed on the head by an elastic band passing ov(3r tlie forelieadj are in the right position, tell your patient to open his mouth widely, to protrude the tongue, and to breathe freely. Some patients will permit you to see into their larynx without in any way fixing the tongue, but this is the exception. As a rule, it is necessary that the patient, or the observer, should take hold of the tip of the tongue with a handkerchief or towel, or to use a tongue depressor, to prevent this "uniuly organ" from slipping back. Without this precaution, you very often fail in your endeavors to see below the epiglottis. Your next step, after having got your patient in the proper position, is to warm the laryngeal mirror. This is necessary, to prevent the vapor of respiration being precipitated on, and dimming the mirror ; but take care not to overheat it. As a precaution, it is well to test the temperature, by applying the back of the mirror to your own cheek. Take hold of the stem of the mirror as if you were holding a pen ; in- troduce it into the mouth without touching the tongue, teeth, or lips, sinking the hand at first, and then raising it gradually, so as to allow the mirror to form a curve until it reaches the uvula. Almost the whole secret of the manipulation in laryngoscopy consists in this. If you touch the lips or teeth, you tease the patient, but if you touch the tongue, you are certain to excite reflex action, and the root of the tongue will arch up to impede your view. Audaceinfortuniajimat. Push your muTor, after having passed the janitors, well against the uvula, and you will rarely meet with any serious impediment in getting a proper view of the larynx. An unsteady hand creates difficulties which need not exist, by bringing the mirror into contact with other parts than the uvula and soft palate. These are not very sensitive, but if you tease the root of the tongue, or the arches of the palate, you infallibly excite reflex action, which will necessitate the withdrawal of the instrument. Having placed your mirror at an angle of about 45° with the horizon, it is well to rest the little finger of the right hand against the patient' s cheek, by which means you will steady the instrument. You then secure a proper illumination of the laryngeal mirror, and by the necessary manipulation, which practice alone can teach, you successively examine all the parts exposed to view. In making the examination and recording the facts observed, you must remember that you are looking into a mirror, which represents the parts in a different relation from their real position. The epiglottis, which in nature is turned from the observer, is represented as opening towards him ; the base of the tongue, which is in front of the epiglottis, appears in the mirror behind it ; and the vocal cords equally occupy in the mirror a reversed position from that which they really possess. As laryn- goscopic illustrations represent the appearances as seen in the mirror, it is necessary to remember the true relation, in order to understand the drawing correctly. The lateral relations will cause less difficult}" than the antero-posterior relations. What ordinarily appears to be the left or right, in the subject of observation placed before us, still continues so. We readily make the necessary allowances here from the habit engendered by custom ; but it is different in regard to objects placed in front of each other, and reflected in a mirror, because for this our daily life offers us fewer precedents. Perhaps the easiest way to realize the position of the parts as seen in the mirror, is to imagine yourselves looking at the Part II. 72 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. epiglottis and vocal cords, through a hole in the cervical portion of the vertebral cohimn. To the beginner I would say, make your first experi- ment upon a case in which you are informed there is no special difiiculty ; remember the rules laid down ; bear in mind the anatomy of the parts, and the direction in which you wish to carry the light ; and, with a light and steady hand, you will scarcely fail, after one or two attempts, to see that which is ordinarily visible by the aid of this instrument. Now, what are you to look for '. The first point that always attracts the attention of the observer, after having got the light and the mirror duly placed, is the epiglottis. It is the Cape of Good Hope of the laryngoscopists, and it is at tunes a difficult matter, a very difficult mat- ter, to round the Cape. You will find that it varies as much m form as the nose, and its position not unfrequently is so prone as to render a good view of the subjacent parts almost an impossibility. Then, too, in irritable persons it undergoes a variety of contortions and contractions, which give it a character for muscularity greater than anatomists show it to possess. Still, as a rule, it serves merely as a land-mark anatomically and pathologically ; anatomically, because its well-known relations tell you in what direction to look for more important organs ; pathologically, because the appearance of the mucous membrane covering the epiglottis is often a valuable indication as to the state of the subjacent parts. Examine the epiglottis carefully, the form, the color, the attachments. It should be perfectly smooth, of a pale, yellowish rose hue, and sym- metrical. Look at the fossa formed by the front of the epiglottis with the base of the tongue, and note the state of any secretions upon or near the epiglottis. In disease you will see its color varying from the dull white of anemia to every shade of uniform, or streaky and patchy redness. It may present ulcers of varying size and depth ; it may be deformed by old cicatrices or congenital malfor- mation ; tumefaction from inflammatory or cedematous thickening of the mucous and submucous layers may present itself ; and it may exhibit extravasations of blood, or be more or less bathed in pus, or covered with a mucous secretion. Similar conditions may be discovered in the glotto-epiglottid fossa, or on the glotto-epigiottid folds. In order to see the parts subjacent to the epiglottis, you will have to depress the handle of your mirror somewhat, so as successively to illuminate the posterior surface of the epiglottis ; the arytenoid cartilages, with the corpuscula Santorini and Wrisbergii ; the superior thyro-arytenoid folds, or the false vocal cords, as they are also called ; and by turning the mirror laterally, you will examine the right and left sides of the introitus laryngis, and especially the state of the ventricles of the larynx. These are cul-de-sacs intervening between the vocal cords proper, and the superior thyro-arytenoid folds. The state of the ventricles has an impor- tant bearing on the production of the voice, inasmuch as their patulous- ness is essential to the free vibration of the vocal cords, and the due pro- duction of voice. If the mucous membrane of the ventricles is swollen, the pitch and sonorousness of the voice is interfered with, and the more the j)oucli is obliterated, the greater will be the interference with phona- tion. It is here that various secretions form and accumulate, and you will readily understand why these should more or less aifect the voice, as they present obstacles to the passage of the air, or diminish the vibra- tions of the aerial pulse. If the secretions are viscid, you may at times be puzzled by strings of mucus extending across the entrance of the larynx, closely simulating the vocal cords themselves. Little patches Part IT. 67 CHATHAM STREET, NEW-YORK. 73 Branch Store, 107 East 28th S'l-., N. Y of secretion may also simulate ulcers. The sponge or brush will readily remove such secretions, and show the condition of the subja(;ent mem- brane. The ventricles, moreover, are the frequent seat of mor})id growths. All these points having been noted, you seek the? vocal cords themselves. In a healthy larynx the vocal cords stand out, with a clear pearly sheen which is peculiarly characteristic. Once seen, the appearance is not to be forgotten ; and you will often, in doubtful cases of laryngeal disease, rejoice at recognizing this striking feature, because it will prove that the most important part involved in phonation (so far as the larynx is concerned) is healthy. The vocal cords, or inferior thyro-arytenoid ligaments, are mainly composed of yellow elastic tissue, but are endowed with the most marvelous capability of minute vibratile adjustment, subject to the controlling power of the will, exercised through the arytenoid, thyro-arytenoid, crico-arytenoid, and other muscles. It has been calculated that no less than one hundred muscles are brought into action in the ordinary modulation of the voice, but the note which is uttered depends upon the exact degree of tension of two ligaments, at the utmost seven lines in length, which is mainly determined by the two sets of muscles mentioned. You will have a measure of the minuteness of this adjustment when you reflect, that a practised singer is capable of uttering three hundred different notes at will, for each of which, on this minute vibrating cord, a different stop must be applied. The vocal cords are covered with mucous membrane, distinguished from the mucous membrane of the rest of the larynx, which is ciliated, by being squamous. The mucous membrane overlies the elastic tissue of the cords, and is liable — though to a much less extent than the mucous membrane in the vicinity — to congestion, and the various morbid changes which are seen in this tissue elsewhere. An accurate knowledge of the anatomy and physiology of the parts will enable you more fully to appreciate the importance of minute shades of difference in the appear- ance of the parts. A roughness of the surface or a discoloration, which would lead to no palpable results elsewhere, here affects the comfort, the occupation, the life of the patient, and is therefore well deserving the study of the practitioner by any additional physical means that may be placed at our disposal. Here, too, we have a good illustration of the difference between vital morbid conditions, and the condition of the same parts as seen after death ; a difference that you should always bear in mind, as you may otherwise easily be misled into a wrong interpretation of the phenomena presented on the post-mortem table. If you had merely seen the interior of a larynx, removed from the body, you would scarcely anticipate the marked contrast that exists in life between the vocal cords and the adjacent parts, nor would it be possible satisfactorily to determine the mode in which the variations of sound are produced by the vocal cords. You will find that there w^as much uncertainty as to the theory to be adopted regarding vocalization, even in Miiller s time ; and it was not until after the practical introduction of the laryngoscope by Czermak, that the study became satisfactory and the conclusions definite. If I name Czermak, it is not because I do not appreciate the labors of others in this field ; but whatever others have done, he certainly has compelled us all, by the demonstration of the comparative facility of laryngoscopic examination, to make it a part of our medical studies. It would be an injustice, in speaking of the subject, not to mention the name of M. G-arcia, a well-known singer and amateur physiologist. Part IT. 74 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfarre. who established by laryngoscopic examination much that is now known as to the physiology of the larynx before Czermak had made known his method ; but the pearl that M. Garcia discovered was not appreciated by our profession, and therefore, so far as the medical world are concerned, laryngoscope remained an unknown quantity until the appearance of Czermak s monograph. It is not my object, for the present, to do more than to interest you in the practical employment of the laryngoscope in the recognition and treat- ment of disease ; therefore I do not attempt to lay before you an account of laryngeal physiology — a branch of science which is capable of further development, and which some of you may feel called upon to promote. Allow me yet to revert to a few points connected with the pathology of the larynx, to which I would draw your attention, as illustrating the value of this mode of investigating disease. The practical examination of the numerous cases that present themselves in our hospital, will serve to impress upon your memory and comprehension more vividly what I now merely show you veluti in specido. I have spoken of various morbid changes seen in or near the vocal cords, showing increased or diminished vascularity, congestive or (Ede- matous swellino-, ulceration, cicatrices, growths, all of which I have myself seen. If you consider the muscular and the nervous functions of the parts, you will expect to see these also materially affected by disease. The j9Zi<:-.s — evidenced by spasm — is not likely to be very visible, because it will not leave you time for any thing but immediate action to relieve your patient ; but the minus of paralytic conditions is frequently observable in the irregular action, or want of action, of one or both vocal cords. It is here that stimulation, and notably the direct application of galvanism, is often of palpable benefit. And you will not examine many larynges before you will satisfy yourselves of the perfect facility with which you may direct the galvanic current, as well as any other medicinal ap]3lication, to any given part of the larynx. I have not, however, quite done yet. You may see further than the vocal cords. Their under surface can at present only be examined when there is a hole in the trachea, and at least one instructive instance is on record where this mode of .exploration was practiced with much benefit to the patient. But these are refinements of practice upon which it is unnecessary to dwell. I now merely speak oi the ordinary employment of the laryngoscope, and I Avisli to remind you, that having explored the entrance to the larynx and the vocal cords, you should examine, as far as may be, the trachea. It is generally easy to' recognize several rings of this tube, and you may, when the larynx is capacious and the patient steady, penetrate to the very bifurcation of the trachea. The only morbid condi- tions that I have definitely recognized in the trachea, have been scattered ulcers ; but it is manifest that, especially in those cases in which foreign bodies have slipped through the glottis, the discovery of their exact site by the laryngoscope may, as it already has been, prove of great practical value to the surgeon. There is no better mode of initiating yourself into the practice of laryngoscopy than to examine your own larynges, or those of your fellow- . students. By this kind of exercitation, yoii "vvill familiarize yourself with the use of the instrument, no less than with the healthy condition of the parts. M. Garcia' s interesting observations were entirely the result of examination made upon his own vocal cords, and as there is room for a further cultivation of this field of physiology, each of you may be enabled Part II. 67 CHATHAM STREET, NEW-YORK. 75 Branch Store, 107 East 28tit St., N. Y. to advance science in this direction. But apart from this, th(; mere dexterity of manipulation will be in(;reased by the practice re(;omm ended, and if you know from experience in your own persons how to behave, you will more readily advise your jaticMits what to do, and sympathize with their difficulties. Not every one, however, is a suitabh; subject for autolaryngoscopy ; the narrowness of the introitus laryngis and the prone condition of the epiglottis, no less than an unusual irritability of the Earts, frequently render the process extremely difficult. Various methods ave been suggested for the removal of undue irritability, such as the inhalation of small quantities of chloroform, the application of bromide of potassium, or the use of astringent gargles. Every now and tlien, even after you have acquired sufficient dexterity in the use of the instru- ment, you will meet with cases which present insuperable difficulties. You are then no worse off than your predecessors were without the laryngoscope. You will have to fall back upon those other symptoms which your knowledge of physiology and pathology will teach you to appreciate, and which this instrument is not intended to supersede. — Lan- cet, April 8, 1865, %>. 360. SETS OF LARYNGOSCOPIC INSTRUMENTS IN CASES. LAKYNG-OSCOPIC SET No. 1. 1 Reflector, 11 -inch focal distance, 3-inch diameter, with Tiemann & Co.'s Head-band, 2 Laryngeal Mirrors, 1 Lente's Caustic Probe, 1 Morocco Case, lined with Velvet, $14 00 LAKYNG-OSCOPIC SET No. 2. 1 Tongue Depressor, steel handle, japanned, 1 Reflector, 11 -inch focal distance, 3i-inch diameter, with Tiemann & Co.'s Head-band, ball and socket movement, 3 Laryngeal Mirrors, assorted sizes, 1 Sponge-Holder, delicate, 1 Lente's Silver Caustic Probe, 1 Morocco Case, lined with Velvet, S20 00 Paht II. 76 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfarkb. eiAL IM'STEUMlHTi. Fig. 311. Tobold's Large Laryngoscope and Student's Lamp. Also Tobold's Pocket Laryngoscopes, with or without Student's Lamp. Fig. 812. Seeger's Modification of Tobold's Laryngoscope for Gas-light. 1 Pabt II. G7 CHATHAM STREET, NEW-Y(;J{K. Branch Store, 107 East 28tii St., N Y. Fig. 3125. Sclirnotter's Lniyiigoacope, -with Nasal Rest. 11 LARYlSrG-OSCOPIC SET No, 3. 3 Laryngeal Mirrors, assorted sizes, 1 Reflector (frontal mirror), ll-inch. focal distance, 3|^-incli diameter, with Tiemann & Co.'s Head-band, ball and socket movement, 1 Churcli' s Tongue Depressor, self -holding, 1 Uvula Hook, hard rubber, 1 Lente' s Silver Caustic Probe, 1 Sponge-Holder, delicate, 1 Morocco Case, lined with Velvet, $25 00 LARYNaOSCOPIC SET No. 4. 1 Reflector (frontal mirror), 11 -inch focal distance, with Tiemann & Co.'s Head-band, ball and socket movement, 1 Church' s Tongue Depressor, self -holding, 3 Laryngeal Mirrors, assorted sizes, 1 Pair Simrock' s Throat Forceps, for holding sponge, camel' s-hair brushes, or for extracting foreign bodies or polypii, 1 Uvula Hook, hard rubber, 1 , Lente' s Silver Caustic Probe, 1 Morocco Case, lined with Velvet, 828 00 Pakt II. 78 GEO, TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. BsEAh MB'iR'^MEMTB, HA- Fig. 313. Mackenzie's Lis^lit Concentrator. Fig, 314. Elsberg's Pocket Laryngoscope. 3. TIEMANN SCO. NY TO OPvDER, STUDENTS' LAMPS, DIRECT LIGHT CONDENSERS, RECIPRO-LARYNGOSCOPES, SMITH'S MIRROR-HOLDERS, SEMELEDER'S SPECTACLE-FRAME LARYNGOSCOPES, WALDAU'S REFLECTORS, CUTTER'S AUTO-LARYNGOSCOPE, ETC., ETC., ETC. Part II. 67 CHATHAM STREET, NEW-YOEK:. 79 Bbanch Store, 107 Eaht 28tii St., N. Y. Fig. 315. Pocket Illuminator. The instrament is main- ly constructed of brass, and is provided with a lamp for kerosene or oil, the wick admitting of an easy adjustment by means of a side-screw. The handle can be folded against the chimney, so that the instrument can be packed in a small com- pass. The light passes through a convex lens, and can, by means of a sliding cap, be focused at varying distances, from two to five inches. It may prove useful in opera- tions upon the ear, vagina, rectum, and throat, and may be of gTeat ser- vice in operations at night, where a strong and reliable light may not always be obtainable. Fig. SlSb. Collins' Lamp. For the illumination of cavities, such as : the eyes, ears, nares, mouth, pharynx, larynx, &c., to aid in speculum examinations. The apparatus consists of a reservoir, V, filled with sponge ; with this a cotton wick comes in contact and runs up to the light chamber ; this is closed by a con- cave reflector, M, and a lens, L, to project the rays of light parallel. "To charge the lamp, the lower part is removed and a quantity of mineral oil poured in — ^just enough to sa- turate the sponge ; it is then turned upside down to expulse any liquid that may have settled on the bottom. To light the lamp, remove the lens, L, with its mount- ing, and ai3ply a match to the wick ; the lens being re- placed, the flame may then be regulated by the screw. To extinguish the light, it suffices to blow into the little chimney of the apparatus. To clean the reflector (after removing the lens), you rub it with a piece of clean linen or chamois-skin. The heat of the hand communicated to the reservoir, sometimes disengages an excess of hydrocarbonic va- por and makes the'flame flicker ; this is overcome by lowering the wick. 80 Pakt it. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarke. 0EAL, LAETHeiAL, AMD ffiSO^PHA- eiAL MST-EUMIHTS. Figs. 316, 317, 318. Tobold's Laryngeal Knives. Fig. 819. Grant's (Edema Glottis Instrument. Part II. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 38th St., N. Y. 81 Fig-. 3226. Mackenzie's Laryngeal Lancet, two blades. Fig. 323. Mackenzie's Laryngeal Forceps, Scissors and Ecraseur Fig. 324. Tiemann & Co.'s Scissors, movable points. Fig. 325. Sclirceter's Laryngeal Lancet and Forceps. Pakt II. 82 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfakre. , LAWimBMAh, MSB fflSOP] Ftg. 326. Buck's Tliroat Lancet. Part II. 67 CHATHAM STREET, NEW-YORK. Bhajs-cii SToiiK, 107 East 28tii St., N. Y, &/1AX, IMBtmUMlHT^e, Fig. 331. Burge's Throat Forceps. 83 Fig. 332. Fauvel's Laryngeal Polypus Forceps. |4S ' iMiB mEm< Pig. 333. Matliieu's Throat Forceps. Fig. 334. Schaflfer's Throat (and Uterine) Scoop. Fig. 335. Tiemann & Co.'s Laryngeal Scoop Fig. 336. Bristle Probang, for Removing Foreign Fodies. TIEMANN-CO NY Part II. 84 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. OMAL/, LAETHe-lAL AMD ffiiOPHA- Part II. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 38th St., N. T. 85 OEAL. LAETHGIAL ABB ffiSOPHA^ ^^^^ wmi: Se Fig. 345. Laryngeal Caustic Carrier, concealed. W o PQ O P-i CO O JO o^jjutmw- CO. r ^r finifuj. PQ P. ptH q^iiiiiiiiiiminiiiTrrmTTTn w pq Fig. 348. Elsberg's Insufflator, or Powder Blower. « s 3 « F^-fl liig »^^ fa «eQ t3 -BS:! 5: 27^ W^ ^' ^ fO o M ^ ^ w CQ fM See page 69. Remarks for using Caustic Probes and Syringes. Part II. 86 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, E. A. Stohlmann. Edward Pfarre. OMAL, LARYBmMAL, AHB ffliOPHA- eiAL IHiTEUMlNT tjO Fig. 350. Laiyngeal Powder-Blower, Hard Rubber. Fig. 351. Clay's Powder Insufflator. Fig. 3525. Leffert's Powder Blower, with mouth piece. Part II. G7 CHATHAM STREET, NEW-YORK. Branch Stoke, 107 East 28tii St., N. Y 87 0EAL, LAETMQ'IAL, AND mSM¥mA QMiMh IHSTr-ElJMlNi:-S. Fig. 356. Fullgraf s Laryngo-Tracheal Douche. Fig. 357. Fullgraf s Flat-Bill Laryngeal Spray. Fig. 358. Fullgraf s Glass Powder-Blowing Tubes^ for tlie Posterior Nares. CD Fig. 359. Fullgraf s Laryngeal and Posterior Nares Douclie. Pakt II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Ppakke. INHALING APPARATUS. Fig. 360. Bergson's Steam Atomizer. a. c S. TIEMANN. CJ . fM v Fig. 361. Tiemann & Co.'s Steam Atomizer. All other Steam Atomizers for sale. Directions for use accompany each Instrument. Part II. 67 CHATHAM STREET, NEW-YOKK. Branch Store, 107 East 28Tir St., N. Y. 89 INHALING APPARATUS. Fig. 363. Richardson's Spray Producer. Fig. 3646. Sass' Spray Producer, with Receiver and Air Pump. Pakt II. 90 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparke. INHALING APPARATUS. Fig. 364r. Tiemann & Co.'s Universal Syringe. Fig. 364rf. Warner's Catarrhal Douche. For Injections of Caustic Solutions, etc. ; appli- cable to the Uterus, Male andTeraale Urethra and Bladder, Ear, Larynx, Nares; with a Hard Rub- ber Stopcock to fit Catheters or Trocars, for Hy- drocele, etc. Fig. 364e. Chapman's Nasal Spray. Fig. 364f. Ramage's Inhaler. Fig. 364^-. Robinson's Powder Blower. Pakt II. 67 CHATHAM STREET, NEW YORK. 91 Branch Store, 107 East 28Tir St., N. Y. INHALING APPARATUS. Fk4. oGi"). JSTewiimn's Atomizer. Fi<; I. 92 Part II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. INHALING APPARATUS. Fig. 367d. Mackenzie's Inhaler. Fig. 367e. Croup Kettle. Fig. 368. Dobell's Residual Air-Pump. Fig. 368&. Hot Air Bath Pakt II. 67 CHATHAM STREET, NEW-YORK. 93 Branch Store, 107 East 28tii St., N. Y. TEACHIOTOMT IHSTEUMIHTB. Fig. 369. Buck's Tracheotomy Guide. K fH K « f^ Fig. 370. Langenbeck's Tracheotomy Double-Hook. T-NNVIM3I-1'0 Fig. 373. Tiemaiin & Co.'s Tracheotome and Dilator. Part II. 94 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, P. A. Stohlmann. Edward Pfarre. TEACHIOTO'MT IFfBTCmUMlF/T- to Fig. 376*. Pilcher's Retractor. Fig. 3796. Fiuo-er Protector. Fig. 381. Silver Trachea Canula. Fig. 381/j. Hank's Tracheotome. fi Eh 6 O a a Pakt IL 67 CHATHAM STREET, NEW-YORK. 95 Branch Store, 107 East 3STir S'i-., N. Y TEACH1©T©MY mBTEUMENTS, Fig. 383. Double Trachea Tube, Movable Plate, Silver. Fig. mi Double Trachea Tul).' Silver, Plain. Fig. 384. Mop, for Cleaning Canulas in situ. Fig. 386. Gendron's Split Canula, Silver. Fig. 385. Trachea Cauula, Hard Rubber. Fig. 387. Trousseau's Forceps, for Removing Clots of Blood or Mucus from the Canula while in situ. Fig. 389. Johnson's Double Canula and Obdurator. Modification of Durham's. Part II. 96 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. TEACHIA IKSTEUMIF/T USS Fig. 390. Tiemann's Tracheal Aspirator. For clearing the trachea of blood -clods or mncns, after the insertion of the trachea-tube. It is simply a hard rubber syringe terminating into a soft rubber cup. This is easy of application over the inserted canula. If the thumb be placed on the air-hole of the barrel, the soft rubber cup applied, the piston drawn, mucus or clods of blood will enter the barrel. By taking the thumb oif the air-hole, the instrument detaches easily, may be cleansed and used again if necessary. Fig. 391. Trendelenburg's Trachea Tampon. The Trachea-Tube (a) is made of silver. A soft rubber sheath is drawn over the front i:»art of it. A small canula (5), to which a rubber hose and bulb attaches, admits of blowing air between the rubber sheath and the silver tube, inflating the rubber so as to completely fill the trachea ; a clamp prevents it from collapsing. The object of this is to keep the blood from entering the trachea or lungs whilst the surgeon is operating in the throat above the instrument, at the same time the lungs are supplied with fresh air through the larger opening of the silver tube. An anaesthetic may be administered by connecting the Inhaling Apparatus (c) with it. In using the apparatus, please observe the following : 1. Before drawing a tampon over the canula, moisten both parts with water. 2. Before inflation, warm the tampon a little. 3. Do not inflate the tamjoon except within the trachea or within a tube of like dimensions, say a speculum or other glass cylinder. 4. The tampon should not be too old. Part II. 67 CHATHAM STREET, NEW YORK. 97 Branch Store, 107 East 28Tn St., N. Y. IPmOMlTlEB ANB PF/IUMATIC s^ ») A nr^iTTl©. Fig, 393. Richardson's Instrument to re-establish Respiration. Fig. 393. Waldenburg's Pneumatic Apparatus. Fig. 394. Tobold's Pneumatic Apparatus. Part II, 98 GEO. TIEMANN" & CO.'S SURGICAL INSTRUMENTS, E. A. Stohlmann. Edward Pparre. IFIEO'lilTimS AHD PNIUMJ. APFAEATUi. Fig. 395. Waldenburg's Pneumatometer. Fig. 396. Brown's Spirometer. Fig. 398. Barnes' Spirometer. Fig. 397. Frankel's Pneumatic Apparatus. Fio. 399. Plutcliinson's Spirometer. Part II. 67 CHATHAM STREET, NEW YORK. 99 Branch Store, 107 East 28th St., N. Y. Ilfi F0E ITMl AUMIM^ TAWi CANAL. Fig. 400. Lever Stomach Pump and Enema Apparatus. DIRECTIONS. When used as a Stomach Pump, attach the stomach tnbe (a) firmly on to the lower tap (b) of the pump, and affix the hose (c) on to the side tap (d). Place the mouth-gag (e) between the jaws of the patient, and intro- duce the stomach tube through the aperture ; this mouth-gag serves the two-fold purpose of keeping the mouth open and of protecting the stomach tube against possible injury from the patient' s teeth. After pressing the lever (/') down, which opens the instrument for asxDiration, the piston is drawn out by the handle (r/) ; this fills the barrel of the pump with part of the contents of the stomach, which are then ejected through the hose (c) by first letting the lever (/) loose, and then pushing the piston down. A few repetitions of this operation will relieve the stomach of its fluid or masticated contents. The hand (s) connected with the lever (/) indicates that tap of the instrument shut towards which its point is turned. Before attempting to discharge the stomach of its contents a quantity of warm water should be iDumped into it, as this will facilitate the operation very much. To charge the stomach, merely reverse the action of the pump, having immersed the hose (c) into the fluid prepared for this purpose, which should be held in a narrow, deep bowl. 100 Part II. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfarre. Tlie hard rubber screw (7/) is used for reducing lockjaw, or for forcing tlie montli open, which is done by screwing it between the Jaws. . WHEN USED AS AN INJECTING APPAEATUS. For self -administration, screw the hose (c) on the side tap {d) of the pump, affix the angular injecting pipe (/) in an upright direction into the other end of the hose, and adjust the short metal foot {k) to the lower end {b) of the pump. Place a basin, containing the enema, upon a chair, and sit iipon another chair opposite ; then, having introduced the pipe, hold the instrument upright in the fluid with one hand, working the handle up and down with the other in the same way as stated above. When the in- jection is administered to another person, the straight pipe {I) is used more conveniently. The elastic tube (m), called "O'Beirn's" tube, is used for severe con- stipation of the bowels, and may be passed up to the arch of the colon. N- B. — In affixing the tubes to and detaching them from the pump, their metal fittings only should be handled. After the use of gruel, or any thick fluid, wash out the instrument by pumping water through it. If the piston gets hard, and allows water to pass over it, it should be oiled, and a little worsted evenly wound around it under the leather, which will ren- der it as perfect as at first. Fig. 401. Tiemann & Co.'s Stomach Pump. Fig. 402. Toswill's Syphon Stomach Pump. (With directions for use.) Part II. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28th St., N. Y. 101 Ilf iimUMlF/TB FOE THE ALIMENT TAWi CAFIAL. Ftg. 408. Paine's Nasal Feeding Tube. For feeding maniacs or persons wlio are unable or unwilling to open the mouth. This tube is made of soft rubber, with our patent velvet eye. Its advantages are that the introduction causes no pain ; there is no struggling to weary the patient ; all the food enters the stomach, and none is thrown about the room ; respiration proceeds regularly, and even conversation may continue without hindrance. The objections to it are those against the much used stomach-tube ; while, over that instrument, from the non- necessity of forcing open tightly clenched jaws, and because of the ina- bility of the patient to prevent its passage, it holds a true and deserved supremacy. Its adaptability is not confined to cases of melancholia. It may be used in choking paretics or in paralysis of the throat from any cause ; it might be used in fractures of the jaw, when teeth would other- wise be sacrificed ; and in cancer of the mouth, or where food cannot be taken readily and naturally. Fig. 40 1. Funnelled Feeding Tube (English and French). «i.T\t*AA.U^- V,Q. Fm. 405. Rectal Feeding Tube. All the above may be used with funnels, or may have an attachment for the stomach pump. Fig. 406. Masticator. For mincing meats. Useful to persons who have lost their teeth, or who are unable to masticate by reason of accident, disease or old age. Also for persons who refuse to take food on account of diseased mind. Part II. 102 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarke. Fig. 407. Tiemann & Co.'s Universal Douche (constant current). A B Fig. 408. Improved Fountain Syringe. Operating automatically, dispensing with all pumping, valves, &c. They do not act spasmodically, and cannot inject air. They serve for injecting the rectum, vagina, urethra, ear, nose, &c. Syphon Syringe, . fig. 553. Part III. Recto-Colonic Pump, . . . . . . fig. 575. Part III. Maw' s Enema Pump, . . . . . . . fig. 678. Part III. Universal Syringe, . fig. 377. Part III. Davidson's Syringe, . . . . . . . fig. 361. Part III. Syphon Syringe, fig. 362. Part III. Woodward's Douche, fig. 375. Part III. On hand, all sizes of Metal and Hard Rubber Syringes of the univer- sally-known old style. Anal and Rectal Instruments, page 117. Part III. Hernia Instruments, . . . ... page 126. Part III. Part III. Edwaeds' Eckaskub. Please do JVOT MUTILATE this Booh. In ordering, merely state the Part of the Armamen- tariuin, the Jfuniher of the Figure, and the Kame of the article desired. Instruments not mentioned in our Price List will he furnished at the loiuest market rates. When GOODS FOR REPAIR are directed to us, the Owner's Kame and Address should accompany them. This will enable us to return them to the proper place and person. Parties finding it convenient to order through dealers are requested to insist upon receiving our manufacture, as otherwise inferior goods are frequently substituted. All instruments of our make have our name stamped upon them. Part III. CEO. TIEMANIT & CO.'S SURGICAL INSTRUMENTS, No. 67 Chatham Street; Branch Store, IVo. lOT Jilasi; T^vonl y-clg-litli Wtreet» NKW-YORK. PEIPUCI mBTEHMMMT Fig. 1. Fisher's Phymosis Forceps. hi G.TIEMANMcSCr Fig. 2. Roger's Phymosis Forceps. Fig. 4. Probe and Spatula for the Frsenum. Fig. 6. Hutchison's Forceps for rupturing the mucous membrane of the prepuce. Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlm.wn. Edward Pfarre. UmiT'HEAL DfiTEUMlHTS. Fig. 8. Weir's Fig. 86. Skene's Folsora's Fig. 9. Desormeaux's Endoscope. Meatoscope. Speculum. Fig. 10. Otis' Endoscopic Tube. Fig. 11. Skene's Urethral Speculum. Fig. 11<5. Laveur's Endoscope. Skene's Endoscope, Fig. 50, Supplement, Part III. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28th St., N. Y. !1A\T> SCALES OR OXJAOES. Fig. 12. Gouley's Metrical Sound Guagc. a. Metrical Diameter. b. English Numbers. u o O w o ^ O 05 O - O - 1 05 O - k <0 O 00 O^ ^■^ o :^ o ^ O e- - o " o 5 Q » o - O ' This Guage consists of twenty numbers, the smallest one millimetre, and the largest ten a half millimetres in diameter, with a difference between each two numbers of half a millimetre instead of one-third, as in the French scale. On one side of this Guage is stamped the diameter of each aperture in m.illimetres, and on the reverse side numbers from No. J^ to No. l8, which very nearly correspond to the numbers of the Englisli scale. Upon the handle of each Gouley's Sound both the English num- l)er and the metrical diameter are stamped. GOULEY'S SET OP 12 COHICAL STEEL SOUITDS. Mckel plated, highly polished, in a mahogany or rosewood case, lined with silk velvet $28 00 Part III. 4 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann, Edward Pfarre. VAU BUREl^ L KEYES' SET OF URITHEAL HfiTEUlilHTS, 1 American Guage, | 4 50 12 Conical Steel Sounds, nickel-plated, 2d, 18 00 3 Whalebone Guides, 1 long, 2 short, 1 80 1 Otis' Catheter, 3 00 1 Silver-Plated Catheter, No. 12, 1 00 2 Silver-Plated Prostatic Catheters, 3 00 I Thompson's Tunnelled Divulsor, 1 2 00 1 Civiale's Bistoury Cache, 5 00 1 Civiale's Urethrotome, 14 00 1 Gouley's Catheter Staff, 3 50 1 Pair of Urethral Forceps, 3 00 1 Cupped Sound, No. 12, nickel-plated, 2 75 4 English G. E. Catheters, 1 00 12 French G. E. Conical Bougies, 9 00 P) French G. E. Olivary Catheters, 6 00 4 Mercier's Elbowed Catheters, 5 00 IT Bougies a Boule, 17 00 1 Mahogany Case, lined with oil-dyed cotton velvet, 12 00 Amount, $121 55 BEl^igUE'S SET OF STEEL SOUUDS. 12 Steel Sounds, Benique's Curve, nickel-plated. 1 Mahogany Case, lined with oil-dyed velvet, $28 00 SET OF PLAIIT CYLIUDHICAL STEEL SOUNDS. 12 Steel Sounds, Thompson's Curve, plain. 1 Mahogany Case, lined with oil-dyed velvet, $18 00 Branch Store, Pakt III. 67 CHATHAM STREET, NEW-YORK. _____^^^ 107 East 28th St., N. Y. UEITHEAX/ IN'Sf ETOIIHTB, Fig. 13 THE AMKRIOAIV SCALE. By Drs. Van Bvrkn ami Kkyes. 2q ooQ^s: o CO «o (3 W 00 lUJ rt< O f^ ra w o ^2 o^ LAi CS U N CO ^s < — o =; s e. O^ o i O^ O "^ o^ O i -o *: iO' .o i to- * O »3 SIZE BY 9 27 M» O STT 10 O — y^--\ ~ 1 12 « o - V J v^,^^ . - 1- < Su X N iuj X Q. z 0. < _ Fig. 38. American Scale, Front. Fig. 39. American Scale, Back. The diameter of each American size is | its number in mills. 15=74 mil] For computing the exact corresponding French size, add K of itself to any American size French numbers are made American by subtracting i- 30 Fr.=(30— 10) ''^O V'=8 3=2* Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohi.mann. Edward Pfarre. WEITHEAL HfiTEUMlHT'i. Fig. 14. THE IMETItIC SC^LE. Comparison of the French and French = No. 28 English, by Dr, Englisli Sound Guages, enlarged to No. 40 Otis. •H O O C\I o M o ■^ O 05 Cd too 00 i>0 ^-^ in O] 0"i %0" O" -oo o n ^ G. TIEMANN &C0 o o. O o wo o o^ 01 /^ — X '^ ~ J G.TIEMANM & CO. Part III. 67 CHATHAM STREET, NEW-YORK, Branch Store, 107 E. 28th St., N. Y. UEITHEAL IlfBTEUMlNITSJ ^.^m Fig. 145. Proper Curves for unyielding Urethral Instruments. RECOMMENDED I)Y DR. THOMPSON, A. B. E. DR. GOULEY, A. B. E. " VAN BUREN, A. B. E. " BENIQUE, C. B. D. " BUMSTEAD, F. B. E. " OTIS, F. B. E. See the works of the above authors for particulars. Fig. 14c. Spermatorrhcea Rin^ Fig. 15. Conical Steel Sound. Fig. 16. Straight Conical Steel Sound. Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. VAK BUEEF S, KEYES' COMPACT SET OF 1 Grooved Staff, $ 2 00 3 Whalebone Guides, 1 long, 2 short, 1 80 4 Tunnelled Sounds, 12 00 1 Thompson's Probe-Pointed Catheter, modified by Otis, 3 00 1 Silver Catheter, No. 12, short curve, . 2 25 1 Thompson's Tunnelled Divulsor, 12 00 1 Civiale's Bistoury Cache, 5 00 1 Civiale's or Maisonneuve's Urethrotome, 14 00 1 Gouley's Catheter Staff, 3 50 1 Silver Probe, 36 1 Small Scalpel, 80 1 Silver Director-Pi-obe 1 50 1 Curved Trocar, 3 00 1 Double Silver Tube, 3 00 1 Morocco Case, with extra spaces, lined v^ith oil-dyed cotton velvet, silk finish, 12 00 Amount, $76 21 VAN BUEEN'S SET OF CONICAL STEEL SOUNDS. 12 Conical Steel Sounds, nickel-plated. 1 Mahogany Case, lined with oil-dyed velvet, $28 00 VAN BUREN'S SET OF CONICAL STEEL SOUNDS 12 Conical Steel Sounds, nickel-plated, 1 Rosewood Case, lined with silk velvet, , . . . $35 00 Part III. G7 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 38th St., N. Y. Instruments for Exploring* Strictures, &c. Fig. 17. No. 1. Bougie a trois noeuds. 2. Bougie a boule. Mallez': 3. Bougie a boule. Dick's. 4. Bougie conique. 5. Bougie olivaire. 6. Bougie conique a ventre. No. 7. Bougie olivaire a ventre. " 8. Olivary Wlialebone Bougie. " fi. Elastic Filiform Bougie. "10. Mallez's Powder Insufflator. "11. Mercier's Sonde coudeo. " 12. Mercier's Sonde bicoudee. Pabt III. 10 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. GOULEY'S COMPLETE STUICTURE SET. (SUPERIOR FINISH.) 6 Steel Sounds, conical, @ $1 75, $10 50 1 Goulej's Diviilsor, nickel-plated, 12 00 1 Gouley's Retention Catheter, 3 50 1 Gouley's Catheter Staff, 3 50' 6 Gonley's Tunnelled Sounds, @ $3 18 00 1 Gouley's Meatotome, 3 00 1 Director Probe, silver, 1 50 1 Beaked Bistoury 1 50 5 English Bougies a boule, @ $1 5 00 12 English olive-pointed Bougies, 9 00 6 English Gum Catheters 2 00 6 Whalebone Guides, 3 60 2 English Tunnelled Catheters, 2 00 1 Metrical Sound Guage, German silver, 2 50 1 Gouley's Dilating Urethrotome, 2 points, 15 00 1 English and French Rule, 40 1 Rosewood Case, lined with silk velvet, 16 00 $109 00 The same Set in a Mahogany Case, lined with cotton velvet, the Sound Guage of Paper, $105 00 GOULEY'S COMPACT STRICTURE SET. 4 Conical Steel Sounds, nickel-plated, @ $1 75, $ 7 00 3 Gouley's Tunnelled Sounds, @ $3 9 00 1 Gouley's Retention Catheter, 3 50 1 Gouley's Dilating Urethrotome, 2 points, 15 00 1 Gouley's Meatotome, 3 00 1 Gouley's Catheter Statt", 3 50 1 Beaked Bistoury, 1 50 1 Grooved Director Probe, silver, 1 50 1 Mahogany Case, (with extra spaces), lined with oil-dyed cotton velvet, 6 00 $50 00 Part III. G7 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 28th St., N. Y. .11 ^^S« Fig. 18. Glass Alealoscopc. Fig. 31. Points of Gouley's Whalebone Guides. Part III. 12 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. BUMSTEAD'S SET OF A. 1 Bumstead's Maisonuetive Urethrotome, $14 00 i Set of Holt's Divulsors, 18 00 1 Bumstead's Retention Catheter, 4 00 12 Filiform Boiiojies, with screw-heads to lit all the above instruments,. . 12 00 1 Oiviale's Bistoury Cache, 5 00 1 Trocar and Canula, 3 00 1 Thompson's Probe-Pointed Catheter, 3 00 1 Pair of Thompson's Urethral Forceps, 3 00 1 Silver Catheter, No. S, French scale 2 25 1 Silver Catheter, No. 22, French scale, 2 25 1 Silver Prostatic Catheter, 3 00 1 Silver Female Catheter, 1 00 1 Syme's Staff, 2 00 6 G. E. Conical Bougies, 4 50 6 G. E. Olive-Pointed Pougies, 4 50 6 Acorn-Pointed G. E. Bougies 6 00 9 Bumstead's Steel Sounds, nickel-plated, a, 23 50 1 Bumstead's Guage, 3 00 1 Rosewood Case, lined with silk velvet, 18 00 Amount, $132 00 Bumstead's Set of Urethral Instniments B. Contains the same number of instruments as No. A, but the Steel Sounds are second quality, nickel-plated, and the lining of the case is oil- dyed cotton velvet, $120 00 BUMSTEAD'S SET OF STEEL SOUNDS. 12 Bumstead's Steel S«.)unds, nickel-plated, 1 Mahogany Case, lined with oil-dyed velvet, $28 00 Branch Store Part Ml. 67 CHATHAM STREET, NEW-YORK. 107 E. 28th St., N. Y. 13 Fig. 26. Caro's Modification of Squire's Vencljrated Catheter Fig. 30. Olivary Gum Catheter. Fig. 31. Thompson's Retention Catheter. G.TLEMANN-Ca. Part III. 14 GEO. TIEMANN' & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre, VAN BUREIT & EEYES' SET OP INSTRUMENTS FOR STONE. 1 Thompson's Searcher, $ 4 00 1 Thompson's Lithotrite, heavy, 35 00 1 Thompson's Lithotrite, light, 35 00 1 Evacnating Catheter, ITott's, 4 50 1 Pail- Urethral Forceps, Thompson's, 2 50 2 Lithotomy Staffs, lateral, @ $2 4 00 1 Median Lithotomy Staff, 2 00 1 Lithotomy Scalpel, 2 00 1 Lithotomy Bistoury, straight, sharp pointed, 2 00 1 Blizard's Knife, 2 00 1 Blunt Gorget, 2 50 1 Little's Director, 2 00 1 Scoop, 2 50 1 Pair of Lithotomy Forceps, with crossed handles, 3 00 1 Pair of Lithotomy Forceps, with curved blades, 3 00 1 Pair of Crushing Forceps, 6 00 1 Tube with globular head, for washing the bladder, 2 00 1 Shirted Canula, 1 50 1 Keith's Tenaculum, .... 1 25 1 Mahogany or Rosewood Case, lined with oil-dyed velvet, 18 00 Amount, $134 75 LITHOTOMY SET. 2 Steel Sounds, .- $ 2 00 3 Lithotomy Staffs, 6 00 1 Liston's Bistoury, 2 00 I Blizard's Bistoury, 2 00 1 Lithotomy Scalpel, 1 50 1 Scoop and Conductor, 2 50 2 Lithotomy Forceps, medium and small, 5 00 1 Double Current Catheter, silver, 6 50 1 Hard Rubber Syringe, with a stopcock to fit the Catheter, 4 50 1 Mahogany or Rosewood Case, 15 00 Amount, $47 00 Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 28th St., N. Y. 15 UEITHEAX- IHBTEUMIMT-S, CA^THETEPtS. Fig. 32. Holt's Self-Retaining Catheter. (See description, page Id.) Deseripiion of Hutchinson's Prostatic Catheter. (Fig. 8.5.) A silver prostatic catheter, with a large eye in its con- cavity, permitting of the in- troduction of a portion of india-rubber tube through it. The india - rubber tube is shown in position. After introducing the tubing into the bladder, the catheter is withdrawn, and a small noz- zle, with rings, is introduced into the end of the india-rubber tube to allow of its being fixed to the penis. A stiletted plug for the nozzle, intended in the first place to plug its orilice, and in the second to stiffen the first three inches of the tube, will prevent its being bent and expelled. The nozzle, having been pas- sed into the meatus, is fastened firmly to the penis by means of tapes and plaster. Take care that it is fixed pretty tightly and with good plaster, and in- struct your patient never to take the plug out excepting when he wishes to void urine. Part III, 16 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann, Edward Pfarre. MAY'S LITHOTOMY SET. 1 Pair of Lithotomy Forceps, large, $3 00 1 Pair of Lithotomy Forceps, medium, 3 00 1 Pair of Lithotomy Forceps, small, 3 00 3 Plain Steel Sounds, @ $1 3 00 2 Lithotomy Staffs, @ $2 4 00 1 Canula a Chemise, 1 50 2 English G. E. Catheters, 50 1 Sharp-Pointed Lithotomy Scalpel, 2 00 1 Probe-Pointed Lithotomy Scalpel, 2 00 1 Probe-Pointed Lithotomy Bistoury 2 00 1 Hard Rubber Syriuge, No. 5, the nozzle to fit the Catheters, 3 00 1 Mahogany Case, lined with oil-dyed velvet, 12 00 Amount, $39 00 THE MANNER OF INTRODUCING HOLT'S SELF-RETAINING CATHETER {Jigs. 32, 33). The Catheter is stretched upon the stilet, and fastened to the handle ready for introduction, which is afi'ected as follows : — Suppose the Catheter a No. 8 guage ; insert the stilet and draw the india- rubber upon it towards the handle, until the size of the Catheter is reduced to a No. 4. Fix it in that situation by tying a piece of string immediately in front of the puckered portion, and fasten it to the hole in the handle. Thus the calibre of the Catheter is reduced one half, and will easily enter the bladder. The string may now be untied, and the Catheter will resume its ordinary size. Where the urethra is sufficiently capacious, the Catheter, previous to being used, may be passed into a No. 12 silver Catheter, having an opening at the end, and when in the bladder the silver Catheter may be withdrawn. (See fig. 35.) VULCANIZED INDIA-RUBBER CATHETERS. {See Jig. 40.) In the case of old men affected with retention of urine without stricture, MM. Richet, Maisonneuve, &c., employ vulcanized India-rubber sounds, as do many of our own surgeons. This flexible sound, even in cases where there exists considerable enlargement of the prostate, seems to find its own way in the urethra with the utmost facility. It causes less irritation than others when left in the urethi*a. The latest improvement is Tiemann & Co.'s Velvet Eye Cath- eter, fig. 38, Supplement. SET OF SILVER CATHETEHS. 12 Silver Catheters, one bottle for oil, one guage, one Mahogany Case, lined with fine velvet, $25 00 Part III. 67 CHATHAM STREET, NEW YORK, 17 Branch Store, 107 East /sStii St., N. Y. SKENE'S URO CYSTIC AND URETHRAL SET. 2 Skene's Urethral Specula , . . <, $3 00 1 Folsom's Speculum (modification) 1 50 1 Skene's Eeflux Catheter for Bladder 2 00 1 Skene's Eeflux Catheter for Urethra 2 00 2 Silver Probes . c .......... , 75 1 Sponge Holder (steel wire) .. , 50 1 Knife (wire) 75 1 Blake's Polypus Snare (Ear) 3 50 1 Allen's Polypus Forceps (Ear) 4 50 2 Glass Pipettes, 6 inches long 50 2 Head Mirrors, on same strap, S^ in. and 1|- in .12 00 1 Lente's Caustic Cup 3 00 2 Skene's Self-Retaining Catheters (modification of Goodman's) 2 00 2 Rectal Endoscopes (long and short) with Fenestrated Rubber Specula, 6 GO 3 Urethral Endoscopes (Kos. 13, 15, 17, American,) with Beveled Rub- ber Specula 6 75 2 Beveled Urethral Endoscopes (Nos. 19, 21, American,) with Fenes- trated Rubber Specula 4 50 1 Brush for cleaning Endoscopes 10 1 Rosewood or Mahogany Case, lined with oil dyed velvet 10 00 Amount.. $63 35 LITTLE'S MEDIAIT LITHOTOMY SET. 4 Little's Staffs, Kos. 7, 9, 10, 12 " $8 00 1 Straight sharp-pointed Bistoury 2 00 1 Little's Director 2 50 1 Pair Dressing Forceps 1 50 2 Pairs Lithotomy Forceps 6 00 1 Thompson's Searcher 5 00 1 Small Sound, for children 1 00 1 Canula a chemise 1 50 1 Hard Rubber Syringe, No. 5, nozzle to fit Catheters 3 00 1 Dolbeau's Stone Crusher 6 00 1 Lithotomy Scoop, ebony handle 2 50 1 Mahogany Case, lined with oil dyed velvet (or morocco covered, if pre- ferred 1500 Amount |54 00 18 Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. UEITHEAL IlfBTEUMlIfTS. CATMIilTEIiS. U o I 3: Tiemann & Co.'s Patent Velvet Eye Catheter, fig. 38, Supplement. Fig. 41. Thompson's Improved Vulcanized IndiaRubber Catheter. A A to B shows the length of the German-silver tube which at this part lines the tube and stiffens it. C. Anterior portion of Catheter, which remains flexible, and conducts away the urine ; a peg is fitted into it D. Posterior portion of Catheter, which remains flexible, and rests in the urethra and bladder. E. A piece of stout silk, the free ends of which, lightly tied behind the glans penis, secure the Catheter in its place. Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 K 28th St., N. Y. 19 UEITMEAL IHSTEUMIF/TS, Fig. 42. Teevan's Tunnelled Catheter and Guide. The conducting' bougie is made of whalebone, and is excessively fine, having each end olive-shaped, which prevents tiie instrument from pricking the mucous membrane or lodging in the lacunse ; it must be two inches longer than the Catheter. The Catheter is about the size of a No. 1 English, and its end is cut off to permit the bougie to enter the canal at a and emerge at b, through the slit extending from b to c, which serves as a groove for subcutaneous or external urethrotomy. 2 shows tliat the groove is made by cutting out a longitudinal piece of the Catheter. Urine will not escape through it, for the mucous membrane is tightly stretched across it, and so completely closes the groove. Fig. 42. Teevan's Tunelled Catheter and Guide. "5 ^ <.r. _ri ■B J^ XJIiETHItOTOM:^' IlVSTiiUiyEKIVTS. Fig. 90. Gouley's Dilating Urethrotome. IG. 93. Otis' Dilating Urethrotome, No. 3. Fig. 92. Fig. 91. Otis' Dilating Geo. K. Smith's Urethrotome, Urethrotome. No. 4. Fig. 94. Otis' Urethra- meter. pj,._ 95_ Bumstead's Urethrotome. tART III. 28 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. UMITHMAL meTEUMllfT \(^A i]Vstiitjm:ents. Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 28th St., N. Y. 29 UEITHEAL mSTEUMllf ^S. Fig. 101 {a, b, c, d,e.) Gouley's Instruments. The capillary probe-pointed whalebone Bou- gie (a) is introduced into the urethra. If it enters a false passage, it is retained in silu by the left hand, while another is pa.ssed by its side. If this second guide makes its way into the false passage, it is to be treated precisely as was the first, and the operation repealed till one guide can be made to pass the obstruction and enter the bladder. The next step is to in- troduce a No. 8 grooved metallic catheter (B), with a quarter of an inch of its extremity bridged over so as to convert the groove into a canal, the bridged portion itself being also grooved, the operator, feels for and opens the canal upon this groove. A loop of silk is then passed through each edge of the incised urethra, the catheter is withdrawn a little, so as to bring into view the black guide ; then the stricture, with about half an inch of the uncontracted canal behind it, is divided. This is best ac- complished by means of the small, narrow, beaked, straight bistoury (D . Amott's grooved probe (c), may be used as a guide for the incision. (e) is a Tenaculum, useful in the operation ; a full description of the operation will be furnished on application. Fig. 102. Hewitt's Staff and Knife. Part III. 30 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. UElTHmAL IKSTEUMlM'Ti* INSTRUMENTS FOR TAPPING THE BLADDER. inOE. RECTAL FXJlSrCTXJRE. Fig. 105. Rectum Trocar. Fig, 108. Dieulafoy's Aspirator, for Supra Pubic Puncture. A descriptive pamphlet on Aspirators may be had on application. Other forms of Aspirators, see page 131, Part I. Pakt III. 67 CHATHAM STREET, NEW YORK. 81 Branch Store, 107 East 28ti( St., N. Y. INSTRUMENTS FOR STONE IN THE BLADDER. Fig. 109. Steel Sound. Fig. 112. Andrew's Searcher. Fig. 113. Otis' Exploring Sound (is also usee' for exploring strictures) Fig. 114. Steel Sound and Billroth's Sounding Board. Fig. 115. Thompson's Searcher. Part III. 32 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. INSTRUMENTS FOR STONE IN THE BLADDER ON THE CONSTRUCTION OF MODERN LITHOTRITES. The articulated Lithotrite of Jaoohson, (fig. 125, a, b,) superseded the Trilabe of Hunter^ (fig. 124.) Weiss introduced the curved instrument with jaws to open and shut, and Heurteloup so modified it, (tig. 122) that percussion, by means of a hammer applied to the extremity of the male blade, causes fragmentation of the stone. This instrument has been gradually superseded by the varieties in use at the present time, i.e. : those worked by lever jpower^ either with rack and pinion, or screw. Sir Wm. Fergusson^s instrument, (fig. 123) is worked by rack and pinion. Its crushing power is regulated by the strength of the operator's hand, and may be increased by exercising a certain jerk- ing impulse, resembling that of the percussion hammer, or by using the hammer itself. The greater eflicieucv of the screw as a power, and the ease and smoothness with which it acts, have led to its very general adoption for Lithotrites Civiales, (fig. 129) Thompson's (fig. !l 27) and Teevan's (fig. 128) instruments are worked in this way. The motive power of these instruments resides in the handles and may be applied or detached at will, so that the male blade can be withdrawn to the required extent, and then brought into connection with the screw, by simply sliding the button on the handle of Thomp- son's instrument, (fig. ]17) or by moving the vertical slide J, on tlie handle of Teevan's, (fig.116). In Civiales Lithotriptor the screw-power is thrown in and out of gear by a quarter turn of a movable disk attached to the handle of the female blade, (fig. 129.) Fig. 117. Handle of Thompson's Lithotrite. C.TIEMANN-C.U. Part HI. 67 CHATHAM STREET, NEWYORK. 83 Branch Store, 107 E. 28th St., N. Y. Considering a Lithotrite as composed of parts, we speak of \\\^ female Made and the male blade. The female blade is the one continuous and fixed to the handle (fig. Ii8), it is deeply grooved for the recep- tion of the viale blade or sliding rod, (fig. iig.) Fig. 118. Female Blade of Thompson's I,ithotrite. Fig. 119. Male Blade of Thompson's Lithotrite. When the male blade is pushed home as far as it will go, we say the Lithotrite is closed — and then call the curved extremity the beak, the other, by which we take hold of the instrument, the handle, (figs. ii6, 117,) and the part between handle and beak the shaft. When the male blade is drawn out, the beak separates, or opens, and we now speak of the halves asjaws, (figs. 120, 121). Fig. 120. Fenestrated Jaws of (Thompson's) Lithotrite. G.TIEMANN-CO. 7'/^^y«wj- of Lithotriptors vary in strength and structure, in accordance with the work required of them. For reducing stones, of large size and considerable hardness, to fragments, the male blade is narrow, with deep and sharp angular teeth, while the female blade is broad, heavy and fenestrated, (fig. 120). In closing the jaws, fragments and detritus are forced through this fenestrum, so that no clogging or impaction can take place. Fig. 121. Closed Jaws of Lithrotrite. For crushing small or soft calculi, or for pulverizing fragments, the jaws of the Lithotriptor are shorter, less heavy and their opposing surfaces are simply roughened, so that detritus produced may pass off with the urine. Mercier has made valuable improvements in the jaws of Lithotriptors, in fig. 121 will be observed a slit at the base of the female blade T, through which accumulated detritus is ejected by means of a ploughshare or spur T, which, at the same time, adds enormously to the strength of the instrument. This spur fits into the eye of the female blade, so that if the finger be passed over the hole when the blades are closed, no inequality will be felt. The spur is also made as seen m fig. lA, which may be regarded as a model instrument. It is not easy to exaggerate the value of the spur T, for it enables us to use a very slender instrument in cases where it would otherwise not have been safe, and thus extends lithotrity to a field from whence it was previously excluded, for there are many patients whose unnary tract is m such a state of irritation that repeated manipulations with heavy lithotrites could not be borne. 34 Part III. GEO. TIEiMANN ^S: CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. UEITHEAL WiTEUMlMTi INSTRUMENTS FOR STONE IN THE BLADDER. LITIiOTRITES. Fig. 122. Heurteloup's Lithotrite and Mallet. Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 38th St., N. Y. 35 FElfHEAL IMSTEUMIHTS, INSTRUMENTS FOR STONE IN THE BLADDER. Fig. 127. Thompson's Lithotrite. G.TIEMANN. CO.N.Y Our Lithotrites are forged out of the best English steel. The groove m the female blade is cut with a ma- chine made for this special purpose. When "finished, thej are tested^ bj breaking with them pieces of soft grindstones. We should advise sur- geons to test their instruments in this manner, before attempting to use them in the bladder ; it will exercise their tact and judgment. When a stone is between the jaws of a litho- trite and the screw turned, the opera- tor will distinctly recognize a certain recoil and spring of the instrument before the stone is crushed. This sen- sation requires to be studied, in order to know how far the instrument may be taxed (when used unassisted by eyesight), on a bladder calculus. CQ Part III. 36 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Umil'MMlX, IlTiTEUlilWT ft(0 INSTRUMENTS FOR STONE IN THE BLADDER. LITHOLAPAXY. RAPID LITHOTRITY WITH EVACUATION. By Henry J. Bigelow, M. D. The following are the chief points connected with the modification in litho- trity which I have described, and for which I propose the above name. 1. The calculus, although not necessarily pulverized, is crushed as rapidly and completely as is practicable. The dust and fragments are immediately evacuated, and a serious source of irritation is thus removed. 2. This can be generally effected in a single operation. 3. The operation — performed of course under ether — may be, if necessary, of one or two hours' duration, or even longer. 4. The method applies to larger stones than have been hitherto considered to lie within the province of the lithotritist. It also applies to small stones, nuclei, phosphatic deposits, and foreign substances. 5. Evacuation is best accomplished by a large tube, preferably straight with a distal orifice, the extremity of which is shaped to facilitate its introduction, and, during suction, to repel the bladder wall — and by an elastic exhausting bulb, which acts partly as a siphon. Below the latter is a glass receptacle for debris. 6. The best size for the tube is the largest the urethra will admit. 7. Such a tube is usually introduced with facility, if passed vertically as far as it will go toward the anus before changing its direction, and afterward di- rected almost horizontally, and passed by rotation through the triangular liga- ment. The first part of this rule applies also to the introduction of a lithotrite, and even a curved catheter. A free injection of oil is important. 8. A small meatus should be enlarged, or a stricture divulsed, to allow the passage of a large tube. 9. If the bladder be not small, a large and powerful lithotrite is always better than a small one. 10. That this may have room for action, the escaping water should be re- placed occasionally, through a tube inserted a few inches into the urethra by the side of the lithotrite. But the bladder should not be over distended. 11. To save time, and also to prevent undue dilatation of the vesical neck, a non-impacting lithotrite is desirable. The jawa of a non-fenestrated instrument will not impact, if the male blade is furnished with alternate triangular notches by which the debris is discharged laterally, and also with a long thin spur at Part III. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28tii St., N. Y. 37 the heel fitted to a corresponding slot in the fen i ale hlade, — provided the floor of the female blade, especially at the heel, be made nearly on a level with its 7-ira. To repel the bladder, the female blade should be, longer and a little wider than is usual. It should have also low sides easily accessible to fragments, — relying for strength less upon these than npon a central ridge beloM' the heel. In the male blade of such a lithotrite the apices of the triangles should be a little blunted. Lastly, a non-fenestrated female blade protects the floor of the bladder, during a long sitting. A fenestrated instrument directs sharp splinters against it. The latter also delays the process of disintegration, by delivering through its opening the same fragments many times. 12. In locking and unlocking a lithotrite repeatedly in a long fig. 129b. Bige- operation, it takes less time and is easier to turn the right wrist, ^°^^ Lithotrite. as in my instrument, than to displace the thumb of either hand ''^''i^^ in search of a button or a lever, as in previous instruments. Boston, May 25tli, 1878. Fig. 129d. Bigelow's Evacuating Apparatus. Fig. 129c. Stand for Bigelow's Evacuating Apparatus. Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann, Edward Pfarre. INSTRUMENTS FOR STONE IN THE BLADDER. LITHOTOIMLlir. Fig. 130. Pritchard's Anklets and Wristlets. Fig. 135. Little's Director for Median Lithotomy •eO-'NNVWHIX'O Part III. 67 CHATHAM STREET, NEW-YORK, Branch Store, 107 East 28th St., N. Y. 39 UEITMEAL IF/STEUMIMTS W^» INSTRUMENTS FOR STONE IN THE BLADDER. Fig. 136. Straight Lithotomy P'orceps. Fig. 143. Scoop and Conductor. a3-jsrii?wjij.'a Paet III. 40 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, r. A. Stohlm.\nn. Edward Pfarre. UEITHEAL IlfBTEUIillfT ^iC-S INSTRUMENTS FOR STONE IN THE BLADDER. lithotom: Y. Fig. 146. Lithotomy Scalpel (Depuytren's). / Part III. 67 CHATHAM STREET, NEW YORK. 41 Branch Store, 107 East 28th St. N. Y. ^EllHEAX/ IN/STEIJMIHTS. INSTRUMENTS FOR STONE IN THE BLADDER. Fig. 140/. Bush's Gorget. mwwa Fig. 151. Depuytren's Double Bistoury Cache. Paet III. 4Z GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. UEITHEAL INiTEUMlNTS, INSTRUMENTS FOR STONE IN THE BLADDER. SXJPHA-PXJBIC LITHOTOIMCY^. Fig. 153. Hooked Gorget. Fig. 153. Sonde a Dart Fig. 154. Keith's Tenaculum. j_j_Tii^i\/iP- rJi\L&. 00= Fig. 155. Aponeurotome. G. I /eMA/V/V-GO Fig. 156. Gross' Artery Compressor. Fig. 156Z>. Little's Lithotomy Forceps. Part III. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28tii St., N. Y. UEITMEAL mSTEUMlNTS, INSTRUMENTS FOR STONE IN THE BLADDER. Fig. 157. Dolbeau's Dilator. ^3 Fig. 157&. Guyon Duplay's Dilator. Fig. 157c. Gouley's Hydro-Heemostat. For arresting Haemorrhage after Lithotomy. pipiiiilllPliiwpf Fig. 158. Gouley's Lithoclasts (double lever) Fig. 1585. Gouley's Lithoclast (plain). 44 Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. INSTRUMENTS FOR STONE IN THE BLADDER. Instmrneiits for* Clear*ing- tlio Bladder* of* I><3l>r*is. Fig. 159. Nelaton's Evacuating Apparatus. S.T/eM/tl\JNCO. N. > Fig. 161. Van Buren's Debris Syringe. Fig. 163. Glover's Evacuating Apparatus. Fig. 166. Van Buren's Evacuating Catheter and Ba Pakt hi. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 38th St., N. Y. 45 UEITHEAL W/STEUMIMT'S, Instniiixoiitjai for Cloiiriii^ tl»o BltKiclor of* Delbriss siikI for Extracting- Foreig-ii Iio > d -o !^ ^ j>- n^ P^ r^ a d 02 d o m a IX! -^ +j O Sh pJ^ ,— T ^ O c^'^C >i © --J O) :3 ^ .^.2 ^ '-^ a> C 1— 1 -tJ O >-: O CJ H J Q pq b T-l ■pH Cq OT fiS. be o (35 O O O 0) ^ cc -t-J O (T) P^ § "So ■-2 ^ g .2 -d ^ =3 ^ ^«= Q C/2 c o .g ? i-, **^ O Ph t3 0) "So 3 O a: ^ pq c^ 56 Part III. GEO. TIEMANN & CO.'S SURGICAT. INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. QYliiM,€QhQm£AL, IHiTEUMElf'fS, Fic. 199. Nott's Speculum, with Chain. Pakt III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 28th St., N. Y. 57 ^» THOMAS' SET OF UTERIlSrE INSTHUMENTS. 1 Thomas' Ciisco's Speculum. 1 Thomas' Sims' Specnhim. 1 Caustic Holder. 1 Pair (Uterine) Dressing Forceps. 1 Thomas' Cotton Expeller. 1 Small Uterine Probe. 2 Whalebone Swabs. . . 2 Sponge Holders. 1 Long Pipe Syringe. 1 Long-handled Tenaculum. 1 Small Phial, for holding solid caustic, none for Jlidd ! place for a small roll of cotton batting and small sponges. 12 Sponge Tents. 1 Uterine Scarificator. 1 Mahogany, rosewood or morocco covered case, lined with oil-dyed velvet, • $4-6 00 Fig. 2045. Emmett's Tenacula. ELLIOTT'S SET OP UTEEINE INSTHUMEITTS. 1 Handle to fit : 1 Simpson's Sound. ^ 1 Guarded Scarifyer. 1 1 Sanger's Porte Caustic. 1^ 1 .Ointment Bougie. 2 Mirror Specula. 1 Long Pipe Syringe, Uterine Probe. Phials with Glass Stoppers. Pair Uterine Dressing Forceps. Rosewood or mahogany Case, lined with oil-dyed velvet. $25 00 58 Part III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre, "M^'CBLBmCML meTEUMlIfT i^o SPECULA V^GJ^IIV^E. Fig. 205. Storer's Speculum, when used as Cusco's. Fig. 206. Hunter's Speculum. Fig 207. Storer's Speculum, when used as Sims Fig. 208. Brewer's Speculum. Fig. 209. Brewer's Speculum, when used as Sims Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E. 38tii St., N. Y. SIMS' SET OP INSTRUMENTS FOR UTERINE SURGERY. 1 Sims' Curette. 2 Sponge Holders. 1 Pair McClintock's Polypus Forceps. 1 Pair of Sims' Polypus Forceps. 1 Sims' Porte-Chain Ecraseur. 1 Aveling's Polyptrite. 1 Simpson's Hysterotome. 1 Pair of Curved Scissors. 1 Sim's moveable-blade Knife. 1 Priestley's Dilator, (or Ferguson's). 1 Pair of Tenaculum Forceps. 1 Uterine Repositor. 1 Porte Tampon. 1 Forked Sound. 1 Vaginal Dilator. 1 Mahogany, rosewood or morocco-covered Case, lined with oil-dyed velvet $125 00 SKEENE'S SET OF UTERINE IITSTRUMEITTS. 1 Sims' Speculum $4 00 1 " latest Needle Forceps, Skeene's modified 5 50 1 Skeene's Scarifyer and Sound 6 00 1 " Elevator 8 00 1 Long Pipe Syringe 1 60 1 Nott's Depressor 1 50 1 Uterine Dressing Forceps, 2 00 1 Straight Scissors 3 50 1 Curved " 4 50 1 Tenaculum I 25 1 Uterine Probe and Slide 1 75 1 Skeene's Curette 2 00 1 Sponge Holder, 1 00 1 Simpson's Sound, graduated 1 75 In Russet Leather Case, oil-dyed velvet 10 00 $64 25 JPart III. 50 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. Fig. 211. Dicken's Speculum. Fig. 213. Thomas' Latest Speculum. ' Pabt III. 67 CHATHAM STREET, NEW-YORK. 01 Branch Store, 107 E. 28tii St., N. Y. NOTT'S SET OF UTERIITE HTSTRUMEITTS. 1 Nott's Speciilnm and Tenaculum $8 00 1 Nott's Depressor 1 50 1 Koux' Needle-Holder 4 60 1 Applicator and Expeller 1 00 1 Sponge-Holder 1 60 1 Lead Sound 40 1 Scarifying Knife 1 00 1 Simpson's Sound 1 60 1 Uterine Probe, pure silver 1 25 1 Nott's Uterine Dilator 3 50 1 JSott's Uterine Catheter 3 50 1 Double Spring Tenaculum 3 00 1 Hard Rubber Syringe, for cleansing Yagina and Uterus 3 00 1 Lente's Ointment Syringe 6 50 1 Lente's Platina Cup ' 3 50 1 Pair of Uterine Dressing Forceps 2 00 1 Pair of Keedle Forceps 4 00 1 Pair of Seizing Forceps 4 00 1 Straight Scalpel - 1 50 1 Curved Scalpel 1 50 1 Pair of Emmett's Scissors 4 50 1 Sims' Adjuster 1 50 1 Sims' Wire Pulley 1 25 1 Sims' Blunt Hook 1 25 1 Sims' Sigmoid Catheter, tin T5 1 Sims' Sigmoid Catheter, hard rubber -. 1 00 1 Sims' Sigmoid Catheter, silver 2 00 1 Buttles' Scarifyer 1 T5 1 Thomas' Dry Cupper and Suppository 2 00 1 Smith's Wire Ecraseur 6 00 G Emmett's Round-Pointed Needles, Silk for Sutures and for Polypi, and six other Needles f 25 3 Coils of Silver Wire 1 50 1 Whalebone Cotton Swab 50 2 Glass Bottles, for Caustic, etc 06 12 Seatangle and Carbolized Sponge Tents 3 00 1 Long Delicate Tenaculum 1 25 1 Pair of Long Straigiit Scissors 3 50 1 Curette for scooping out the Uterus 1 ^^ 1 Rosewood Case, lined with oil-dyed velvet, neatly arranged 20 00 Amount $111 46 A descriptive Pamphlet of this case of instruments may be had on application. Part III. 63 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarrk. ^fmM€mMm€Mi' ihst'eumihts, SPECXJL^S. v^\.oi]V^e:. Part III. 67 CHATHAM STREET, NEW-YORK. 63 Branch Store, 107 E. 28th St., N. Y. PEASLEE'S SET OF UTERIUE HTSTRUMEITTS. 1 Sims' Speculum. 2 Ferguson's Glass Specula. 1 Pair of Speculum Forceps. 1 Peaslee's Depressor. 1 Uterine Tenaculum. 1 Simpson's Sound. 1 Peaslee's Sound. 1 Whalebone Probe. 1 Emmet's Applicator. 1 Peaslee's Metrotome. 1 Pair of Curved Uterine Scissors. 1 Uterine Scarificator. 1 Tube for Intra-Uterine Applications. 1 Uterine Syringe. 1 Catheter. 1 Peaslee's Curved Needle. 1 Emmet's Needle. 1 Pair of Needle Forceps. 1 Rosewood, Mahogany, or Morocco-covered Case, lined with oil-dyed Velvet. $60 00 Bozeman's Set of Instmments for Vesico Vaginal Fistula. 2 Pairs of Bozeman's Scissors, R. and L., curved. 1 Pair of Stout Straight Scissors. 1 Pair of Scissors, curved on the flat. 1 Pair of Shot-Smashing Forceps. 1 Perforating Awl. 1 Pair of Self-Closing Seizing Forceps. 1 Pair of Curved Forceps, lined witli copper on the points, for holding and drawing wire sutures. 1 Bozeman's Clamp or Button Adjuster. 1 Bozeman's Wire Adjuster. 1 Fork Pulley. 1 Long Steel Probe in Ebony Handle. 1 Blunt Hook. 2 Tenacula. 2 Straight Scalpels. 2 Angular Scalpels, P. and L. 1 Urethra Depressor. 1 Curved and 1 straight Needle-Holder, both to fit one handle. 1 Pair of Shot-Perforating Forceps, with 1 exti'a Point. 1 Pair of Plain Forceps, finely cut at the points, inside. 3 Metal Sigmoid Catheters (Bozeman's). 5 Sizes of Silver Buttons. 2 Swan-Bill Speculums, four sizes. 3 Coils of Silver Suture Wire and some Silk. 1 Common Probang. 2 Sponge Holders. 12 Assorted Needles (Bozeman's). 1 Rosewood Case, lined with oil-dyed velvet. $100 00 Part III. 64 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. BJmM,C&h&m€AL MBTmBMEmTB. Fig. 225. Tiemann & Co.'s Trivalve Steel Speculum. Fig. 226. Weiss' Speculum. c.ti£:mann &,co. Fig 229. Baxter's Speculum. Fig. 230. Sims' Bivalve Speculum. Fig. 231. Howard's Speculum. Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store 107 East 28th St., N. Y. 65 <. Sims' Set of Instmments for Vesico-Vaginal Fistula. 1 Pair of Scissors, curved on the flat. 1 Pair of Straight Scissors. 1 Pair of Scissors for removing Sutures. 1 Sims' Tenaculara. 2 Sims' Scalpels. 1 Sims' Speculum. 1 Sims' Suture Adjuster. ] Sims' Wire Carrier. 1 Sims' Blunt Hook. 1 Pair of Sims' Dressing Forceps. 1 Pair of Sims' Seizing Forceps. 1 Pair of Sims' Wire-Twisting Forceps. 2 Sims' Sponge-Holders. 6 Needles and Silk. 2 Coils of Silver Suture Wire. 1 Morocco-covered Case, neatly arranged and lined with oil-dyed velvet. $50 00 Sims' Set of Instruments for Vesico- Vaginal Fistula. 2 Silver Sigmoid Catheters. 2 Metal Sigmoid Catheters. Sims' Speculum,* plated. Pair of Sims' Needle Forceps. Pair of Straight Long-Handled Scissors. Pair of Curved Long-Handled Scissors. Pair of small, smooth-pointed Forceps. Pair of Twisting Forceps, slide-catch. Pair of Seizing Foj-ceps. Sims' Scalpels. 1 1 1 1 1 1 1 2 2 Sims' Tenacula. 1 Sims' Blunt Hook. 1 Sims' Suture Carrier. 1 Sims'' Wire Adjuster. 6 Sims' Needles. 1" Coil Silver Wire. 2 Sponge Holders. Some Lead Wire. 1 Mahogany, Kosewood or Morocco-covered Case, lined with oil-dyed velvet. $55 00 PapxT hi. 16 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Fig. 332. Schlotterbeck's Speculum. Pat., Feb. 24, 1874. Fig. 333. Ball's Speculum. Part III. 67 CHATHAM STREET, NEW-YORK. 67 Branch Store, 107 E. 28™ St., N. Y. FOIi VESICO - VA.OI]V^^L FI^TXJI^A.. Sims' Set of Instruments for Vesico- Vaginal Fistula and Uterine Operations. Sims' Specului Depressor. Silver Caustic Probe. Simpson's Sound. Sponge Holders, Pair of Sims' Twisting Forceps. Pair of Sims' Seizing Forceps. Pair of Scissors, curved to the right side. Pair of Scissors, curved t& the left side. Pair of Sims' Needle Forceps. Pair of Straight Scissors. Sims' Revolving Knife. Sims' Wire Adjuster. Sims' Suture Carrier. Sims' Uterine Eepositor. 2 Sims' Scalpels. 2 Sims' Tenacula. Sims' Blunt Hook. Sims' Silver Sigmoid Catheter. Metal Sigmoid Catheters. Coils Silver Wire. Sims' Needles. Mahogany, Rosewood or Morocco-covered Case, lined with oil-dyed velvet. $75.00 Part III. 68 GEO TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann, Edward Pfarre. 1 FOTl VESICO-V^OIINaL FISTULA. Fig. 243. Sponge- Holder, German Silver. Fig. 244. Sponge-Holder, Iron, Ebony Handle. Fio, 245. Bozeman's Button Adjuster. ■Ol -^ K'MV1AJ311 '0 Fig. 246. Bozeman's Depressor- Fig. 247. Sims' Sigmoid Catheter. Part III. 67 CHAllIAM STREET, NEW-YORK, 69 Branch Store, 107 E..28th St., N. Y. BRICKELL'S SET OF OBSTETRICAL INSTEUMENTS. 1 Pair of Brickell's Lona; Foi-ceps. 1 Pair of Brickell's Short Forceps. 1 Pair of Straight Craniotomy Forceps. 1 Pair of Curved Craniotomy Forceps. 1 Perforator. 1 Yectis. 1 Guarded Blunt Hook. 1 Guarded Crotchet. 1 Leather Pouch, lined with oil-dyed velvet. 1 the instruments nickel-plated. $48.00 BEDFORD'S SET OF OBSTETRICAL INSTRUMENTS. 1 Pair of Bedford's Forceps. • 1 Bedford's Perforator. 1 Pair of Placenta Forceps. 1 Blunt Hook and Crotchet, combined. 1 Leather Pouch, lined with oil-dyed velvet. $28.00 BUDD'S SET OF OBSTETRICAI^ INSTRUMENTS. 1 Pair of Budd's Forceps. 1 Blunt Hook and Crotchet. 1 Perforator. 1 Pair of Placenta Forceps. 1 Pair of Craniotomy Forceps. 1 Pair of Simpson's Short Forceps. 1 Patent-Leather Case, neatly arranged and lined with oil-dyed velvet. $40.00 THOMAS' SET OF OBSTETRICAL INSTRUMENTS. . 1 Pair of Elliott's Forceps, rather heavy. 1 Pair of Davie's Short Forceps. 1 Trephine, for Perforating. 1 Blunt Hook and Crotchet. 1 Simpson's Cranioclast. 1 Cephalotrite. 1 Gum Elastic Cntheter. 1 8 oz. Phial for Chloroform. 1 Case, patent leather. $66.00 Part III. 70 GEO. TIE^IANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. QYB:M€mLO GICAL IHSTRFMlHTi Vesico-T^agrinal IFistxila axid Uterine Scissors. ' Fig. 2G0. Bozeman's Angular Scissors. Part III. 67 CHATHAM STREET, NEW-YORK. 71 Branch Store, 107 E. 28Tir St.. N. V. %€&LiQm€AL, IH/S^^i^^TrTriiTrw^wrri^ r JL M .m^/%^%M'M^i%yjWMi.vuM.MUi jli^j m jlm^^%j) k^Mmi-L^i jl o** FOIi VESICO-VAOIJVAL FISTULA. Fig. 267. Bozeman's Double Curve Scissors. o Fig. 267S. Jenk's Uterine Probe. mss&m^ G.l\EW\ftNN8cCQ ELLIOTT'S SET OF OBSTETRICAL IHSTHUMEITTS. 1 Pair of Elliott's Foreeps. 1 Ebony-Handled Blnnt Hook. 1 Ebony-Handled Crotchet. 1 Blots' Perforator. 1 Pair of Plain Placenta Forceps. 1 Pair of Ramsbotham's Craniotomy Forceps. 1 Roll-up Pouch, lined with oil-dyed velvet. $35.00 TAYLOR'S SET OF OBSTETRICAL INSTRUMENTS. 1 Pair of Taylor's Forceps. 1 Smelley's Perforator. 1 Pair of Craniotomy Forceps. 1 Pair of Placenta Forceps. 1 Blunt Hook and Crotchet combined. 1 Leather Pouch, lined with oil-dyed velvet. $28.00 HODGE'S SET OF OBSTETRICAL INSTRUMENTS. 1 Pair of Hodge's Forceps. 1 Blunt Hook and Crotchet, combined. 1 Bedford's Perforator. 1 Leather Pouch, lined with oil-dyed velvet. $16.00 .Pakt III, 72 GEO. TIEMANN ^; CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. Fig. 268. Arranging the Button or Shot Suture. Fig. 269. Bozeman's Button<5 Applied Bozeman's, Emmet's and Sims' Needles &c. See also Fig. 354, Sims' new Needle and Knife-Holder. Part III, 67 CHATHAM STREET, NEW-YORK. Branch Store. 107 E. 28fH St., N. Y. 73 // JLiL J|LM^» Fig. 375. Thomas' Hard Rubber Probe. Fig 280. Silver Uterine Probe. Fig. 283. No. 1 is a modification of Roux Needle-Holder. It is an excellent Needle-Holder, which may be used in the operations of vesico-vaginal fistula, cleft palate, etc., and it is m.\de to serve as a handle to the instruments accompanying it No. 2 combines the Applicator with the Sponge Tent Expeller. No. 3 is a Sponge Holder and l.igating Forceps. No. 4, a Lead Sound, which easily follow^s the curve of the uterus. No. 5, Intra Uterine Scarifying Knife, blunt point. No. 6, Simpson's Sound. No. 7. Uterine Probe, of pure silver. 74 Part III. GEO. TTEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmanx. Epward Pfarre. BYBiM: COlv/OeiC AX- Ilf BTEUMlli'T liCS XJterine I>ressinj2: Insti:Mi.iM.eiits. ■ Fig. 285. Bozeman's Dressing Forceps. "■''^ryt.^^,,.^ Fig. 386. Sims' Caustic Forceps. Curved Uterine Knife |gg£iSf^^£ifiiiSa*it*i V -iVnVr i»~ a.T/£MflfiJN &■ CO. Fig. 289. Newman's Metrorganon. ^fUBEMI^) 'r^ &mAL WW^mEMMmTB V^m XJterine SouikIx siikI Ele-vatorjs. Pakt III. 76 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. ^ Edward Tfarre. Ci¥W=^;COL/OGrICAL IHSTEFMllfTS. XJtei'ine Soimcis, Probes a,iicL Iier fs^oarLfying-. Fig. 349- Curved Scissors for the AmpuUition of the Cervix, Fig. 350. Clark's Tooth-Edged Scissors. Fig. 351. Thomas' Punching Forceps. Fig. 352. Peaslee's Uterotome. Fig. 354. Sims' Knife-Holder and four Knives. Fig. 355. Thomas' Dry Cupper. C nEMMH-UI. Part III. 83 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlman, Edward Pfarre, BjmMiC&hQimeAh iwiTmuMiifTi For* Iirjection of* tlie Vag-iiia aiwi Uterine Cavity. Fig. 361. Davidson's Syringe. Fig. 362. Syphon Syringe for the Vagina. Part III. 67 CHATHAM STREET. NEW-YORK. 83 Branch Stork, _,.__._ .,^ 107 E. 28th St., N. Y. . For iMJeotioii o±- the Vag-iiiti itna Uterine Ca,vity. Pakt III. 84 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann, Edward Pfarre. Fox- Injecton o±* tlie Vag-ina and Uterine Cavity. Fig. 374. Maw's Ene.na Pump. Fig. S75. Woodward's Uterine Syphon Douche. Fig. 377. Tiemann & Co.'s Universal Syringe. 6 b bJj bis 'u >-. m b£ <5t!:- Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 E 28th St., N. Y. // For I>isplt*.ceiTicnts oF tlxe TJ-teriis. Fig. 378. White's UTERINE REPOSITOR. ilC^l Fig. 1. a. c. d. e. / Uterus in process of reduction. Anterior lip or wall of the uterus M'ifch the fingers of the left hand pressing upon it and assisting in pulling open the uterine cavity. Posterior uterine wall semi-reflected. Anterior vaginal wall. Wooden or hard rubber stem of Repositor, its en- larged extremity held in contact with the fundus by the intra- vaginal hand of the operator. Distal extremity of stem made into a screw, so as to fasten into ^, a coil of No. 11 steel spring wire, re- quirino; eight or ten pounds pressure by the breast of the operator, against which it is placed, to bring it down. Fig. 2. h. Uterine extremity of stem 6, which is terminated with a soft India rubber disci 1-inch diameter, the concavity into which the fundus is received being about one- half inch deep, with its terminal margin thin and soft. Past III. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A Stohlmann. Edward Pfarre. BYmM,€BhO)m€AI, OTiTEUMllfT ^ie; For 31>isj>laceimeiit:s ol;' the XJtenis Fig. 379. Hornby's Pessary. Fig. 380. Tiemann & Co 's Uterine Supporter Part III. 67 CHATHAM STREET, NEW-YORK. B7 Branch Stork, 107 E. 28th St., N. Y. For lI>isj>laceiM.en.i:s ol* the TJt-ems. Fig. 385. Thomas' Ante- Fig. 386. Thomas' Re version Pessarj'. troversion Pessary. Fig. 387. Fig. 388. Thomas' Smith's Pessary. Anteversion Pessary. Part III. 18 GEO. TlEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann, Edward Pfarre. Fig. 393. Buttles' Pessary. Fig. 394. Nceggerath's Pessary. Fig. 395. Ring Pessary. FiG. 396. Graily Hewitt's Pessary. Fig. 397. Sleigh Pessary. • Part III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St.. N. Y, UYmM,€&L,Qm€AL mS-TUMMESTB, For I>isj>lsicements of tlie Xltenis. Fig. 405. Fig. 406. Kinloch's Pessary for Fig. 407. Kinloch's Retroflexion Pessary. Prolapsus of the Bladder. Kinloch's Anteversion Pessary. Fig. 408. Ball's Stem Pessary. Fig. 409. Kinloch's Retroflexion Pessary. Fig. 410. Fig. 411. Thomas' Intra Uterine Fig. 412. Thomas' Anteflexion Thomas' Retroflexion Pessary. Stem Pessary for Anteflexion. Pessary (open) when m situ. Fig. 413. ^ Thomas' Antiversion 5 Pessary (open;. ^ Fig. 414. Thomas' Antever- Fig. 415. Thomas' Antefiex- sion Pessary (closed). ion Pessary (closed). Fig. 416. Hitchcock's Anteversion t Pessary. ^ Fig. 419. Hodge's Clo.sed Lever Pessarv. Part III. . 90 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoiii.mann Edwarh Pfarre. f* the XJteriiS. Fig. 420. Braun's Colpeuiyntor Fig. 4206. Trask's Pessary. Fig. 421 Coxeter's Stem Pessary. Pakt hi. 67 CHATHAM STREET, NEW YORK. 91 Branch Store, 107 East 28th St., N. Y. Fig. 428. Stem Pessary. For Displaeements of the XJtenxs. Fig. 428A. Fir,. 428f. Cutter's Rins^ Pessary. Weber's Pessary. Fig. 429. Graily Hewitt's Pessary. Fig. 4296. Hodge's Horse-shoe Pessary. Fig. 4316. Thomas' Anteversion Pessary. Fig. 430. Peaslee's Stem Pessary. Fig. 431. O'Leary's Pessary. Fig. 4S\c. Fowler's Pessary. FiG. 43M. Skeene's Urinal Cup Pessary. "■"^'^'^-Nf^'s:^ Fig. 432. Sims' Pessary Introducer. Part III. 92 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F A. Stohlman, Edward Pfarre. Ql'mM,C&LmBICAL mSTEUMlllT ^^O For XJt'ei'ine! a.xi.d O-^ariaii Tumors. Fig. 433. Van Buren's Ligator. 144' Paut tit. 67 CHATHAM STREET, NEW YORK. 93 Branch Store, 107 East 28th St., N. Y. DFor XJterine and Ovai-ian Tumors. Fig. 488i5. Braxton Hick's Ecraseur. Fig. 438c. Smith's Wire Ecraseur. Fig. 438e. Tiemann's Long Chain Ecraseur. Fig. 438/. Cintrat's Ligator. Sim's Port Chain Ecraseur, fig. 47U. Ligators for HEemorrhoidai Tumors, page 122, Part III Part III. 94 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. ;^}T1¥ «r:fl)Tf r/U'llICW.lL^/ M1N'TS« For Uterine and Ovarian Tximors, Fig. 439. Gueride's Clamp. Fig. 442. Nott's Rectilinear Ecraseur. Pakt III. 67 CHATHAM STREET, NEW YORK. 95 Branch Store, 107 East 28th St., N. Y. m:E(M,C&L&mCAL mSt^BMEET-S. For uterine a^nd O-varian Tuniors. Fig. 445. Spencer Well's Pedicle Clamps. Consisting of 3 clamps, 1 set of levers for closing and 1 set for removing them. Fig. 445&. Byford's Clamps. Consisting of 2 clamps and 1 pair of lever forceps. ^i3^.%^^^v^w b- e.o.^.-r Fig. 446. Darby's Clamps. Part III. 96 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlma.nn. Edward Pfarre. gumMiCOh&QMML, IMBTmUMlHTS. IFoi* XJterine sind O^^arian Tvimors. Fig. 447. Atlee's Clamp. Part III. 07 CHATHAM STREET, NEW YORK. 97 Branch Store, 107 East 28Tir St., N. V. For TJtei*jLno anFARRE. // iifBim^ *-^^?rrJO Fic. 489. Loewenthal's (1, 2). pAliT III. 67 CHATHAM STREET, NEW-YORK. Branch Store, 10.-) 107 East 28tu St., N. Y. BYmM,C0Jh&QmML IlfSTEUMlHT-S. Fig. 493. Robertson's. Fig. 494. Vectis. Fig. 495. Davis'. Fig. 490. Bedford's. Fig. 497 Tarnier's New Obstetric Forceps. Part III. l06 GEO. TIEiMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. ^ Edward Pfarre. Fin. 498. McLean's. Fig. 499. Nstjeli's. Fig. 500, Roller's. Fig. 501. Blake's. Fig. 502. Ives' Fig. 502b. Draper's. Fig. 503, Hunter's. Fig. 504. Thomas' PakT III. 07 CHATHAM STREET, NEVv^-YORK. lot Branch Store, 107 E. 2Bt][ St., N. Y. Cff¥lf^;C©L©'QliC;AL mSTRCriilNTS. Fig. 505. Tarsitani's. Fig. 506. (1, 2.) Brickel's. Fig. 507. Comslock's Fig. 509. Taylor's. Fig 510. Robinson's. Part III. 108 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohi.mann. EnwARD Pfarre. Fig. 510?'. Hale's. Fig. 510t'. Jenk's. Fig. 510^. Trueheart's. Fig. 510e. Vedder's. Fig. 510/. Bethel. Fig. 510^1'. Rockwell's. FiG, 510h. Mathew's- Part III. 67 CHATHAM STREET, NEW YORK. 109 Branch Store, 107 East 28th St., N. Y. mMiC&L&QmALi mST-EUMlN Fig. 510i. Newman's. Fig. 510A;. Sawyer's. Fig. 510/. Gillette's. Fig. 510m. McFerran's. Fig. 510?i. Ryerson's Vectis. Fig. 510o. Robinson's Insufflator. For the lungs of infants who are born in a state of semi-asphyxia, after prolonged or difficult labor. Paut III. 110 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlman, Edward Pfarre. Placenta and Emlbi-yotomy Instmnaeiits. Fig. 511. Dewee's Hook and Carey's Lever. G.TIEMANN & CO. FiG. 512. Tiemann & Co.'s Embryotomy Forceps. C__,^ Fig. 514. Bachelder's Embryotomy Forceps. See also Figs. 318, 319, 426, Sponge Tents, Barne's Dilators, Trocars, etc. Fig. 515- Pulling's Funis Clamp. {Extract from the Medical Record.) The possible occurrence of hemorrhiage from the umbilical cord, through loosening of tbe liga- tures, is frequently a source of anxiety to the ac- coucheur, when he leaves his patient after delivery. Accidents from this cause, if not very frequent, are yet sufficiently formidable to give importance to ef- fective means by which pressure on the cord may be rendered constant under all circumstances. Hav- ing this end in view, I have devised an elastic funis clamp, made of a single strip of thin steel doubled on itself, and shaped as shown m the cut, which represents it enclosing a sec- tion of the funis. Through the skill of Messrs. Tiemann & Co., it has been rendered safe, effective, simple and cheap. The opposed surfaces being convex, the pressure is nearly as great when they are approximated as when the separation is considerable. It is clasped and unclasped by sliding the extremities of the arms at h past each other. I have used one of these little instruments in about twenty cases, and it is still in good order. I generally remove it on my second visit, when I find the cord beneath it compressed to the thinness of paper, and the vessels perfectly obliterated. It is very convenient, besides giving such a sense of security that I should be very unwilling to do without it now. Two or more clamps should be carried, one being used to apply temporarily to the placental end of the iyxm%.~Ezra R. Pulling, M. D., New York. April 22, 1875. Paiit III. 67 CHATHAM STREET, NEW-YORK. Ill Branch Store, 107 E. 28th St.. N. Y. BYmM,CQihQ)m€AL KF/STE.lFlilFf'E-S y-^§> Fig. 516. Holme's Perforator. Fig. 517. Bedford's Perforator. Fig. 519. Smellie's Perforator. Fig. 520. tJNTsegelie's Perforator. « Takt III. 112 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. FOIi OBSTItXJCTED Lv^BOIi. Fig. 523. Thomas' Perforator. Fig. 524. Taylor's Blunt Hook Fig. 525. Bedford's Guarded Blunt Hook and Crotchet. Fig. 526. Blunt Hook and Crotchet. Fig. 527. Decapitating Hook G. TICM/^NN &.C0. FjG. 528. Guarded Blunt Hook and Crotchet e. TIEMmN & CO. Part III. 67 CHATHAM STREET. NEW- YORK. 113 Branch Store, __^__.-^^^ ^^^ ^^ ^'^'^" ^'''■' ^ ^- Fig. 539. Meig's Craniotomy Forceps. Part III. 114 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmamn. Edward Pfarre. FOR OBSTRUCTED LABOR,. Fig. 533b. White's Perforator. Fig. 533d. Trueheart's Trephine Perforator. Fig. 534. Braun's Cephalotrite. Fig. 534&. Simpson's Cephalotrite. Pakt III. 67 CHATHAM STREET, NEW-YORK. W. Branch Store, 107 K. 28th St., N. Y, < Fig. 535. Ashton's Ruptured Perineum Needle. Fig. 536. Helical Needle for Ruptured Perineum. Fig. 537. Agnew's Forceps, with Adju.'^ter. O f^ Peaslee's Needles for Ruptured Perineum. Suture Needles, full curve, half curve, or straight. See page 63, Part 1 , of this Catalogue. Part III. 116 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. ® For Lacerations of* tlie Female Fei'iiieiiiii. Fig. 541. Brickell's- Perineal Stay. Fig. 5416 Munson's Quill Suture Stay. c.."\\t.\ivu.\\u a^co "^S^ G.TIEMAlxlN &C0. Fig. 542. Peaslee's Perineum Needles (detachable handle). Fig. 5426. Peaslee's Perineum Needle (right and left). Fig. 543. Parker's Perineum Needles (encased in handle). Fig. 544. Usual Perineum Needle. Agnew's Set of Instruments for Ruptured Perineum. 1 Scalpel : $1 00 1 Pair of Agnew's Forceps, with Adjuster 2 75 1 Ashton's i^eedle 75 4 Curved Sutui-e I^Teedles 50 1 Agnew's ISTeedle-holder and 3 ISTeedles 4 50 2 Coils of Silver Wire 1 00 1 Shot Compressor 2 50 1 Pair Curved Scissors 3 50 1 Tenaculum 80 2 Skeins Silk Ligature 20 1 Probe-pointed Bistomy 1 00 6 Pieces of Cane or Bougie for Quill-Sutures 25 1 Skein of Twine 10 1 Piece of Wax — 1 Maliogany or Rosewood Case, lined witli oil-dyed velvet 5 50 * Amount $24 35 Part III. 67 CHATHAM STREET, NEW- YORK, Branch Stork, 117 107 E. 28tu St., N., Y.. Fig. 545. Bodenhamer's Reflector and Lens. I'lo. 546. Ashton's (It can be used for gas, oil or any other Fenestrated Speculum Ani illuminating material.) ' Fk;. 547. Trivalve Trellis Speculum Ani. Ftg. 549. Gorget Formed Anal Speculum. GLTJtAMfl/A/ & On. Fig. 548. Bodenhamer's Recto-Calonic Endoscope. Fig. 550. English Rectal Bougie (Cylindrical), 12 sizes. G. TIE MANN ScCO . Fig. 551, English Rectal Bougie (Conica. Point), 12 sizes. G.T/EMANN &C0. See Baxter's Speculum, fig. 229-, Bivalve Speculum Ani, fig. 237, etc. ; Dome Top Speculum, fig. 223 ; Ferguson's Specu- lum, fig. 218 ; Sims' Speculum, fig. 242 ; Tiemann & Co.'s Speculum, fig. 225. Part III. lis GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarrk. AEAh & EICTAL IHS'f'EUlilWT'S, Fig. 553. Bodenhameis' Rectal Explori Sounds or Bougies (10 sizes). Fig. 553. .Syphon Syringe. Fig. 554, Small Bivalve Anal .Speculum, for Children. G.TIEMANN &.C0. Cautery Lamp and Galvano-Cautery Batteries, figs. 472 and 473. Part III. 67 CHATHAM STREET, NEW YORK. Branch Stork, 107 E. 28Tir St., N. Y, 119 ABAh & EICTAJL/ mBTWJSMMMTS ^« Pakt ITI. 120 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. ^ Edward Tfarre. AHAL, & miCf AX; IF/BTmiUMlIfT! Fig 573. Rectal Curette (for scooping out the Rectum in Atony or Paralysis of that organ, and also for removing Ascarides of the Rectum.) Fig. 575. Recto-Cololic Enema Apparatus, consisting of a Force-Pump with a Colonic Tube attached, for injecting or forcing fluids both into the Rectum and Colon. Fig. 576. Hutchinson's Improved Breech-Loading Syringe, for administering semi-solid substances into the rectum, etc. See also Tiemann & Co.'s Universal Syringe, fig. 377 ; Davidson's Syringe, fig. 361 ; Syphon Syringe, fig. 302 ; Woodward's Syphon Douche, fig. 375. Paut IIT. 67 CHATHAM STREET. NEW-YORK. Branch Store, 107 E. 28th St., N. Y. 121 AMALi & ^# Fig. 580. Rectal Brush-Holder (^stem of flexible wire). Fig. 531. Verlebrated Recto-Coloiiic Lxplorini^ Sound. CTIfiWlAMN-CO. Fig. 583. Small Blunt-Pointed Curved Bistoury (for incising preternatural pouches or Sacculi of the Rectum. Fig. 584. Bistoury Cache, for Rectal Strictures. Fig. 585. Bodenhamer's Blandin's Knife. For making the sub-mucous and sub-cutaneous section of the sphinatores ani muscles, in anal fissure. Part III. 122 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. AH/AL & EICTAX, IHiTEF/MllfT i\0 -Fig. 591. Bodenhamer's Bistoury Cache, for Fistula en Ano. Fig. 593. Gooche's Canula for ligating Haemorrhoidal Tumors. Fig. 593. Camel's Hair and Cilass Brushes. Fig. 594. Carroll's Knot Tier. Fig. 595. Flexible Silver Director (grooved and probe-pointed. Fig. 596. Bodenhamer's Curvilinear Forceps, for facilitating the ligation of Haemorrhoidal Tumors. Fig. 598. Lent's Platina Cup for fusing Nitrate of Silver. Fig. 599. Pin for transfixing Haemorrhoidal Tumors. See also page 92 — Ecraseurs. Pakt III. 67 CHATHAM STREET, NEW-YORK. Branch Stork, 107 E. 28tu St., N. Y. 123 AWAIv/ & ElC;f AX, IMBITEU'MIHTS., Fkj. 600. Lent's Ligature Carrier. Fig, 601. Bodenhamer'.s Spring Forceps, for seizing and ligating bleeding vessels, as well as Polypoid Tumors of the Rectum, when high up. Fig. 603. Hutchinson's Needle, for the Subscutaneous Ligation of External Hsemorrhoidal Tumors. e, TIE MANN & CO Fig. 604. Skeene's Needle for Ruptured Perineum. ,7lliNIANN&C0. l£/Vi.ARG£D VlliW. Fig. 606. Rectal Porte Mesche at Tampon. Fig. 607. Straight and Fig. 008. Small Trocar and Acupuncture, or Exploring Needle, for testing Curved Suture Needles. the character of ambiguous swellings or fluid collections of the rectum. •lEV/iMM&CCI."!'" Fig. 609. Angular Pile Needle Part III. 124 GEO. TIEMANN & CO.'b SURGICAL INSTRUMENTS. F. A. Stohlman, Edward Pfarre. Fig. 611. Ruptured Perineum Needle. Fig, 612. Prolapsus Ani and Pile Supporter. Fig. GI4. Gibson's Instrument for the Introduction of the Ligature in Anal Fistula;. Fig. 615. Trousseau's Pile Supporter, and for treating Spermaton'^""" Fig. 617. Pile Bougie and Prolapsus Ani Supporter. Part III. 67 CHATHAM STREET, NEW YORK. 135 Branch Store, 107 East 28th St., N. Y. AWAL & EICTAL, IK'SIF-EeMlKT-S ^9 Fig. 619^. Dcpuytrcn's Enterolome. For facilitating the introduction of the Elastic Ligature. A double Jigature can be readily drawn though a fistula or under a tumor. It is not necessary, in fistula, to see the hook, for if the finger with a loop of India rubber around it De passed up the rectum, the loop can, with great facility, be directed over the end of the probe and caught in the notch quite unassisted by vision. C shows the sharp-pointed instrument adapted to the .same canula, so that onl^- one handle and one canula are required to complete the double instrument. Many other simple surgical operations maj' be advantageously performed by means of the Elastic Ligature. DITTEL'S ELASTIC LIGATURE, (1 yard Icng, 25 cents). Exerts a constant and almost painless constriction upon the parts ligated with it. 126 Part III. GEO. TIEMAXN & CO.'S SURGICAL INSTRUMENTS, F. A. STOHLM.A.NN. Edward Pfarre. HIMMA IIfSTR,lIMlliTS. : &; S, '!Tc"^,':ii^iKS";7«XTi. ''""■'"°°"' ■ """''>■'' "'''"•"• "=■ '" • ''""'' «' Part IV Tape Measure. Please do KOT MUTILATE this Booh. In ordering, Dierely state the Fart of the Armamen- tarium, the JVumher of the Figure, and the Mame of tlie article desired. Instruments not irientioned in our Frice List will he furnished at the lowest market rates. When GOODS FOR REFAIR are directed to us, the Owner's Mame and Address should accompany them. This will enable us to return them to the proper place and person. Farties finding it convenient to order through dealers are requested to insist upon receiving our manufacture, as otherwise inferior goods are frequently substituted. All instruments of our malce have our name stamped upon them. Paet IV. GEORGE TIEMN & CO.'S SURGICAL INSTRUMENTS, Branch Store, 107 East 28th Street, J^ew-York. ORTHOPAEDIC APPARATUS. Appratis for tie Treatmeit of Dlstortiois aift UeMlities of tk Tmi. Shoulder Braces. For unconfirmed curvatures, or " round shoulders," in children and youths. This condition, brought on by a habit of stooping, or by a constant bending forward of the head and neck over the book or desk, is amendable by mechanical treatment. The most approved instruments for these cases are represented by Figs. 1, 2 and 3. Figs. 1, 2. Elastic Shoulder Braces. For ladies and gentlemen, arranged as Suspenders or Skirt Supporters. Fig. 1. Elastic Shoulder Brace, for Gentlemen and Ladies, 2. Elastic Shoulder Brace, for Gentlemen, Price. 52 00 to $3 50 2 00 to 3 50 Part IV. 2 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. - Edward Pfarre. Fig. 3. Steel Back Shoulder Brace. For more advanced cases of round shoulders. Price, $4 to $5. Directions to Measure for Shoulder Braces; 1. Patient's name (sex). 2. Elastic or Steel- Back Brace. 3. Crest of ilium to axilla, . . inches. 4. Circumference of pelvis, . a . " 5. Circumference of chest under axilla, . , . " Apparatus for Spinal Distortions. Extracted from the '■^Medical Journal,''^ New Yorlc. Aug. 1, 1868. Fig. 4. Tiemann L Co.'s New Brace for Pott's Curvature of the Spine. Price, $35.00. " It is intended to afford an entirely elastic continuous and gentle pressure to the parts to Avhich it is applied, giving to the patient, along with adequate support, an easy and comfortable feeling. It is made of light temper- ed springs, and softly padded wherever it comes in con- tact with the body. " The belt below passes round the pelvis, and the principal weight is thrown upon the gluteal region. The front portion is broad, so as to compress the pro- truding abdomen. Two upright parallel bars pass on each side of the posterior elevation, having a portion of silk elastic rubber between them, which gives a constant pressure upon the protuberance. If the latter "is in- jiamed, a portion cut out of the elastic material prevents o^imAHn-w. direct pressure upon the extremity of the bone. Upon these side bars are attached two elliptic and padded springs, yielding to every pressure, and adaptinp; Part IV. 67 CHATHAM STREET, NEW- YORK. Branch Store, 107 East 28th St., N. Y. Fig. 5. SiXi^BSini'-eo. themselves to the sides of the spinal column and keeping the body in an erect position. These are removed or applied by a very simple process. The two padded crutches are elastic, and elevate the body by pressing mostly under the margin of the scapula, thns obviating any tendency to pressure upon the axillary veins. They are constructed in such a manner that the equilibrium of the body can be restored in case one shoulder is depressed." Fig. 5. " The elastic belt shown in the cut is for the purpose of giving additional pressure, if needed, but mainly to compress the sternum, which generally pro- trudes. It is also designed to be worn at night, when the apparatus itself is not applied." We pay special attention to the correct and care- ful fitting of these Braces. Surgeons residing at a distance, whose patients cannot visit us for adjustment, will have their orders j)romptly attended to, by sending us the following particulars : Measurement for Tiemann c& CoJs Brace for Posterior Curvature. {Pott'^s Disease.) Patient's name (or sex). " age. '' weight (estimated). " ^ J INCHES. Distance from sacro lumbar articulation to vertebra prominens, 6. Distance from sacro lumbar articulation to first vertebra involved, 6. Distance from sacro lumbar articulation to last vertebra involved, T. Distance from crest of ilium to axilla, right side, . . . Do. left side, 8. Distance from the centre of one scapula to the centre of the other, 9. Horizontal (transverse) diameter of the pro- tuberance. 10. Circumference of chest under axilla, .... 11. Circumference of pelvis one inch below the iliac crests. Fig. 6. (C to D) (C to G) (C to D) (A to H) (E to F) (H) Pig. 7. Tiemann ^ Co.'s Brace for Lateral Curvature. (scoliosis.) Price, $35.00. To the pelvic belt are attached laterally two elastic crutches, as in the brace for Pott's disease ; to relieve the spine of the weight of the trunk posteriorly, a single, gtrong, upright bar, holdmg a couple of adjustible pads for the scapulae, and just Paet IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. below, a leather band, of proper width (attached bj a number of small brass but- tons), terminating in strong elastic India-rubber webbings. This band is passed around the protuberance obliquely, and buckled to the YiG.I. pelvic belt in front, an inch or two beyond the linea • alba, and will bo found to exercise a gentle, but con- tinuous elastic pressure, at the same time rotating the ribs around their vertebral axes, and thus mifolding the helical curve. Measurement for Tiemann & Co.'^s Brace for Lateral Curvature {Scoliosis.) Surgeons residing at a distance, whose patients can- not visit us for adjustment, will have their orders promptly attended to, by sending us the following par- ticulars : Is the convexity of the curve to the right or left side ? {In the figure of the accompanying skeleton it ■■ , - is to the right.) 1. Patient's name (or sex). 2. " age. p^^ g ^' . " weight (estimated). ^ ^^^^^3_ 4. Distance from sacro lumbar articulation to vertebra prominens, ""^fex / 5. Distance from sacro lumbar articulation to first vertebra involved, 6. Distance from sacro lumbar articulation to last vertebra involved, IJj,,,J^^^^.|L //. 7. Distance from crest of ilium to axilla, right — J|V^:/II ■ side, .... rf^\^. U '■ ^^- leftside, ;S'.->AAkJd, G. 3, Distance from the centre of one scapula Li to the centre of the other, "£^ 11/ 9. Horizontal (transverse) diameter of the -A. protuberance. o# YW' -^Q^ Circumference of chest under axilla, i'if 11. Circumference of pelvis one inch below the iliac crests. (C to D) (C to G) (C to D) (A to H) a (E to F) (H) Pig. 9. Spine Brace Ij Dr. Chas. Washtmrn. Price, $15 to " Some two years ago it became necessary for me to have constructed a brace for the treatment of angular curvature of the spine, a considerable number of such cases having been quite suddenly thrown upon my hands by the resignation of a Pakt IV. . 67 CHATHAM STREET, NEW-YORK Branch Store, 107 East 28th St., N. Y. consulting orthopedist to St. Luke's Hospital, New York. It was inj desire to obtain an apparatus, which, while fulfilling the indications perfectly, should be simple in construction and not expensive." "In the accompanying figure aa is a steel band which passes half way around the pelvis, just above the trochanters, hb are two flat bars of steel, parallel to each other, and curved upon their flattened sides to the form of the spine to which the apparatus is fitted. These bars are curved a little less than the spine, so that when secured in position, their elasticity will constantly oper- ate to rectify the spinal curve. The cross bar at the upper ends of the parellel ones is firmly riveted to them, and is to cross the back just above the spines of the scapulse. At the ends of this bar are affixed buckles to receive the shoulder straps ; gg are two movable pads which slide upon the bars to which they are attached — these are best stuffed with chopped cork. These com- presses are to be brooght one upon each side of the pro- jecting knuckle of spine and secured firmly by means of the screws provided for that purpose. Buckles are attached to various parts of the brace, by means of which it is secured to the front part of the apparatus, which consists, as shown, of a piece of twilled muslin, or other strong material, which covers the chest and abdomen and is provided with straps. Such parts as are in con- tact with the body are carefully padded." " Success with this apparatus depends entirely upon the faithfulness with which it is kept adjusted to the spine of the patient. It is only necessary that a gentle pressure should be maintained if it is constant. As the spine approaches its normal shape the curve of the brace will require to be altered from time to time. The steel has a soft temper, so that it will take the form into which it is bent when considerable power is applied, but will be suffi- ciently elastic for the purposes of this apparatus. With children's braces the necessary bending is readily accomplished by hand." Surgeons residing at a distance, whose patients cannot visit us for adjustment, will have their orders promptly attended to, by sending us the following par- ticulars : Measurement for Washburn'' s Braee for Posterior Curvature of the Sjpine. ( Potfs Disease) 1. Patient's name (or sex.) 2. " age. 3. " weight (estimated). 4. Distance from sacro lumbar articulation to vertebra prorainens (C to D), inches. 5. Distance from sacro lumbar articulation to first vertebra involved (C to G), " Pakt IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Fig. 10. — -//. 6. Distance from sacro lumbar articulation inches. to last vertebra involved, . (C to D) 7. Distance from crest of ilium to axilla, right side, ... (A to H) Distance from crest of ilium to axilla, left side, . ■ ■ 8. Distance from the centre of one scapula to tne centre of the other, . (E to F) 9. Horizontal (transverse) diameter of the protuberance. 10. Circumference of chest under axilla, (H) 11. Circumference of pelvis one inch below the iliac crests. Pig. 11. Dr. Thomas M. Markoe's Brace for Torticollis. Price, $35.00 to $45.00, according to size and finish. This apparatus is constructed in the following manner : An upright steel bar is fastened to a pelvic band, and carried along the spine to a little below the level of the shoulders, secured in position by straps passing over the shoulders under the axillae, and fastened to buttons or pads situated over the scapulae. A steel lever for extension of the neck, is provided inferiorly with a slot, to admit of adjustment, and connected with the upright bar by means of two screws ; the top of this lever is made Fig. h. to form a powerful clamp, for the purpose of holding the head-band, and of securing the head in position. The head-band is formed of a steel spring carried half around the back of the head, softly padded, and the cov- ering extended to the front and buckled there. A strap may also be passed across the top of the head from ear to ear. A bandage, the size and shape of the patient's chin, is buttoned to this head-band laterally with four straps. Fastened to the steel spring of the head-band is a steel stem about one inch or less in length, terminating in a ball; this is held within the grasp of the clamp, thus forming a universal joint, moving freely in all direc- tions. By turning a thumb-screw with which the clamp is provided, the head of the patient may be fixed in any position by the arrest in the movement of the joint. Part IV. 67 CHATHAM STREET, NEW-YORK, Branch Store, 107 East 28th St., N. Y. Measurerfient for' Marhoe's Jirace for Torticollis. Fig. 12. 1. Patient's name (or sex). 2. " age. 3. " weight. 4. Distance from saero Inrabar articulation to vertebra prominens, 5. Distance from sacro lumbar articulati(jn to base of skull, 6. Circumference of pelvis one inch below iliac crest, .... 7. Circumference of chest under axilla, 8. Circumference of the head, inches. Fig. 13. Tiemann & Co.'s Wry-Heck Brace. • Price, $5.00. This is a simple collar, made of pliable iron wire and covered with silk or buckskin. It is placed on one shoulder and held in position by axillary straps. The iron admits of adjust- ment. It is a good instrument for slight cases of wry-neck when the head leans to one side, by reason of contract-ions, lesions of muscles, or burns, but when accompanied by tortuosity of the vertebra, it is not as efficient as Markoe's brace. This has been improved upon by Dr J. E. Wood. See Fig. 48, Supplement. Measurement for Tiemann S Cd^s. Wry -Neck Brace 1. Patient's name (or sex). 2. " age. 3. Head leans to rigJit or left side ? 4. Circumference of the neck, 5. Length of the neck at side from clavicle to mastoid process, 6. (Circumference of chest under axilla. inches. Part IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfap.re Fig. 14. Davis's Apparatus for Caries of the Spine, Price, $20. {Extracted from Hamilton'' s Principles and Practice of Surgery.) '' The principles which ought to govern the construction and application of mechanical supports, in cases of caries of the spine, are the greatest degree of lightness, compatible with the requisite firmness, accurate adaptation ; pressure in opposing directions upon the spinal column, sufficient to insure support and stead- iness, and to transfer, in some degree, the weight of the spinal column from the affected vertebrae to their corresponding oblique processes, while at the same time these vertebrae shall not separate from each other in a manner to defeat the end desired, namely, their final union and consolidation by callus ; the pressure being so applied on either side of the spinous processes, and not upon the processes themselves, so that it shall cause the least pain and not endanger ulceration or excoriation, giving support to the tumid or pendulous belly; interfering in no way with the free motions of the arms or legs. These indications we find more or less completely fulfilled in the apparatus of Davis, Bigg, or Taylor." Fig. 14. Fig. 15. Fig. 16. Fig. 16. Taylor's Apparatus for Caries of the Spine. Price, $24.00 to $30.00. Measurement for Davis's or for Taylor'' s Apparatus for Caries of the Spiiie {Pott''s Disease). 1. Patient's name (or sex) 2. " age. 3. " weight (estimated). 4. Distance from sacro lumbar articulation to vertebra proniinens (C to D), inches. 5. Distance from sacro lumbar articulation to first vertebra involved (C to G), 67 CHATHAM STREET, NEW-YORK, 9 Branch Store, 107 East 38th St., N. Y. 6. Distance from sacro lumbar articulation to last vertebra involved (C to D), inches. 7. Distance from crest of ilium to axilla, right side, (A to II), . " Do. do. leftside, " . . " 8. Distance from the cenrre of one scapula to the centre of the other (E to F), . . . . . . " 9. Horizontal (transverse) diameter of the protuberance, . . " 10. Circumference of chest under axilla (II). . . . . " 11. Circumference of Pelvis one inch below the iliac crests, . . " Abdominal Supporters and Trusses. Fig. 17. UmlDilical Bandages. Price, $6.00 to $8.00. These Bandages are made of linen, satin-jean, or canvas, with hard pads of wood, cork, lead, etc., and with soft pads made of sponge, horse-hair, or of India rubber, inflated with air. Fig. 18. Chase's Umtiilical Truss. Price, $4.00. Has a hard wooden pad, and is a comfortable ap- pliance for corpulent per- sons, having the advantage of being light and cool, making it comfortable for summer wear. Fig. 19. Bow Spring UmlDilical Truss. Price, $5.00. The spring of this truss is made in form of a bow, the convex side of which, supporting the pad, is ap- plied t© the rupture. It is forced to conform to the shape of the body by draw- Part IV. 10 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. irjg on the straps on either side, which are then buckled just tight enough to be comfortable. Thej are made with soft or hard pads. Fig. 20, Children's Bow Spring Umbilical Truss, Price, $2.50 to $3.00. Fig. 21. Children's Umhilical Truss. Price, $2.50 to $3.00. G. TIEMANN ««. CO. Crescent Spring, and with Soft or Hard Pads. CHILDREN'S UMBILICAL BANDAGES, $2.00 to $3.00. Fig. 22. Bow Truss, Single, Wooden Pad. Price, $3.50. J^p^ The order for an Umbilical Bandage or Truss should be accompanied by the following Measurement : 1. Diameter of the protuberance. 2. Circumference of the body at the Umbilicus. Pakt ly. 67 CHATHAM STREET, NEW YORK. f^ Branch Store, 107 East 28th St., N. Y. Pig. 23. Ratchet Truss, Hard or Soft Pad, Price, $4.60. Pig. 24. Best Prencli Truss, Single, Soft Pad. Price, $4-.00 to $5.00. Pig. 25. Best Prencli Truss, Double, Soft Pad. Price, 16.00. jjj^^ For a Trnss, measure around the pelvis and describe the rupture. Trusses carefully litted. A lady will wait on lady customers at the Branch Store, 107 East 28th Street. l^ART IV. 13 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 26. Chase's Truss, Cedar Pad. Price, $4.()0. Fig. 27. French Adjustahle Truss, Soft Pad. Price, l-i.50. Fig. 28. German Truss, Soft Pad. Price : Sino:le Truss, $3.00 ; Double Truss, $4.50. C. TiEMANN Si. C 1^^ For a Truss, measure around the pelvis, and describe the rupture. Trusses carefully fitted. A lady will wait on lady customers at the Branch Store, 107 East 28th Street Paet IV. 67 CHATHAM STREET, NEW-YORK. jg Branch Store, 107 East 28ti£ S'i., N. Y. Fig. 29. Best Common DouTdIg Truss, Soft Pads. Price, $4.00 to $5.00. '.22JI NNVW3I1 -O Pig'. 30. Hull's Truss, Soft Pad. Price, $2.00. G. TIEMANN &, CO. Pig. 3L Self- Adjusting, or Ball and Socket Truss. Single, Soft Pad. Price, $3.00 to $5.00. 1^" For a Truss, measure around the pelvis, and describe the rupture. Trusses carefully fitted. A lady v/ill wait on lady customers at the Branch Store, 107 East 28th Street. Part IV. 14 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pkarre. Fig. 32. Self- Adjusting, or Ball and Socket Truss. Double, Soft Pad. Price, $B.()U to $8.00. Fig. 33. French. Adjustable Truss, Double, Soft Pads. Price, $8.00. Fig. 34. Tiemann ^ Co.'s Finger-Pad Truss. Price, $5.00. For a Truss, measure around the pelvis, and describe the rupture. Trusses carefully fitted. A lady will wait on lady customers at the Branch Store, 107 East 2Sth Street. Pai?t IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y, 15 Fig. 35. Dr. Folsom's Hew Truss. Price, $20.00. {Extract from Medical Record^ New Yorh^ " This instrument consists of a back -plate of metal, which rests npon the flat surface at tbie upper part of the sacrum. To this are hinged two arms of steel, which curve around the pelvis just below the crest of the ilium, to avoid the action of the glutei muscles, but fitting very accurately to the shape of the body. To their extremities are attached the pads, upon which they exert such moderate pres- sure as will ensure safety in each particular case, without aggravating the condi- tion intended to be relieved. The necessary adjustment of curve is, therefore, given in each case, by the hand of the surgeon, before tempering and finishing the instrument. In no other way can the same degree of firmness and efiiciency be obtained. The two pads are connected by a single strap, buttoning on studs at their upper part. A double truss is used in every case of hernia." " The Truss is plated with nickel, and instead of being covered with any absorptive material, is worn over a silk handkerchief or flannel bandage." Pig. 36. Dr. Schuppert's G-alvanic Truss. Price, $15.00 to 1^" For a Truss, measure around the pelvis, and describe the rupture. Trusses carefully fitted. A lady will wait on ladj customers at the Branch Store, lOY East 28th Street. 16 Part IV. GEO TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Fig. 37. Bow Spring AlDdominal Supporter. Price, $4.00 to $5.00. Fig. 38. Fitch's ATDdomiiial Supporter. Price, $4.00 to $6.00. Fig. 39. Eugene ATDdominal Supporter. Price, $6.00. jj^^ The order for an Abdominal Supporter sliould be accompanied with the measure around the pelvis. Supporters and Trusses carefully fitted. A lady will wait on lady customers at the Branch Store, 107 East 28th Street. Pakt IV. 67 CHATHAM STREET, NEW-YORK Branch Store, 17 107 East 28th St., N. Y. Fig. 40. London AlDdominal Supporter. Price, $5.00. Fig. 41. Abdominal Bandage. Price, $6.00. JlJIiiiiiiiliiiiiiiiiiliiiiiiiiiiiiiiliiiliiliiliiiiiSili hliilll!liill!ili;. iji,^ ,;: , ' , , ; : ' . . ■ ,i r.''!', '. . . ■ i ■ Fig. 42. Noeggerath's 43. Thomas' 44. Silk Elastic Belt. Price, I 6.00 GE0.TIEIV1ANN&C° N.Y. Price, $ 8.00 Price, $ 12.00 to 16.00 1^^ The order for an Abdominal Supporter shonld be accompanied with the measure around the pelvis. Supporters and Trusses carefully fitted. A lady will wait on lady customers at the Branch Store, 107 East 28th Street. Part IV. 18 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. We have on hand cotton elastic abdominal helts, canvas riding belts, satin-jean" abdominal belts, etc. ; also Braints', Phelps', Duo-as', Scanzoni's, the Boston, and a variety of other supporters, and make to order any other pattern desired. Cotton ELastic Abdominal Belt, Braun's Abdominal Supporters, Phelps' Abdominal Supporter, Dugas' Abdominal Supporter, Boston Abdominal Supporter, Riding Belts, with stays, lined with chamois, Canvas Abdominal Belts, Satin-jean Abdominal Belt, rice. 8.00 6.00 5.00 5.00 6.00 5.00 4.00 6.00 Measurement for ISupporters : 1. Circumference at the iliac crests, - - inches. Supporters and Trusses carefully fitted. A lady will wait on lady customers at the Branch Store, 107 East 28th Street, Branch Stoke Part IV. 67 CHATHAM STREET, NEW-YORK. ]07 East 28tji St., N. Y. 19 Fig. 45. Prolapsus Ani and Pile Supporter. Price, $ 8.00. Fig. 46. Miliano's Compressor for Varicocele, Swelling, etc., of the Testes. We keep in store a lartre assortment of Suspensory Bandages of ail kinds and patterns, made of silk, linen, cotton, leather, etc. Part IY. 20 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. r. A. Stohlmann Edward Pfarre. SUSPENSORY BANDAGES. 46. Miliano's Compressor for Varicocele, etc., Cotton Suspensory Baudage, - Linen Suspensory Bandage, Silk Suspensory Bandage, Elastic Suspensory Bandages, PRICE $2.00 .50 to .75 .75 to 1.25 1.50 to 5.00 2.00 to 5.00 Figs. 47, 48, 49, 50. Urinals for Incontinence. Fig. 47. Fig. 48. Fig. 50. Fig. 47 is Tiemann & Co.'s instrument for inverted (Extrophy of) bladder. It consists of a metallic or hard rubber shield, to the lower extremity of which is attached an elastic tube leading to a soft rubber pouch, to collect the urine. This is buckled to the thigh, or may be carried down to the boot. Figs. 48, 49, 50, represent soft rubber urinals for incontinence of urine. We have various other patterns for males and females of English, Freiach and American make. 47. Tiemann & Co's Instrument for Extrophy of the Bladder, 25.00 to 75.00 48. India Rubber L'rinal, male, plain, .,.-.. 2.50 The same, male, best, ...... 4.00 49. India Rubber Urinal, male or female, . . . 4.50 to 9.00 50. India Rubber Urinal, male, . . . 2.50 to 5.00 Paet IV. 67 CHATHAM STREET, NEW YORK. 21 Branch Store, 107 East 28th St., N. Y. Fig. 51 Apparatus for Un-united Fracture, of the Humerus. Price, $35.00 to $70.00. The object of this instruinent is to restore an arm to usefulness, which has been deprived of the power of motion by reason of ununited fracture, or of resection of the humerus. This is accomplished by substituting an external lever, upon which the muscles can act, for the injured bone. A brass cap, well padded, is acourately fitted to the shoulder, and kept in place by axillary straps and suspenders. To this cap we attach, by means of a sort of universal joint, a concave steel bar, covered with leather, fitting the arm, and buckled thereto, just above the elbow-joint, and as high up as may be necessary. With the aid of this apparatus a person can use his arm in many directions. In order to make this appar- atus fit well, the patient must either visit us for adjustment, or, if this is inconvenient, the sur- gical attendant must send us an accurate plaster- paris cast of the shoulder, and the following in- formation and Measukements : 1. Patient's name (or sex). 2. Right or left arm ? 3. Length of the arm from axilla to forearm when flexed, 4. Length from shoulder to elbow, 6. Cireum'ference of the arm above the elbow, 6. Circumference of chest under axillae, .- Fig. 52. A Substitute for the Hand. By David Prestce, M. D., Jacksonville, 111. Price, $60.00. (From Medical Record, N. Y.) "It has been a desideratum to provide a substitute for the hand which will enable a person. to hold a pen or pencil, and with the same instrument to grasp the handle of a hoe or shovel. In 186-i I explained my plan to Mr. Stohlmann, of the firm of Tiemann t% Co., of ]^ew York. Mr. Stohlmann entered with enthu- siasm into the idea and produced an instrument which combined the two points of usefulness, the capability of grasping small objects like pins and pencils, and objects of considerable size, like the handle of an axe or hammer, a whip, &c. A conception of the instrument will readily be obtained by a glance at the cut. The apparatus a is fastened to the investment of the limb by means of a screw, 22 Pabt IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. ■ Edward Tfarre. and, hj aid of the other band, it may readily be repLaced by a fork, if it is not preferi-ed to liold the fork in the grasp of the insti-umeut, or a gloved hand can be screwed on in place of the useful instrument. The fenestrnm b is for holding a whip or hammer, and its size is regulated by a screw so as to iit objects of different sizes. Small objects are held in the fork at the ends of the apparatus, and by screwing down more or less the lever which constitutes one side of the fenestrnm, the grasp can be accommodated to the size of a needle or a pencil. The instrument is represented in the cut as not quite closed, for small objects. The screw, which constitutes the shank of the instrument, is so arranged that it can be made stationary, a necessary condition in holding a whip or a hammer, or left to rotate, as would be necessary in holding the handle of a plough. It will be seen that the instrument has great variety of adaption. There are elastic, sti-aps cg attached to the investment of the arm, and to a shoulder-cap d, and passed around the chest to prevent the whole apparatus from sliding off in pulling or in carrying a weight. The instrnment is very far from being an adequate substitute for the natural hand, but it is believed that it combines the utility of a grasp for large objects com- bined with the capability of holding small things better than any instrument which has yet been devised.^^ An order for Prince's Substitute for the Hand should be accompanied by the tollowing : MEAStOREMBNT I 1. Right or left arm. inches. 2. Distance from shoulder to elbow, . . . '' 3. Distance from elbow to the extremity of stump, " 4. Distance from axilla to elbow, . . , " ' 5. Distance from axilla to extremity of stump, . . " 6. Circumference of wrist, . . . , " Y. Circumference of forearm, . . . . " 8. Circumference of arm, . . . . . " 9. Circumference of chest, . . . . , " " 10. Length of the sound arm, . . . . " ' 11. A pencil sketch of the size of sound hand. Part IV. 67 CHATHAM STREET, NEW-YORK. 23 Branch Store, 107 East 28th St., N. Y. Fig. 53. Apparatus for False Anchylosis of the Elhow-joint, Price, $18.00. The apparatus here represented is for the gradual extension of contracted muscles. By persistent and daily passive and active exercise, a flexible and useful joint may be restored, it may also be used for forcible break- ing up of false anchylosis, if the surgeon prefers this to gradual extension. It forms also a safeguard against malposition, for should it be deemed impossible to effect a cure, the arm may be fixed in such a position to anchylose as shall give it the greatest usefulness. lEMANN&OO Description and Measueement. 1. Right or Left Arm. Length from wrist to elbow-joint {A to C), Length from wrist to axilla (A to D), Circumference of wrist (A), Circumference of forearm (5), Circumference of elbow-joint {€), Circumference of arm {!)), Fig. 54. Glove for Paralysis of the Hand and Fingers, Price, $20.00 to $30.00. This apparatus, made of strong yet pliable material, reaches about two inches above the wrist, and is ar- ranged to lace snugly, to prevent displacement. Five india-rubber cords, acting as artificial extensors, are distributed along the back of the fingers and thumb. The ends of these cords are provided with hooks which take hold of loops at the extremities of the fingers and thumb, and of chains connected to straps at the wrist. These artificial muscles act independently one of the other, and their strength can be regulated by hooking them to the chains so as to make them more or less tense. They are passed through loops to prevent their slipping out of place. Description and Measurement. 1. Right or left hand. 2. Lay the hand on a sheet of paper and trace the out lines with pencil, as far as the glove is to reach. 3. Circumterence of the wrist. 4. Circumference of the hand anterior to the thumb. Part IV. 24. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. S6. Apparatus for Preventing Dislocation of Shoulder-joint. Price, $6.(10 to $9.00. Tliis apparatus is to be worn after re- duction of a dislocated liumerus, to f^uard against a recurrence, and also for the pur- pose of relieving permanent dislocation arising from a laxity of tlie ligaments, or from paralysis of tlie deltoid and scapular muscles. It is made of satin-jean with a leather shoulder-cap. Directions for Measurement. 1. Patient's name. 2. Patient's weight (estimated). 3. Right or left shoulder. 4. Circumference of the arm. 5. Circumference axilla to acromion. 6. Circumference of chest under axilla. Dislocation at the Shoulder- Joint. — Dislocation at the shoulder may be very conveniently reduced by causing the patient to mount to a convenient height on some "steps," placing his arms across the top step, upon which is placed a pillow. The top step acts as fulcrum, and the weight of the patient's body answers to a great extent as counter-extension. — Dr. G. Hamilton. Pig. 56. Sir Astley Cooper's Apparatus for Dislocated Clavicle. Price, $5.00. G. TIEMANN &C0 Supporters and Trusses carefully fitted. A lady will wait on lady customer? at the Branch Store, 107 East 28th Street. Part IT. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 2Htu St., N. Y. 25 Aparatns for tlie Treatment of Deformities and DeMlities of tlie Lower Eitremities. Fig. 57. Extension for a Short Leg. Price, of brace, $9.00.* For a short leg, the result of infantile paralysis, when the bones have not kept pace in growth with those of the corresponding extremity, we make an extension to correct the patient's limp, and to guard against the danger of spinal curvature. The apparatus consists of a steel frame of proper height, securely fastened under a plain shoe. The steel base has a leather sole attached, to avoid noise when walking on pavements, stone or wooden floors, and to prevent falling on slippery ground. These extensions are light and comfortable. See also Figs. 58 and 59. Directions Foe Measurement. 1. Have the patient (both feet bare) stand np, place books or blocks of wood under the short foot until the shoulders and pelvis are in a horizontal plane, then mea- sure these books or blocks, which will be the height required for extension. 2. Send us a well-fitting shoe. 3. Right or left leg ? Fig. 58. Extension for a Short Leg and Brace for Weak Ankle comhined. Price, of brace, $18.00.* If shortness of a leg is accompanied with inability to bear the weight of the body, the muscles being too weak to keeu the ankle straight, the simple contrivance described (Fig. 57) is not sufficient, and the apparatus," as shown by Fig, 58, will be required to support the joint. (This is in reality the apparatus Fig. 57 and Fig. . 60, combined.) Directions for Measdrement. 1. Heighth of the extension as directed for Fig. 57. 2. Right or left leg? inches. 3. Distance from sole to ankle-joint, . . " " 4. Distance from sole to calf, . . " 5. Circumference of calf, . . . " 6. Send us a well-fitting laced shoe. If we are to furnish shoes, send the following measure : a Length of sole of foot, h Circumference of ball of foot, Circumference of instep, d Circumference alcove the ankle, * Shoes are charged extra, according to quality. 26 Part IT. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. Edward Pfarre. F. A. Stohlmann. Fig. 59. Bigg's Instrument for Short Leg. Price, $35.00. This iiistrutuent is very useful where shortening of the limb is the result of anchylosis of the knee- joint. It is a modification of Bigg's, and consists of a thigh trough, well padded, and attached to a strong steel stem, bifurcating below the knee, and running down the side of the leg, terminating in a socket which is filled up with a rubber bottom to rest on the ground. The thigh is secured into the apparatus by straps and buckles. The weight of the body is trans- mitted to the ground by the side stems in a vertical line, without straining the knee. For further comfort, the knee may be kept in place by a knee-cap. A strap is passed over the middle of the leg, whilst the foot rests on a swiveled plate placed between the bifurcated stem. Directions fok Measurement. Patient's name. Right or left leg ? Length from sole of foot to knee-joint. Length from knee-joint to upper third of thigh. Circumference of the thigh, .... Circumference of the calf, ..... Degrees of the angle of flexion, . . . . Distance from the heel of the patient's shoe to the ground when standing erect, .... Fig. 591d. Steel Soles for Flat Feet. Price for one sole, $2.50. Price for a pair, $5.00. For flat feet we make a plain steel sole well tempered, and shaped to approach an ideal arch of a foot. These soles are covered with buckskin and fastened inside of a common shoe with a single screw. They afford a person afflicted vvith flat feet immediate relief They should be thin to yield a little, but strong enough to keep the bones arched In ordering the steel sole for flat feet, state if they are wanted for the right, left, or both feet and send the shoes or outlines of the soles of the shoes traced on paper. Paet IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28tu St., N. Y. 27 Fig. 60. Apparatus for the. Support of Weak Ankles. Price of a brace, for one leg only, $8. to $10.00 Price for a pair of Braces, $16. to $20.00 1^^ Shoes are charged extra according to the quality. These instruments are used to maintain the position of the foot, ufter tlie relief of valgus or varus by the regular clubfoot shoe, and also for correcting simple lateral inversion or eversion of the ankle-joint, resembling varus or valgus, commonly called weak ankle. We attach, by means of three rivets, to the sole of a common laced shoe, a lateral stem, jointed at the ankle (a), passing as high as the centre of the calf, and here fixed to a band (5).* The ankle is supported and kept in its corrected posture by a triangular Y-shaped leather strap (c) acting against and buttoned to the steel stem on the opposite side. The best direction for selecting the side on which the instrument should be applied, is, that if the outer ankle has a tendency to eversion, the apparatus should invariably be placed to the inner side, and vice versa. In obstinate cases it is made with double stems, in order to give greater secu- rity, and to keep the sole in a strictly horizontal plane ; the ankle may be further protected by a small round soft pad, to prevent chafing against the steel. In ordering the apparatus, send the description and measurements as directed on the next page for apparatus. Fig. 62. Pig. 61, Talipes Eq^mnus. Pabt IV. 28 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 62. Apparatus for Weak Ankle and Contracted Tendo Achillis. Price of a brace, for only one leg, $8 to $12.00 Price of a pair of braces, $16 to $24:. 00 IJ^^ Shoes are charged extra according to quality. (talipes equinijs.) Should there be contraction of the tendo achillis, and consequent dropping of the toes, it is conveniently corrected by means of an artificial elastic muscle, one end of which is fastened to tlie sole of the shoe (Fig. 62), the other to the calf-band (J) ; it may be regulated to any degree of tension by means of a buckle (' 3. Circumference of instep (c), _ _ _ _ " 4. Circumference of ball of foot (a), . . . _ " 5. Circumference above ankle (h), . . . . " 6. Length from sole to upper part of calf {d) . - « Y. Eight or left foot? 8. Talipes — varus or valgus? Pakt IV. 30 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. € TJEWIANN&CO" Fig. 64. Dr. L. A. Sayres' Improved Ball and Socket Clubfoot Shoe. Price of a single Shoe, complete, $ 10. to 14.00. Price of a pair of Shoes, complete, $ 20. to 28.00, according to size. The accompanying drawing (Fig. 64) and explan- ations give a very correct idea of its construction and modes of action. A cushioned iron cap to receive the heel, the leather covering of which is carried over the instep and ankle, and fastened by lacing. Elastic tubing {IV) to go in front of the ankle-joint, to further secure the heel in position, and fastening at (C) an iron hook on outside of heel-cap. Sole of shoe (D), cush- ioned, and laced securely in front of the medio-tarsal articulation. Ball and socket-joint {IE), connecting sole with heel. Elevated plate of iron {F), properly cush- ioned, to make pressure against base of first metatar- sal bone. Steel bars {G), connecting the shoe with strap {H) to go around the calf. Joint {K) opposite the ankle. Stationary hooks (Z), opposite the toes, for attaching the india-rubber muscles {M M M). These india-rubber tubes have chains attached, and are for the purpose of making flexion and eversion. This shoe has been made more comfortable and convenient by a slight heel, and by making the upper leather nearly like that of an ordinary shoe, and not so clumsy as the primitive clubfoot shoe. The upper leather adapts itself more perfectly by lacing than if arranged Avith straps and buckles. This shoe, as pictured above, is an-anged for valgus or varus. There is really no essential difference, only observe the principle to apply the artificial muscles in such Dosition as shall best supply the place of those paralyzed. Measueements : 1. Length of sole of foot, . . . . Inches. 2. Circumference of calf, . , = . " 3. Circumference of instep, . . . . " 4. Circumference of ball of foot, . „ . " 5. Circumference above ankle, . . . . «« 6. Length from sole to upper part of calf, . , " 7. Right or left foot ? 8. Talipes — varus or valgus? Sayres' Chains and Tin Splints always on hand, Fig. 76. . Hip-joint Splints, Fig. 82. Rubber Tubing for Artificial Muscles, per foot, 12 cents. Knee-joints, Fig, 93, and Ankle-joint Splints, Fig, 98, always on hand. Wire Loops and Hooks, price each 10 cents, Paht IV. 67 CHATHAM STREET, NEW-YORK. 31 Branch Store, 107 East 28tu St., N. Y. Fig, 65. Talipes Valgus. Fig. 66. Talipes Calcaneus. Fig. 67. Apparatus for Talipes Calcaneus. Price for a brace, for one leg only, $10. to $12. Price for a pair of braces, $20. to $24. This instrument consists of a pair of steel stems, fast- ened to a shoe, provided with joints at the ankle, and secured to the leg with a calf-band. A sti-ong elastic cord, or webbing, is fastened posteriorly to the calf- band above, and to a spur-like piece of steel at the heel of the shoe below. By drawing this cord tight, the uplifted sole is faced downward, and the strain on the tendo achillis is diminished ; at same time the contracted muscles in front of the leg are extended. Fig. 68, Apparatus for Talipes Calcaneus. Price of a brace, for one leg only, $10. to $12. Price of a pair of braces, $20. to $23. Fig. 68, shows the same apparatus with this differ- ence: instead of the cord, or elastic webbing contracting posteriorly in Fig. 67, we have a Steel Spiral Speixg, placed on a pivot and playing between brackets of the leg and ankle stem, to depress the front part of the foot by extension. There is not so much danger of falling with this apparatus, when descending stairs, the spurs, shown in Fig. 67, being dispensed Avith. Measures for figs. 67 and 68, see next page. Sho^s are charged extra according to quality. Part IV. 32 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. 1. Patient's name. 2. Patient's weight. 3. Patient's age. 4. Right or left foot. Inches. 5. Length from sole to ankle-joint, ..." 6. Length from sole to calf, . . . . '' 7. Circumference of calf, . . . . " If Ave are to furnish shoes, the following measures are required in addition a Length of the foot, . . . Inches, b Circumference of ball of foot, ..." G Circumference of instep, . . . . " d Circumference of ankle, . . . . " Fig. 69. Apparatus for the Support of Weak Legs. Price of Apparatus for adults, $35. to $70.00. Price of Apparatus for children, $25. to $35.00. This apparatus is for the support of weak legs, when, by reason of relaxed joints, softening of the osseous struc- ture, or partial paralysis, they cannot quite bear the weight of the body; but where the muscles still retain some power to perform their respective functions. Yery light steel springs are secured to shoes, and carried up the sides of the legs and to the pelvis. They are provided with joints corresponding to the natui'al ones and secured to calf, thigh, and pelvis by well-padded bands and buckles. Measures required : Inches. 1. Patient's name. 2. Patient's age. 3. Length from sole of foot to ankle-joint,. . . " 4. Length from sole of foot to knee-joint, . . " . 5. Length from sole of foot to hip-joint, . . , " 6. Length from sole of foot to iliac crests, . . " 7. Circumference of pelvis one inch below iliac crests, , " 8. Circumference of thigh, . . . . " 9. Circumference of calf, . . • . , . " Send well-fitting laced shoes, or if you wish us to furnish them, the following measurements : a Length of sole of foot, . ... Inches. h Circumference of ball of foot, . . . . " c Circumference of instep, ..".•" d Circumference above ankle, , . . . " m^" Shoes charged extra, according to quality. Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store. 107 East 28tji St.. N. Y. 33 Fig. 70. Apparatus for Partial Paralysis of the Leg or Thigh. Price of tlie apparatus for one leg, full length, as shown in fig. 70, $25. to $30. Price of the apparatus, for both legs, full length, $30. to $60. According to size and workmanship. Shoes extra. «» ^ In cases of wasting palsy, or when certain groups of mus- cles become atrophied losing the power to perform their functions, an apparatus as shown, Fig. 70, suited to the case, should be worn. The muscles are excited into action, and aided by artificial substitutes made of elastic rubber or steel, placed on the instrument so as to gently exercise the affected parts. This will often recall them to a sense of their duty. Directions for Measurement: Inches. 1. Patient's name. 2. Patient's age. 3. Right or left leg. 4. Length from sole of foot to ankle-joint, 5. Length from sole of foot to knee-joint, 6. Length from sole of foot to upper third of thigh, 7. Circumference of calf, .... 8. Circumference of knee, . 9. Circumference above knee, .... 10. Circumference of thigh, .... Send laced shoes. If you wish us to furnish shoes, the following additional meas- urements are required : Inches. a Length of sole of foot, . . . , & Circumference of ball of foot, c Circumference of instep, • . . . " d Circumference above ankle, . . . , " If both legs are of equal length the above apparatus is suflficient ; but if the affected limb is shorter than its fellow, the extension apparatus, Fig. 57, must be combined with it, this will add $8.00 to the price above stated. PHYSICIAN'S POCKET MEDICINE CASES, Designed for SQUIBB'S STANDARD PHARMACEUTICAL PREPARATIONS, By ROBERT M. FULLER, M. D., New York. See page 126, Part I. 34 Part 1Y. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 71. Apparatus for Hemiplegia. Inches. Price of apparatus, for one lea^, %'?><). to The apparatus represented bj Fig. 71 is for hemiplegia, affecting the limb to tlie hip-joint. We have often had occasion to make it, and found it to answer a good purpose, both as a support, and in aiding the restoration of the mobil- ity of the muscles. It answers to the same description as Fig. 70; but is carried up to the pelvis. On to a broad steel pelvic band we fasten the artificial muscles for flexion or extension, as the case may require. It may also be worn with good re- sults after treatment of hip-joint disease, when, by adding a per- ineal band, the weight of the body is borne by the apparatus. Send the Following Measurements : 1. Patient's name and description of the case. 2. Patient's age. 3. Right or left leg. 4. Length from sole of foot to ankle-joint, 5. Length from sole of foot to knee-joint, . 6. Length from sole of foot to trochanter-major, 7. Length from sole of foot to crest of ilium, 8. Circumference of calf, 9. Circumference of knee, .... 10. Circumference above knee, 11. Circumference of thigh, .... 12. Circumference of pelvis one inch below iliac crests, Patients will furnish their own laced shoes, or send the following additional measurements, if they wish us to furnish them : a Length of sole of foot, . . . Inches, h Circumference of ball of foot, . . " c Circumference of instep, . . " d Circumference above ankle, . . " Shoes extra. Fig. 72. Apparatus for Paraplegia. Price of apparatus for both legs, $35. to $70. Shoes extra. The apparatus for paraplegia answers to the same description as the one for hemiplegia, except that it is double. It is used when both the lower extremities are affected. A general description of the case is necessary to guide us in placing the artificial muscles in the right spot. The directions for measurements are the same as for the apparatus for hemiplegia. Fig. 7L Pakt IV. 67 CHATHAM STREET, NEW-YORK Branch Store, 107 East 28ti£ St., N. Y. S5 Fig. 73. Bow-leg Braces, Price for a pair of braces, $25. to $30.00. Shoes are charged extra, according to quality. The mechanical treatment of bow legs is very simple. 1. The bones in a softened condition, yielding under the weight of the body, must be as- sisted by extraneous help. 2. The arched bones must be restored to their normal condition. The instrument illustrated by the cut answers the pur- pose admirably. The support is given by double stems of steel (secured to a shoe) carried up as high as the thigh — jointed at the an- kle and knee to allow the patient perfect freedom of motion. They are kept in place by calf (a), and thigh-bands (b). The bow is corrected by pads (c) and (d) being placed re- spectively against the ankle and knee on the concave side of the limb, whilst a strap (e) passed ai'ound on the highest point of the arc, inside of the outer step, tightly buttoned to the steel bar on the concave side, gradually compels the leg to become parallel with it. In slight cases, or when the bow is greatest below the calf, an instrument carried up to (d) is sufficient. To insure a good fit, please, in ordering the apparatus, to send the following description and measurements. DiKECTIONS FOR Measukement : 1. Patient's name, or sex. 2. Patient's age. 3. Length from sole of foot to ankle joint (c), . 4. Length from sole of foot to knee-joint, inner side {d), 5. Length from sole of foot to knee-joint, convex or outer side {d), ..... 6. Length from sole of foot to upper third of thigh, inner side of leg (5), .... 7. Length from sole of foot to highest point of the arc (e), 8. Circumference of calf (a), .... 9. Circumference of thigh {b), Inches, Patients will furnish their own laced shoes, or send the following measure- ments, if they wish us to furnish them : a Length of the sole of the foot, b Circumference of ball of foot, c Circumference of instep, d Circumference above ankle, Inches. 16 Paut IV 36 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfakre. Pig. 74. Genu-valgum, or Knock-knee Brace. Price fur a pair of braces, $30. to $40. 1^^ Shoes, are charged extra, according to quality. The mechanical treatment of knock-knees requires a proper instrument of suffic- ient strength and yet not too heavy — to suit the condition of the patient. The one represented is tlie simplest and most effectual one of which we know. It con- sists (if the deformity be double) of two lateral stems, with joints at the ankles, knees and hips, extending from the heels of strong shoes (a) to a well-padded pelvic band \b). The pelvic band is made in two halves in order to admit of adjustment — the tightening of the posterior buckle everting the toes, that of the front buckle in- verting them. A pair of padded straps secured to each other cross- wise act in the following manner : End 1 is buttoned to the thigh stem (c), carried from behind, below the inner condyle, to the front, termin- ating in the end 2, which is buttoned to the leg stem The end 8 buttons to (c) is carried from the trout to the back of the knee, passing over the inner condyle, and secured to the button (d). In this manner they support both the head of the tibia and femur, whilst their combined direction of force being outwards grad- ually corrects the deformity.* Some surgeons prefer to have the apparatus without a joint at the knee, but is there not a risk of inducing anchylosis by too long retention of the limb in one posi- tion ? Besides, the patient is liable to fall with stiff splints, and is thus in constant danger of fracturing the bones of the thigh or leg. In ordering the apparatus, send the following description and measurements for knock-knees: 1. Patient's name. 2. Patient's age. 3. Length from sole of foot to ankle-joint, 4. Length from sole of foot to knee-joint, 5. Length from sole of foot to hip- joint, . 6. Length from sole of foot to iliac crests, Y. Circumference of pelvis 1 inch l)elow iliac crests, 8 nirpnm-fprPTicp of thiyh ate ( A stick to be placed on the out- O. \^ircumieiencc Ul LIU^II d,L c, j ^jde ofthe limb, and tliese two 9. Circumference of leg at C?, ( measures take., around both. 10. Ptight, left, both feet. Inches. ♦This instrument exerts very much more power, and answer better when provided with padded metal bands at the thigh (e) and calf (/') Part IV. 67 CHATHAM STREET, NEW YORK. Branch Store. 107 East 28th St., N. Y. 3Y If yoii wish us to furnish shoes, send the tbllowini^ udditional irieasureraents ; 11. Length of sole of foot, .... Inches. 12. Circumference of ball of foot, . ..." 13. Circumference of instep, . . , " 14. Circumference above ankle, . . . . " Fig. 75. Brace for Correcting Anterior Curvature of the TilDia. Price of a brace, for one leg, $12. to $18. Price of a pair of braces, $24. to $36. 1^^ Shoes are charged extra, according to quality. This cut is a fair representation of the instrument. It consists of two upright steel stems, fastened below to a shoe and terminating above in the calf-band. The deformity is corrected, either by passing a leather bandage around the stems and tightly lacing it in front over the arc of the curvature (a), or by a strap passed over the arc of the curvature and fastened to a spur suspended from the calf- band behind (c). The points of resistance being in either case the heel of the shoe (b) and the posterior trough of the calf -band (c). In ordering the apparatus, send the following partic- ulars and measurements: 1. Patient's name (or sex). 2. Patient's age. 3. Anterior curvature of the tibia. 4. Which foot? 5. Length from sole to ankle-joint, G. Length from sole to calf (c), .... " 7. Circumference of calf, ....." If you wish us to furnish shoes, send the following additional measurements: a Length of sole of foot, . . . . Inches h Circumference of ball of foot, . . . . " G Circumference of instep, .... " d Circumference above ankle, . . . . " Inches. Illustrated Price List of Clinical Thermometers Page 75, Part I. Pakt IV. 38 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Fig.' 76. Barwell's Attachments and Artificial Muscles for Ad- justing ClulD-feet. Price, Wire Eyes or Hooks, 10 cents, each. Tin Plates, with loops, each, 20 cents. Rubber Tubing for Muscles, per foot, 12 cents. Moleskin Plaster, per yard, $1.50. Club-foot cubed without Tenotomy. — The ordinary cause of deformity of the foot is not contraction of certain tendons, but paralysis of the muscles connected with the uncontracted ones. Hence division of tendons which retain their normal power is not the way to cure the deformity. The author's mode of treatment is to supply the place of the paralyzed muscles by means of elastic cords. By a light and simple contrivance, these cords are fastened to points as near the orio-in and insertion of the paralyzed muscles as possible, and the patient is encouraged to use his limb, while at the same time constitutional remedies are prescribed, and local means, such as friction, galvanism, &c., are employed. This treatment proceeds on the principle that our aim ought to be to strengthen weak parts, and not to weaken strong ones. The author has adapted his method to the treatment of knock-knees and crooked shins, and he has devised means by which spring force may be brought to bear upon these deformities in such a way as to draw the bones into a more natural position. ( Mr. E. Barwell, p. 124.) Fig. 77. Apparatus to Evert the Price $6. to $10.00. Price of apparatus, with Pelvic Band, $30. Shoes, are charged extra, according to quality. This apparatus answers well for in-door exercise, but patients cannot get up or down stairs, nor walk on uneven ground without being in constant danger of falling. An apparatus carried up to a pelvic band, made in two halves, answers this purpose better. This pelvic band admits of adjustment, the tightening of the posterior buckle everts the toes, whilst that of the front buckle inverts them. All our pelvic bands on the appa- ratus for the lower extremities are arranged in this manner, and answer the purpose very well. (See pelvic bands described on appa- ratus, Fig. 74:.) Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y. Fig. 78. Bigg's Apparatus for Bunions. Price for Apparatus, for one foot, $8. to $12. Price for Apparatus, for both feet, $16, to $24. This apparatus consists of a delicate lever of spring steel, with an oval ring in the centre, which is provided with hinges at its anterior and posterior margin. The apparatus is attached to the instep by a faced band, and the toe to the extremity of the spring by a piece of web- bing. It affords the articulation freedom of motion in the natural plane, whilst the malposition of the toe is gradually rectified by constant lateral traction. It can be worn in a shoe. Directions foe Measukembnt. 1. Place the foot on paper and trace with pencil. 2. Circumference of ball of foot, . Inches. 3. Circumference of instep, . . , . " 39 79. Apparatus for Over-riding Toes. Price of Apparatus, for ojie foot, $7. to $15.00. Price of Apparatus, for both feet, $14 to $30. The apparatus ibr over-riding, or "ham- mer toes," consists of a steel sole arranged with slits corresponding to the spaces be- tween the toes. A strap of webbing is passed through these slits and over the con- tracted toe (or over each and all, as the case may require), and buckled or tied under the sole, tense enough to straighten the toe. This apparatus is kept in place by a thin silk, linen or cotton covering, laced to the instep, and may be worn in an ordinary shoe. DiEECTIOJSS FOR MEASUREMENTS. Place the foot on paper and trace with pencil. Circumference of ball of foot, Circumference of instep. Inches. Dry Cupping for the relief of Rheumatic Pains, Paralysis, and Atrophy of Muscles. See Figs. 176, 177. Janod's Boot and Arm. Application of Cold and Heat for the treatment of Paralytic conditions. See Fig. 182. Hamilton's Eevulsor. See Electro Magnetic and Galvanic Batteries, &c. page 100, Part I. G-alvanic Belts and Soles, page 104, Part L Part IV. 40 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F, A. Stohlmann. Edward Pfarre. Fig. 80. Apparatus for False Joints in the Leg or Thigh resul- ting from Resection or Fracture of the Bones (Ununited) . Price of Apparatus, for children, $25. to $35. Price of Apparatus, for adults, $40. to $75. 1^^ Shoes, are charged extra, according to quality. This apparatus consists of two lateral steel stems, the inner one of these is carried to the upper third of the thigh, the outer one terminates in a pelvic band situated an inch l)elow the iliac crests. Calf and thigh- bands, made either of sole-leather nicely moulded, to the limb, or of sail-cloth, stayed by a number of steel springs, corset-like, and well-padded, connect the steel stems, which latter are provided with joints for the an- kle, knee and hip. The strength of these stems must be in proportion to the patient's weight. The leather or sail-cloth casing is required only at the place of the false joint, the other band may be softer and smaller, as convenient. If desired, the knee-joint may be made to remain stiff when walking, and flexible when sitting down, by merely touching a spring with the hand out- side the clothing. Directions foe Measurements. 1. Patient's name. 2. Patient's weight. 3. Right or left leg. 4. Position of false joint. Inches. 5. Length from sole to ankle, . . . . " 6. Length from sole to knee, . . . . " 7. Length from sole to crutch, (perineum), . . " 8. Length from sole to trochanter major, ..." 9. Length from sole to iliac crest, ..." 10. Circumference at 1st buckle, . Indies. 2d " . . » 3d " . . " 4th " . . " 5th " . . " 6th " . . " 11. Circumference of pelvis one inch below iliac crests, 7th bu ckle. 8th 9th , 10th 11th 12th Inches. If we are to furnish shoes, the following additional measurements are required; Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y. 41 a Length of the sole of foot, . h Circumference of the ball of foot, c Circumference of instep, d Circumference of ankle, Inches. Fig. 80b. Hooper's Knee Extension Apparatus. Price, $35.00. It consists of a band encircling the thigh, of an- other for the calf, and of one above the ankle. These are fastened to two lateral shafts provided with joints at the knee. Two semicircular brass tiibes, fastened to the loM^er calf shafts, contain each a spiral spring, acting on bows fastened to the thigh shaft, thus exert- ino- constant elastic extension, which is sure to over- to come muscular contraction soon. Directions foe Measurement Circumference above knee, " at knee, " below knee, " above ankle. Length from above ankle to knee, ' ' knee to upper third of thigh. Inches. Fig. 81. Davis' Hip-Joint Splint. Price of Splint, $15.00. Price of Adhesive Moleskin Plaster, per yard, $1.50. Davis' Portable Extension Apparatus allows mobihtj of the joint, while it diminishes friction of its surfaces. It is used in at- tempting to re-establish the natural functions of the part. The apparatus is to be worn when the acute stage is passed. Exten- sion is made from the foot, counter-extension from a two-fold peri- neal band, the outer one of which is inelastic, the other composed of elastic webbing, so as to allow extension to a certain point only, when the joint can be fixed. It is applied to the limb by means of adhesive plaster strips, secured with roller bandages. It is applic- able to either right or left leg. Directions for Measurement. Length from the ankle to iliac crest, • Inches. This is- the only measure needed, as the splint admits of con- siderable adjustment of length. pAltT IV. ^^ GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. ^^^.....^ Edward Pfarre. Fig. 82. Dr. L. A. Sayre's Apparatus for the Treatment of Hip- joint Disease. Price of splint, small size, $15.00. Price of splint, medium size, $16.00. Price of splint, large size, $18.00. This apparatus consists of two portions, the upper, made of corrugated steel, attached by means of a univer- sal joint to a pad of proper size (d) fitting on the dorsum below the crest of the ilium, and holding in place a peri- neal band (e) adjustable by strong -webbing and buckles {hh). The lower portion (/), is simply a ratched bar, sliding "within the first. Its inferior extremity is easily adjusted by means of a single screw to either side of two semi-cir- cular bands {aa), embracing the thigh just above the knee, making the apparatus answer for both limbs. The cut representing the same arranged for the left leg. Extension is made by working the splint with key /. Directions foe Measurement. 1. Length from trochanter major to knee-joint. Inches. 2. Circumference of thigh above knee, - - " G. TIEMANN &CD. The Application of the Splint, Is as simple as its construction. Take strong adhesive plastBr, spread on twilled muslin, cut two fan-shaped pieces (Fig. 83), one large enough to reach from the perineum to within two or three inches of the condyle of the femur, on the inner side of the thigh, the other from the trochanter major to a point directly opposite the end of the inner plaster. Sew on the narrow end of each (Fig. 83), a, one of the webbings, represented in Fig. 82, aa (not on the sticky side). Apply to their respective places, and after pressing them with the warm hand, to obtain a firm adhesion, secure them further by a well-adjusted roll- er. The instrument contracted, is now laid over the thigh, the web- bing (Fig. 83), «, firmly fastened over the rollers to the buckles (Fig. 82), aa, and the remaining one around the thigh. The perineal band is now adjus- ted, rather firm, and the instrument extended with the key, just enough to make the patient comfortable, and then locked by pulling the slide down over the spring ■ (Fig. 82), c. In order to prevent the limb from swelling below the bandage, Dr. Sayre recom- mends the use of an elastic stocking or knee-cap. Price of Elastic Hose, see fig. 101. Price of Moleskin Adhesive Plaster, per yard, $ 1.50. Part TV. 67 CHATHAM STREET, NEW- YORK. 43 Branch Store, 107 ICast 28th St., N.' Y. Figs. 84a. 841d. Hamilton's Wire Qanze Splint for Hip-Joint. Fig. 84a. Price, $15.00. Fig. Sih. The above splint consists of an iron wire frame, moulded to the outside or back of the pelvis and thigh, covered Vv^ith wire gauze. It is kept in place by a pelvic and a broad thigh-band, and secured with buckles. Dr. Hamilton advises its use whenever it is desirable to secure immobility of the joint, together with exercise in the open air. DiEECTIONS FOB MEASUREMENT: 1. Name of patient. 2. Age of patient. 3. Weight of patient (estimated). 4. Right or left side. 5. Crest of ilium to the condyles of the femur, 6. Circumference of the pelvis at iliac crest, . 7. Circumference at the nates, 8. Circumference of the upper part of the thigh, 9. Circumference of the thigh above the knee, . Inches. [J^°° Andrew's Morbus Coxarius Splint, Fig. 191. M Part IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Pig. 85. Bauer's Hip-Joint Apparatus. Price $25.00. 1^^ Slices are cliarged extra, according to quality. This apparatus affords extension in a vertical line, and com- plete immobility of the joint. By being fastened to the shoe it utilizes the foot for extension, the tuber ischii for counter- extension and the key rack and pinion for a moving power. [No adhesive strips are used with this apparatus. Directions foe Measurement: 1. Patient's name. 2. Patient's age. 3. Patient's weight (estimated). 4. Eight or left leg. Inches. 5. Length from the sole to the tuber ischii (sound leg) " 6. Length from the sole to the tuber ischii (diseased leg) " T. Circumference of calf, . . •. " 8. Circumference of thigh, . . . . " Send a shoe or the following additional measures if you wish us to furnish one : a Length of foot, h Circumference of ball of foot, c Circumference of instep, d Circumference above ankle. Inches Fig. 86, Bauer's Wire Breeches. Price of Wire Breeches, small size, $15.00. Price of Wire Breeches, medium size, $18.00. Price of Wire Breeches, large size, $25.00. Bauer's Wire Breeches are used after excision of the head and neck of the femur in necrosis, after the removal of shattered bone, or balls in gun-shot frac- ture, and in the treatment of chronic inflammation of the hip-joint when perfect rest and position of the affected parts ai-e desired. It consists of a heavy wire frame covered with wire gauze to fit the posterior half of the body from the axillary cavity to the sole of the foot. Proper sized openings may be cut through the gauze to admit of dressing any wounds, without being obliged to remove the splints. There is also an open- ing for the anus, so that the patient can pass his faeces by having the lower end of the apparatus raised and a bed-pan placed under it. The apparatus may be lined with cotton batting, and the patient securely fastened with adhesive Pakt IV. 67 CHATHAM STREET, NEW-YORK. 45 Branch Store, 107 East 28Tit St., N. Y. plaster strips and roller-bandages. After the feet arc secured to the foot-board, extension can be made by turning the thumb-screws from the healthy extremity. counter-extension being Directions fok Meabueement, 1. Patient's name. 2. Patient's age. 3. Patient's weight. 4. Length from sole of foot to axilla, Length from sole of foot to perineum, Circumference of calf. Circumference of knee, Circumference of thigh, , Circumference at the nates, 10. Circumference of pelvis at iliac crests, 11. Circumference of waist, 12. Circumference of chest under axillae. Inches. 5. 6. Y. 8. 9. Fig. 87. Taylor's Hip-Joint Splint. Price of Taylor's Hip-Joint Splint, small size, $25. to Price of Taylor's Hip-Joint Splint, large size, $35. to $40. This splint extends from the sole of the foot to the crest of the ilium, at which point it is connected to a pelvic band by means of a joint allowing flexioa and exten- sion, abduction and adduction: which latter motion is regulated by means of a thumb-screw. Extension is made by means of a rack and pinion rod, sliding within a steel tube, moved by a key, and kept in position by a spring catching the teeth of the rack. Counter-extension is made by means of two perineal pads fastened to the pelvic band with straps and buckles. At the knee-joint is a movable cross-piece for attaching a leather cap to steady and support the knee. At the bottom of the instru- ment is a foot-piece with a leather sole attached, to prevent jar in walking. A leather strap, passing under the foot, through apertures in the foot-piece, turns up an end on each side of the ankle, and fastens to buckles in adhesive strips, Avhich prepare as follows : Cut two pieces of plaster, to reach from the waist to the foot, from three to five inches wide at the top, and from 1 to 1^ inches at the lower end, and divide tops into five tails, cut a piece about live inches long, from each centre tail, and add it to the lower ends of the plaster to strengthen them, then add two or more similar pieces at the same place and attach a buckle. Apply the plasters against the lateral aspects of the leg, beginning, about two inches above the internal and external maleolii with the ends having the buckles attached. The centre tails reaching the entire length of the leg and thigh, to the perineum and trochanter respectively ; Part IV. 46 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. then wind the lower ends spirally around the leg up to the pelvis and afterwards FfG. 87. the other two tails, which first cut down to just above the knee. This involves the limb in a complete network of adhes- ive strips, the leg having about one-fourth, the thigh three- fourths thej'oof, which is found to be the proportion to pi'otect the leg and knee equally from compression or strain. A few turns of roller bandage are then made around the ankle, just under the lower ends of the straps, to protect the flesh under the buckles, and then continued over the strips on the whole limb. The patient should be laid on his back, and great care ought to be taken that the pelvis is not inclined forward by contractions of the flexor muscles; should this be the case : elevate the leg until the lumbar vertebrae come near the couch and the spinal column assumes its normal shape. The instrument is then applied. The pelvic-band ought to be loose enough to allow the pelvis to move freely in it. The anterior superior spine of the ilium ought to be above the pelvic-band. In applying the ankle straps leave a little space be- tween the foot and the footpiece so that in standing^or walking the weight of the patient does not rest on the leg, but on the instrument. The perineal straps must be so adjusted that the patient sets flrmly and comfort- ably upon them. The foot is dressed with a shoe in the ordinary manner. When all is adjusted the patient still lying on his back, extension is made by turning the key. As this arrangement, for supporting the patient on the instrument, increases the length of the aS'ected limb, the sound leg should have the same amount, or a little more, add- ed to its length by increasing the thickness of the sole of the shoe. 1. Name of patient. 2. Age of patient. 3. AVeight of patient. 4. Right or left leg. 5. Length from sole to crest of ilium. 6. Circumference of pelvis at iliac crests. Price of Adhesive Plaster Price of Moleskin Adhesive Plaster (spread on twilled goods) Price of Poller Bandaffe per yard. $ .75 " " $1.50 per pound $1.50 Paut IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28'jh St., N. Y. 47 Pig. 88. WashlDurn's Hip-joint Splint. Price, $7.00. This is a simple, straight bar of steel, jointed to a pel- vic band. It is intended for poor patients, and has neither racks, pinions, nor screws. Extension is made, after fas- tening the lower end with adhesive strips, simply by the degree of tensity to which the perineal straps are adjusted. A knee-cap assists in keeping the splint in place. Directions foe Measukements ; 1. Length from ankle to dorsum ilii, 2. Circumference of pelvis. Inches. Fig. 89. J. C. Hutchison's Hip-joint Apparatus. Price of Apparatus, small size, $ 25. Price of Apparatus, large size, $ 35. Pine Unished Apparatus, small size, $30. Fine finished Apparatus, large size, $ 40. Shoes are charged extra, according to quality. This apparatus is portable, and, being fastened to a shoe, needs no adhesive strips. Two rods of steel extend from the foot to the upper third of the thigh and are secured to the leg with calf and thigh-bands. The outside rod, longer than the other one, is ratched, and slides in a steel tube which is hinged by a ball and socket joint to a pel- vic band. To this pelvic band is attached a perineal strap for counter-extension. Extension is made by working the splint with a key. The splint is j^rovided with joints for the ankle and knee, the later one is adjustable to any degree of flexion and extension, and may bs fixed at any point or its motion limited, by an arrangmentof a screw and two Buts. Directions for Measurements: 1. Name of patient. 2. Age of patient. 3. Weight of patient. {J 48 Pai.t IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. 4. Eight or left leg. 5. Length from sole of foot to ankle-joint, 6. Length from sole of foot to knee-joint, 7. Length from sola of foot to trochanter major, 8. Len<;tli from sole of foot to crest of ilium, , 9. Circumference of calf, . 10. Circumference of thigh, 11. Circumference of pelvis, Inches. If yon wish us to furnish shoes, send the followinoj additional measurements! a Length of foot, h Circumference of ball of foot, c Circumference of instep, d Circumference of ankle, . Inches. Fig. 90. Long Anchylosis Apparatus. Price, $35.00. to $40.00. 1^^ Shoes, are charged extra, according to quality. For overcoming muscular contractions of the knee-joint, and for favoring the re-establishment of motion in cases of false anchylosis. It consists of metal troughs 1, 2, 3, for the reception of the thigh and leg, united by two lateral shafts, provided with joints at the knee and ankle and attached to a shoe. A knee-cap, adjusted to but- tons on the lateral shafts with strong elastic straps, exerts pressure on the patella, whilst the instrument may be flexed and extended by means of a key {g) and rachet-joint, opposite the knee. It is an admirable apparatus for the gradual exten- sion of contracted muscles and for favoring the re-es- tablishment of motion in cases of false anchylosis, and of remaining stifEness and dryness after treatment of joint disease. By persistent and daily passive exercise a flexible and useful joint may be restored without confining the patient to bed or room. The mechanism is powerful, and may be moved swiftly, adapting it to the forcible breaking up of adhesions as well, should the surgeon prefer this to gradual extension. If desired the instrument can be made to detach from the shoe, for the greater comfort of patients who are obliged to wear the apparatus continually, but wishing to remove the shoe at night. It is also the best guard against malposition, for should it be deemed impossible to effect a cure the limb may be placed in a situation (to anchylose) most conducive to its future usefulness. Pakt IV. 67 CHATHAM STREET, NEW-YORK. Branch Store. 107 East 28th St., N. Y. 49 DiKEOTlONS FOE MEASUREMENTS: 1. Patient's name. 2. Anchylosis apparatus, Fig. 90. 3. Right or left leg? 4. Patient's age. Inches. 5. Length from sole of foot to ankle-joint (a), . . " 6. Length from sole of foot to knee-joint (t^), . . ' 7. Length from sole of foot to upper third of thigh (/), " 8. Circumference above ankle (J), ..." 9. Circumference of calf {c\ . . . . " 10. Circumference of knee (, Fig. 108a), attached by a slide and thumb-screw to the mortice in the external splint, and capable of removal at pleasure. This is intended, first, to prevent a usual tendency to eversion of the foot; and secondly, by projecting a little beyond the toes, to take ofi^ the pressure of the bed-clothes." Application of the Apparatus. " Having laid the patient on a firm, unyielding mattress, covered, if you prefer, with one or two folded blankets, and measured the respective lengths of the sound and injured limbs, comparing the results of two or more measurements (from the anterior superior spinous process to the internal maleolus), shave the leg fi'om the knee to the ankle, apply a strip of adhesive plaster, three inches broad, and well warmed, to both sides of the leg, from just below the knee, allowing them to extend some inches below the sole of the foot. These free ends are to be warmed and smoothly stuck to a thin block a trifle wider than the ankle-joint, through holes on either side of which a strong cord is to be passed, to be attached to the hook or ring terminating the screw. A roller bandage is now to be applied from the foot to the groin, taking care to make considerable pressure over the adhesive strips. The long splint, having been adjusted to the length of the limb, and its cushion secured to it is to be placed along the outside of the limb, its top just reaching to the crest of the ilium ; then, having passed the pelvic band under the body, a guttered splint fur- nished with a thin cushion, long enough to extend from the tuberositv to thepoplit- 64: Part IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarrk. eal space, is to be passed mider the thigh. At the same time the perineal band, previously buckled to the iron brace, is to be passed under the thigh and adjusted in its proper place. The extending band is now to be secured to the screw, while an assistant is making moderate traction on the foot, and at the same time pushing up the long splint; the object of this being to tighten everything before commenc- ing extension with the screw, every turn of which will then give an increase of tension. If, after this, the splint is found to have been forced up a little higher than the crista ilii, the perineal band must be buckled at either end a little tighter, in order to rectify this. The inside splint may now be applied, and the concavity between its cushion and the leg a little more than filled up with folds of old blanket, or some such elastic material ; so that, when the splints come to be bound firmly together, the inner condyle of the femur may not be painfully pressed upon, a circumstance which causes great discomfort to the patient; a guttered splint a little longer than the posterior must now be placed on the anterior aspect of the thigh- and then all the splints with the enclosed limb are to be encircled with four strips of strong muslin or linen about an inch and a half wide, and long enough to pass twice around the splints and tie in a bow-knot, two of these for the thigh and two for the leg. The arrangement of these bands is of considerable importance, as it is thus that we are enabled to dispense with the old-fashioned splint-cloth, a very troublesome contrivance, and to keep the splints from tilting forward without it. One end is to be passed under the limb, then around it in front, under again, and around in front, to be there tied to the other end. In doing this, it is seldom requi- site to raise the limb sufiBciently to disturb the patient. These bands are now to be loosely tied ; and, having made a degree of extension, by means of a screw, corres- Part IV. 67 CHATHAM STREET, NEW YORK. Q^ Branch Store, 107 East 28'jh St., N. Y. ponding to tlie amount of shortening, the foot-piece is to be Bcrewed on so as to be HI apposition with the outer surface of tlie foot. The bands are now to be firmly tightened and tied ; and, if care lias been taken to keep the inner condyle from un- due pressure, they may be tightened to any required degree without any inconven- ience to the patient. Next, the wedge-shaped cushion is to be placed under the ap- paratus; and. finally, the pelvic band is to be tightened as firmly as the patient can comfortably bear. A patient nnder treatment with this apparatus can attend to the calls ot nature with very little inconvenience. He has only to raise his hips slightly with the aid of the leg and arm of sound side, wliile the bed-pan is slipped under him without deranging the apparatus in any degree. The peculiar arrangement of the perineal band secures it from being soiled, as it is removed from the immediate vi- cinity of the anus." Pig. 109. Bulge's Apparatus for Fractures of the Femur. Price, $ 50.00. For Instrnments to Operate on Fractured Bones, See onr Catalope, Part I. Bone Forceps, see Figs. 31, 39, 40, 41, 42, 43, 68, 69, 77, 79, 80, 81, 82, Bone Drills, Figs. 34, 35, 36, 50,61. Pereosteotomes, Figs. 37, 38, 70, 71. Saws, Figs. 1, 2, 3, 9, 16, 51, 52, 53, 54, 55, 57, 58, 60, 65, 66, 67, 78. Trephines, 47, 48, 49. Retractors, Figs. 62, 73, 74, 76. Mallet, Fig. 83. Chisels and Gouges, 84, 85, 86. Chain Saw Conductor, Fig. 60. Part IV. 65 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 110. Liston's Improvement of Mclntire's Splint. Price, $16.00. Liston's Splint is particu- larly applicable to the treat- ment of fractures of the condyles of the femur and of the upper extremity of this bone attended with a dispo- sition to displacement of the lower end of the upper frag- ment It may also be ad- vantageously employed in compound fractures attended with severe contusion and laceration of the integuments, as it affords an easy and comfortable position to the injured limb. It is applied to the limb by attaching the foot to the foot-board and the limb to the splint by a roller bandage. The angle of flexion is regulated by the screw. The splint is made of galvanized iron. We have on hand also, Inclined Plane Splints made of wood, see page 67. Fig. 111. Henry's Shears, (To facilitate the removal of plaster of paris dressing and starch bandages.) Price. $7.50. The illustration conveys a clear idea of the form and features of the instrument. The upper blade is heavy, with clean incisive power. The lower blade is longest and blunt-pointed, and made in the form of an elevator, which enables the operator to insinuate that point under the dressings, and, if necessary, press on the soft parts Part IV. 67 CHATHAM STREET, NEW- YORK. 67 Branch Store, 107 East 28th St., N. Y. beneath without doing any injury. He can then cut as easily througli the plaster of paris dressings as the tailor does heavy cloth with the ordinary shears. The handle is nearly at a right angle to facilitate movements, and adds to the cutting force." Seutin's Bandage Shears, Price $5.00. PRICE LIST OF CARVED WOOD SPLINTS. Double Inclined Planes, of wood, - - . . | Y.OO 8.00 9.00 Lining Splints, set of 20, -..___ $5.00 Leg and Ankle Splints, per pair, - - - - .. - 2.00 Forearm Splints, u a . . . , . 1,25 Elbow Splint, plain, ...-_,_. 1,50 Elbow Splint, jointed. - - - - - - - 2.50 Patella Splints, - - - . - - - - - 1.50 Radius Splint, -----.._ 1.25 Bond's Splint for Fracture of Radius, - - - - - 2.25 Clavicle Splint, -----_.. 4.0O Condyle and Humerus Splint, --_.._ iqq Large Extension Splint, Bar and Garter, _ , . _ 700 Short Extension, without screw, - - - - - - 3,00 Interosseous Splint, _ - . . _ . . 75 Joint Arm Splint, - - - - ... _ 3.00 Dressing Splints, per pair, ...... 125 Bass Wood Splints. Set of 12 Straight Splints, ---_--. i.oo Set of 12 Radius Splints, - - - ' - - - 1.25 Hatter's Board for Splinting, per yard, - - - - - 4.00 Gutta Percha for Splinting, per pound, - . , _ 3.00 to 4.00 Plaster Paris Splinting, see pages 83, 99, 101, 102, 103. Wire Splints, made to order. NEW FRACTURE DRESSHSTG. At the meeting of the Society, Dr. "Wackerhagen presented a new supporting material for frac- tured bones. It is prepared from plaster of Paris, shellac, glua and flannel. "When soaked in hot water, it becomes soft and flexible in about two minutes, and can be readily moulded to the contour of the injured limbs. It is applied over cotton wadding, and Avill become hard and supporting in five minutes after the applicatian of the roller. Dr. W. believes it to be superior to anything of the kind now in use, because of its lightness, the short time it requires to become hard and supporting, and the low price, when compared with felt or gutta-percha. It is prepared by Tiemann & Co. Dr. W. has left samples at the Rooms for inspection. — Proceedings of the Medical Society of the County of Kings, August, 1878. pat?t ly. 68 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohi.manx. Edward Pfarre. Apparatus for Fracture of the Patella. The object of all apparatus for fracture of the patella is to counteract the action of the extensor nuiscles, Avhieh have a tendency to draw the superior fragment iip- \vards, away from the lower. Some of the most efficient contrivances for keeping the fragments in coaptation are those sketched below. They are all simple, and will readil}^ be understood bj viewing the cuts Figs. 112 to 118. Fig. 112= Turner's Apparatus for Treatment of Fracture of the Patella. Price, $12.00. Described and used by Fkancis V. White, M. D, (Extracted from the Medical Record, July 15, 1867.) " The apparatus consists of thigh and leg-pieces of sheet-iron, with two buckled straps attached to each, united by two lateral bars and one posterior bar of steel. To the posterior bar are two troughs (part of a circle), on a double reversed screw; and, by turning the key in opposite directions, the troughs separate or approach each other. The apparatus, being japanned, is always ready for new cases when cleaned. The apparatus should be applied in simple fractures as soon as possible ; but if, in the opinion of the surgeon, it would aggravate existing imflammation, thereby jeopard- izing the joint, it could be applied as a posterior splint, withont using the coapting iippliance, until anti-phlogistic measures make it safe. The apparatus, to be applied properly, should be well padded with flannel or other material, for protecting thigh and leg from the splint and straps ; quadriceps fem- ori^ should be relaxed, the limb held by the thigh portion, and buck- led ; also buckle the leg portion. Use an anaesthetic if necessary. First fix the lower fragment, by drawing it up, smoothing the integ- uments down ; this being held by an assistant, the surgeon applies a sti'ip of adhesive plaster, of sufficient width to hold the fragment, and overlaps it sufficiently to prevent any tilting up, passes the free ends of the adhesive plaster around the upper trough, crosses them and applies them to the skin. The up- per fragment being coapted, the integuments being smoothed up, a similar piece of plaster is applied around the lower trough as around the lower fragment. Interpose something where the plasters cross each other, to prevent their sticking together- Pakt IV. 67 CHATHAM STREET, NEW-YORK, Branch Store, 107 East 28tu St., N. Y. 69 For firmness, use double strips of plaster. Snip the upper edge of tlie upper plaster, thus a rounded edge instead of a cutting edge will be presented to the integuments, avoiding in a degree excoriation. Tiie apparatus should I'emain applied thirty or forty days. When new dressings are applied, the patella Ijoing held, cautious passive motion may be made. After the apparatus is ]jermanently re- moved, the patient, to favor consolidation, should wear something to prevent too much use of the patella, say for four or six months, viz., an elastic knee-cap with a ring arrangement over the patella, or posteriorly a piece of gutta percha oi- leather strapped above or below the joint, either of which being soltened by warm water can be aj)plied, and allow of a certain flexion. Passive motion can be occasionally made, but not extreme, under six months. Directions for Measurement. 1. Length from above the ankle to upper third of thigh. 2. Right or left leg. - 3. Circumference of thigh, 4. Circumference of calf, - . _ _ INCHES. iC n Fig. 113. Lewis' Apparatus for Treatment of Practure of the Patella. Price, $ 6.00. This apparatus consists of a broad pad, resting on the popli- teus, to keep the knee extended, and a narrow pad, fitting the upper border of the patella. A strap connected with the lat- ter one is first passed through a ring attached to the popliteal pad, then continued down the leg on each side, being finally buckled to a lined foot-pad. This makes the foot a fixed point for extension, and the ring through which the strap passes gives it also a direction backwards, maintaining a firm hold of the upper fragment of the patella, whilst the lower frag- ment is readily kept in place by a strip of adhesive plaster. Directions for Measurement. 1. Circumference above knee, 2. Leno;th from sole of foot to knee. . Incht DR. VON BRUNS' COTTON LINT. WouND-DREssiNG-coTTON. Prepared by the International Manufactory of wound dressing materials. Schafhausen. Pakt IV, 10 GEO. TIEMANN & CO."S SURGICAL INSTRUMENTS, F. A. STOHLArANN. Edward Pfarre. Figs. 114a, 114b. Boisnot's Apparatus for Treatment of Fracture of the Patella. Fig. 114a. (^ Price, $12.00. This- apparatus is adapted to the limb at an angle natural to it, and therefore consistent with coaptation of the fragments. The splint is con- cave, to suit the convexity of the limb. The semi- lunar pieces are of stout leather, doubled and crimped. The cords pass over pulleys to revolv- ing transverse pieces, which are protected from -slipping by spring and ratchet. The patient is not confined to bed. Directions for Measurement: 1. Length from above the ankle to upper third Fig. 114b. of thigh, 2. Ch'cumference of thigh, 3. Circumference of calf, Inches. Fig. 115. Hartshorn's Apparatus for Treatment of Fracture of the Patella. Price, $7.00. This apparatus consists of a light tin splint, fitting the posterior half of the limb. It is cov- ered with morocco and is made to lace or to buckle in front. The coapting appliances are a pair of strong webbings or straps, well padded in the middle, which are drawn across the fragments obliquely, tightened by means of buckles or hooks. The application is very simular to that of Turner's Splint. Directions for Measurement 1. Length from above ankle to upper third of thigh, .... Inches. 2. Kight'or left leg? . , " 3. Circumference of thigh, . . " 4. Circumference of calf, ... " Part IV. 67 CHATHAM STREET NEW-YORK Yl Branch Store, 107 East 2Btii St., N. Y. Fig. 116, Hamilton's Apparatus for Treatment of Fracture of the Patella. Price $ 8.00 to $ 10.00. [Extracted from Hamilton on Fractures and Dislocations. \ " The dressing which I have usually employed in thr treatment of this fracture, consists of a single inclined plane, of sufficient length to support the thigh and leg, about six inches wider than the limb at the knee. This plane rises from a horizon- tal floor of the same length and breadth, and is supported at its distal end by an up- right piece of board, which serves both to lift the plane and to support and steady the foot. The distal end of the inclined, plane may be elevated from six to eighteen inches, according to the length of the limb and other circumstances. Upon either side, about four inches below the knee, is cut a deep notch. The foot-piece stands at right angles with the inclined plane, and not at right angles with the horizontal floor. It may be perforated with holes for the passage of tapes or bandages to secure the foot. Having covered the apparatus with a soft and thick cushion carefully a- dapted to all the irregularities of the thigh and leg, especial care being taken to fill the space under the knee, the whole limb is now laid upon it, and the foot gently secured to the foot-board, between which and the foot another cushion is placed, The body of the patient should also be flexed upon the thigh, so as the mor© effect- ually to relax the quadriceps femoris muscle. A compress made of folded cotton cloth, wide enough to cover the whole breadth of the knee, and long enough to extend from a point four inches above the patella to the tuberosity of the tibia, and one-quar- ter of an inch thick, is now placed on the front of and above the knee. While an assistant presses down the upper fragment of the patella, the surgeon precedes to secure it in place with bands of adhesive plaster. Each band should be two or two and a half inches wide, and sufficiently long to enclose the limb and splint obliquely. The centre of the first band is laid upon the compress, partly above and partly upon • the upper fragment, and its extremities are brought down so as to pass through the two notches on the side of the splint, and close upon each other underneath. The second band, imoricating the first, descends a little lower upon the patella, and is secured below in the same manner. The third- and so on successively until the whole 72 Paet IV. GEO. TIEMANN cS: CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. of the compress and knee is covered, is carried more nearly at right anscles around tlie leg and splint, the last band i^assiiig obliquel)- from below the ligamentum patellre upwards and backwards. The dressing is now completed by passing a cotton roller lightlj' around the whole length of the splint, commencing at the toes and ending at the groin." Fig. 117. Tiemann ^ Go's Knee-cap for After-Treatment of Fractured. Patella. Price, $5.50. Authorities on surgery say that great care must be taken not to rupture the ligaments of the newly formed union, which so often happens after recovery of the patient from iractured patella. For the purpose of guarding against such a recurrence, we make the apparatus shown, Fig. J 17. It consists of a knee- cap made of buckskin or satin jean, which is adjustable to the knee by buckles or laces. It is provided with a pair of coap- tation pads, to retain the newly united patella in place. These pads are arranged to approximate by drawing on laces, as shown in the upper border of the cap, represented Fig- 117. ■ It affords the patient exercise of the knee-joint, the best guard against the danger of anchylosis, at the same time preventing any undue strain on the newly united upper fragment of the patella. DiEECTIONS FOE MeASUKBMENT I 1. Circumference above knee, 2. Circumfei'ence of knee, 3. Circumference below the knee. Inches. Fig. 118. Steel Spring and HiilDlDer Cup for Treatment of Fractured Patella. -^^ Price, ^6,00. Part IV. 67 CHATHAM STREET, NEW-YORK. 1$ Branch Store, 107 East 28th St., N. Y. Apparatus for llie Treatment of Fracture of ttie TiWa aiifl FiMla. Fig*. 119. Hodgen's Apparatus for Complicated Fractures of the Lower Extremities. Price, $6.00. This apparatus consists of a wooden frame, formed of four square bars of the length of the h)wer extremity. These bars are united by a crescent-shaped piece of wood situated at the back of the knee, and by a foot-board below, two on either side of the leg. The lower two serve the purpose of holding together, and giving the apparatus an inclined plane; the upper bars serve as points of attachment for a number of linen straps or rollers to suspend the limb. They are placed side by side and fast- ened with pins, and constitute a perfect bed, having the advantage of adapting themselves to the differences in the conformation of the limb. The foot is retained to the foot-board by long adhesive plaster strips being passed around the foot-board and carried upwards and secured to both sides of the leg with roller bandage, leav- ing a sort of loop beneath the foot-board, through which a rope is passed and attached to a little bag weighted with sand, for the purpose of keeping up extension. Counter-extension is made by a perineal band, the end of which is secured to the head of the bed. A long cross-bar under the foot-board, resting on the bed, pre- vents the apparatus from tilting. Bricks may be placed under the inferior legs of the bed, to give the apparatus an inclination towards the pelvis. One of the ad- vantages of this instrument is that each of the bauds of linen may be removed separately, any wound dressed and the band reapplied without displacing the others. ROHLAND'S STYPTIC COTTON. Price, per box, 35 cents. Promptly arrests bleeding, either active or passive hemorrhages. Apply a thin layer of this cotton with gentle pressure to the surface of the bleeding wound. If desired, it can be easily removed a few minutes after application, although the healing process will be accelerated by leaving it on. It should be kept dry. 74 Part IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 120. Smith's Anterior Splint for Treatment of Gunshot Fractures of the Lower Extremities. Price, $3.00. See also Fig. 103. "We make to order ail otlier Suspending- Apparatus, and Salter's Cradle. Also Carved Wooden Splints for the leg and ankle. Lining Splints, made of thin boards of wood held together by a sheep-skin lining. Bauer's Wire Splints, a frame made of iron wire covered with gauze. Fig. 121. Raphael's ModifiGation of Pott's Splint. Price, $5.00. Used for fractures of the fibula, when ihey occur about two or three inches above the lower end, usually resulting from a fall upon the foot, in consequence of which the foot is violently twisted outwards, and sometimes the ankle is itself dislocated. The above is a modification of Pott's Splint, consisting in the addition of the screw for extension. Pott's original dressing is composed of an outside angular splint seven inches in width, constructed of deal board with a projection to accomodate the foot ; it is well Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, . 107 East 28th St., N. Y. 75 padded, and has a hole with bevelled edges to accommodate the external raaleolus. It is placed on the outside of the limb, which must be flexed on the abdomen, and the leg kept at a right angle with the thigh. On the inside of the leg a padded straight splint of felt, leather, or paste-board, extending from the ankle to the knee, is placed, and the two secured by roller bandage. The limb is allowed to rest on its outer side. Carved Wooden Splints are also used. See also Depuytren's Splint. Mim for lie Trealient of Fracture of tlie lower Maiillary. Pig. 122. Hamilton's. Price, $ 5.00. Silk, extra fine, $ 12.00. A firm leather strap passes under the chin and is buckled over the top of the head. It is stayed by two counter-straps of linen webbing. One of these is looped apon the maxillary strap at a point just above the ears, and may be elevated or depressed to fit different heads. This strap is buckled under the occiput posteriorly, and across the forehead anteriorly. A vertical strap passing over the top of the head in the line of the sagittal suture, unites the maxillary and the occipital strap. To prevent the maxillary strap being displaced backward, a chin-piece is fasten- ed to it. ROLLER BANDAGE. Roller Bandage, per pound, - - - - Adhesive Plaster, per yard. Strong Adhesive Plaster, on twilled goods, per yard, $1.50 .75 1.50 Pakt IV. 7(5 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Anpratns for tlie Treatment of Fractures of the Clayicle. Fig. 123. Levis' Apparatus for Treatment of Fracture of the Clavicle. Price, 5.00, eacli, for either size. {A) is a wedge-shaped pad for the axilla, which is put in place thick side up. Two straps faste- ned to this pad pass directly upwards, and buckle to the broad supporting band on the accromion of the afflicted arm. This band is then pass3d across the back and over the shoulder of the sound side, and terminates in front of the chest {E'). A sling to support the arm, elbow flexed, is buckled to the broad baud. A strap (D) is attached to the back of the sling a short distance above the elbow, and passed obliquely across the back and buckled to the supporting band in front. The extra buckle comes in play when the apparatus is to be reversed, in using it for the other side. The shoulder is kept out by the wedge, up by the sling, and back by the strap (2)). These apparatus are made of four sizes : two sizes for adults, two sizes for children. Fig. 124. Ricliardsoii's Splint for Fractures of the Clavicle, Scapula and Humerus. Price, S 6.00. " It is composed of three parts, and has three points of attachment, viz., to the side, axilla, and arm. " The arm and body pieces are semi-cylin- drical in shape, made of hard rubber, and fasten- ed together by means of rivets, with sufficient space left between them to allow the passage of straps of adhesive plaster. The crescentic pad is received as a crutch in the axilla. " For fracture of the clavicle, the crutch is crowded firmly in the axilla, aiid the arm-piece secured to the arm by circles of adhesive straps ; the shoulder is then raised, and the arm carriedbackwards until the fragments are brought into position, when the bod^^-splint and crutch are secured alike by straps of plaster. If thought desirable, one strap may be passed over the opposite shoulder. Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store. 107 East 28th St., N. Y. 77 "For fracture of the scapula, the arm is carried forward instead of backward, be- fore the splint is secured to the side. ''For fracture of tlie humerns, the arm is secured in its most natural and easy- position. In all other respects tlie splint is adjusted the same as I'or fractui'e of either of the above-mentioned bones. "After the splint has been applied, tlie arm may or not be flexed at a right angle on the chest, and su})ported by a sling from the neck." Four sizes of tliis splint are made : two for adults, and two for children. FOX'S CLAVICLE BANDAGE, Fig. 147. Price, $5.00. Is very similar, in principle, to the one described on page 76. Figs. 125, 126, 127. Jayre's Dressing for Fracture of the Clavicle. (Extracted from the A; Practitioner 'iox July, 1871.) Fig. 125. "After drawing the arm backward and retaining it there by a strip of adhesive plaster, pass another piece of plaster from the well shoulder across the back, and by pressing the elbow well forward and inward the first plaster around the middle of the arm is made to act as a fulcrum, and the shoulder is necessarily carried upward, out- ward, and backward ; and the plaster, being carried over the elbow and fore-arm (which is flexed across the chest) to the opposite should- er, the place of "starting, and then secured by pins or stitches, permanently retains the parts in postion. Strong and good adhesive plaster (Maw's moleskin is the best) is cut into two strips, three or four inches wide (narrower for children) ; one piece long enough to surround the arm and go completely around the body, the other to reach from the sound shoulder a- round the elbow of the fractured side and back to the place of starting. The first piece is passed around the arm just below the axill- ary margin and pinned or stitched in the form of a loop sufficiently large to prevent strangulation, leaving a large portion on the back of the arm uncased by the plaster. The arm is then drawn downward and backward until the clavicular portion of the pectoralls-major muscle is put sufiiciently on the stretch to over- come the sterno-cleido-mastoid, and tnus pull the inner portion of the elavid-j Part IV. 78 GEO, TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarke. Sayre's second bandage for Fractured Clavicle. Back view. down to its level. The plaster is then carried smoothly and completely around the body, and pinned to itselfon the back to prevent slipping', as seen in Fig. 125. This first strip of plaster fulfills a double purpose : first, by putting the clavicular por- tion of the pectoi'alis major muscle on the stretch, it prevents the clavicle from riding upward ; and, secondly, acting as a fulcrum at the center of the arm, when the elbow is pressed downward, forward, and inward, it necessarily forces the other extremity of the humerus (and with it the shoulder) upward, outward, and backward ; and it is kept in this position by the second strip of plaster, which is applied as follows ; commencing on the front of the shoulder of the sound side, drawing it smoothly and diagonally across the back to the elbow of the fractur- ed side, where a slit is made in its*middle to receive the projecting olecranon. Be- fore applying this plaster to the elbow an assistant should press the elbow well forward and inward (figure 126), and retain it there, while the plaster is continued over the elbow and fore-arm (pressing the latter close to the chest, and securing the hand near the oppo- site nipple); crossing the shoulder at the place of beginning, it is there secured by two or three pins, as seen in figures 126 and 12T. When this has been done the deformity will have entirely disappeared, the fractm^ed bones will be accurately adjusted, and as long as the strips of plaster maintain their position no amount of force can displace them, I have repeatedly tested this fact before my class by seizing the pa- tient by the arm of the fractured side and whirl- ing him like a top on his feet, without ever caus- ing the slightest displacement or giving the slightest pain. By this plan of treatment the patient is only detained from his daily advoca- tion a suffi(dent length of time to properly adjust the strips of adhesive plaster." Fig. 127. Sayre's Dressing for Fractured Calvicle. Front view. Price of Adhesive Plaster, per yard $ .Y5 Price of Moleskin Adhesive Plaster, (spread on twilled goods) per yard $1.50 Price of PoUei- Bandage, per pound, $1.50 Part IV. G7 CHATHAM STREET, NEW-YORK. ^9 Branch Store, 107 East 28Tir St., N. Y. Pig. 128. Hewit's Splint for Colles' Fracture. Price, $7.00. Tliis splint is designed, in addition t, move upon pivots, and as the extremities of the appa- ratus are secured by their adhesive straps at JL, A, the joint D moves forward and downward, describing the arc of a circle, the radius of which is the bar E. Pressure is thus made directly upon the head of the tibia by the band F^ and this can be very greatly augmented by using the extension rod at G^ which further relieves the joint of pressure by additional extension in the position already acquired by the preliminary extension of the rod B. His an accommodation — not properly an extension rod — which glides forwards as the extension is applied at B. As soon as the leg is thrown sufficiently forward, the accommodation rod is secured by a slide, and an extra turn of the key at B and G leaves the joint free from pressure, and with adequate extension aj)plied directly to the contracted flexors. The thigh and leg bands at If and / move upon pivots so that they adjust themselves readily to any position, and at If there is an arrangement by which the curved bar Z may be adjusted to suit the requirements of the extension rod B. The bars J/ and O are secured to the thigh and leg parts by double rivets. Through the buckles, at P, P, P, webbing straps (padded) are passed, producing counter extension in addition to that secured by means of the adhesive straps. ' ' Part lY. 67 CHATHAM STREET, NEW YORK, Branch Stoke. 107 East 28Tir St., N. Y. 91 Fig. 147. Fox's Apparatus for Fracture of the Clavicle. Price, $5.00. It consists ofa padded ring Vv'itli buckles attacti- ed, which fits over the sound slioulder ; and of a wedge-shaped pad fitting the axilla of the injur- ed side. On the top of this pad, pieces of weh- bing are fastened, one of which is to be passed anteriorly over the chest and buckled to the ring over the sound arm ; tlie other over the posterior wall of the thorax, and fitted to the posterior portion of the ring, a sling, made of stout linen or other material, in length about two-thirds of the forearm, and in depth sufficient to cover it completely, is then applied to the elbow and se- cured tightly to the ring. Fig. 148. Hamilton's EITdow Splint. It is made of gutta-percha, moulded to fit the shoulder, arm, and forearm ; must be well padded, placed upon the limb and secured by roller bandage. The forearm should be placed at a right angle with the humerus, and maintained in this position by a right angled splint. The gutta percha splint, covered with a Avoolen or cotton sack, is first secured to the fore- arm by a roller; and then, in a case ot irac- ture of the humerus above the condyles, while extension is made, the upper portion of the splint is secured to the arm in a sim- uiar manner. The front or bend of the elbow should always be well covered with cotton batting before enclosing the elbow- joint in the turns of the roller. Price of Gutta Pereha for Splinting: thick, per pound, $3.00 thin, " " 5.00 Roller Bandage, per pound 1.50 Dislocation Pulleys, (See Fig, 131), per pair, $7.00. 92 Pakt ly. GEO. TIEMANN cS: CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 149. Apparatus for Fracture of Surgical Ueck of Humerus. The fragments being reduced as well as possible, a single splint, made of leather, felt, or giitta perclia, long" enough to extend from the acromion process to the elbow joint, must be applied to the outside of the arm, enclosing about one half of the circumference of the limb. This should be moulded and allowed to become dry and hard before it is secured to the arm. A second short splint should be laid on the inside of the arm; both of these splints, having previously been covered with a sack of M'oollen cloth, are then to be made fast to the arm bj a roller; and finally, the forearm being flexed upon the arm and suspended by a sling passing under the wrist, the arm must be secured to the side of the body by a separate- roller. (Hamilton's Surgery). Fig. 150. Mayor's Apparatus for Dislocated Clavicle. The outer or acromial end of the clavicle is not unfrequently dislocated upwards and m.ore rarely it is driven fairly over the acromion process, constituting a disloca- tion upwards and outwards. This dislocation is easily reduced, but the clavicle is with difficulty retained in place. The treatment consists in the application of a force over the top and outer end of the clavicle, with a counter-force applied below the elbow, so as to elevate the humerus and scap- ula, while the arm and forearm are confined by a sling and bandage against the side and front of the body. ( Figs, c a). These indications will be fulfilled by Mayor's apparatus. Price of Mayor's apparatus for dislocated Clavicle, . . . . 1 5.00 Gutta Percha for Splinting, per lb., - 3.00 5.00 Extra Fine Htpodekmic Points. — Dr. Wm. A. Green Avrites in his "Practical Talk about Hypodermic Medicine:" I have recently had Tiemann & Co. to manufacture for me the most delicate and smallest point or needle that has ever been made, only a little larger than the proboscis of a fly, so delicate, in fact, that fluids thin as water barely pass through them, and that quite slowly. This in the hands of a physician of ordinary skill, can be passed through the coats of the skin into the cellular tissue positively, without pain. The smaller the point the less the pain. This delicate point, they have succeeded in making with exactness. Pakt lY. 67 CHATHAM STREET, NEW-YORK. 93 Branch Store, 107 East 28Tir St., N. Y. Fig. 151. Heduction of Dislocated Radius and Ulna. Fig. 152. Geo. Tiemann ^ Co.'s Improved Wire Arm Sling. Price, $4.50. With sliding extension splint for the hand, to facilitate passive motion of the wrist, without removing; the support. Fk; 152a. Fig. 152b. Eoller Bandage, per pound, - - - - Adhesive Plaster, per yard, Strong Adhesive Plaster, on twilled goods, per yard, $1.50 .To 1.50 94 Pakt IV. GEO. TIEiMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohl.mann. Edward Pfarre. Fig. 153. Clark's Apparatus for Fracture of the Olecranon. Price, $ 5.00 to $ 8.00. Clark's apparatus consists of a band of ordinary sole leather, about two inches, in width, and of sutiicient length to surround the arm, lined with cloth or chamois and well padded with hair or cotton. In order to give the band additional firmness, and also to secure it around the arm, a strip of harness leather is stitched upon the outside, to one end of which two small buckles are attached, while the other end, which extends about three inches beyond the band, is split or cut in two straps to correspond with, and fasten into the buckles. The band is fastened around the arm above the fractured process, and may be drawn to any degree of tightness necessary to bring the broken fragment down, when traction is made. Fig. 154. Smith's Anterior Suspending Splint in the Treat- ment of Fractures of the Lower Extremity. By Charles Shrimpton, ]\I. D., Paris. Price, $3.00. Tlie apparatus is of itself extremely simple : a splint made of two parallel wires of sufticient length to extend from above the anterior superior spinous process of the ilium to beyond the extremity of the toes, a suspending cord, some wadding, and some bandages. The suspending cord is formed of two parts, one to hang perpen- dicularly from its support, the other with a hook at each end, to be attached to tlie sliding bars of the splint. This part of the cord passes through a pulley, which is hooked to the extremity of the perpendicular cord. The perpendicular cord, is double, with a block in the middle, so that the limb may be raised or lowered by lengthening or shortening the cord at will. The wadding to be placed on the surface of the limb before the splint is applied. A double stout band to pass around the pelvis, and fix the upper part of the splinf. Five short pieces of band, one to pass around the foot and the splint, two in the same way around the \eg, and two around the thigh to keep the splint iu place whilst it is being adjusted. Several RvnT IV. 67 CHATHAM STREET, NEW-YORK. 05 Branch Store, 107 East 28-i-jr S'l., N. V. strong rollers to be applied to the whole length of the liuil) to rei)la(;e the short bands, which are to he withdrawn us the roller is applied. The cut represents the splint in situ before the roller-bands are applied. The limb ib supported by the temporary short bands. The wadding has been with- drawn to show that the wires cease to touch the limb as soon as it is suspended. Yery little remains to be said in describing the mode of ap])lication of the splint. The fractured limb should be left, as it may then be, until the splint has been Fig. 154. adapted to the sound limb, in order to take its exact length, bends, &c. The suspending cord being now fixed, and the splint prepared with a bend correspond- ing to the groin of the fractured limb, we may proceed to suspend the limb. The large double thick band is to be attached to the upper part of the extremity of the splint and passed lirmly round the pelvis. The wadding is to be placed on the front part of the fractured limb to receive the splint, and the short bands are now to be tied lightly round the foot, leg, and thigh. This done, the limb can at once be suspended by the cord without any attempt at reduction, and the reduction will take place almost of itself by the mere weight of the limb. As soon as the splint is perfectly adjusted ^araZ^eZ to the axis of the livih the rollers may be lightly ap- plied, leaving any part requiring dressing free from every kind of bandage. The wounds may thus be attended to without interfering in any way with the rest of the apparatus. Extension and counter-extension are necessary only to bring the limb to the length ot the splint whilst the rollers are being applied. Price of Adhesive Plaster, per yard $ .75 Price of Moleskin Adhesive Plaster, (spread on twilled goods) perj^ard §1.50 Price of Roller Bandage, per pound, $1.50 96 Part IV. GEO. TIEMAXN & CO.'S SURGICAL INSTRUIMENTS, F. A Stohlmann. Edward Pfarre. Fig. 155. Shrimpton's Forceps, For bending Smith's Anterior Splint while in situ, to adapt it to the limb. Price, $3.00. Fig. 156. Salt's Cradle or Swing. Price, $20.00. For protecting a fractured limb from the pressure of the bed-clothes, and to permit change of position without the risk of dis- placing the bones. It is a frame resting upon the bed and having on its central bar a small railway, upon which travels two pulleys, suspending by a chain the wound- ed limb (placed in such splinting as the surgeon may select) and protecting it from all external pressure. Fig. 157. Clark's Splint. Price, $ 30.00. Pakt IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y. 97 The attacliineiit for extension is by means of adhesive strips (m) extending to near tlie knee and passing around a foot-piece (v.) to which is attached a snj?]l Ijracket {h) which liooks over tlie lower end of the main s))lint. Then the limb is suspended by four liooks {dd) whicli are attached to thimbles that slide back and forth upon the bar, and are fixed at the desired point by means of thumb-screws in their outer sides. Extension is made by means of the cord (c), attached to tlie hook in the pul- ley at (s), passing forward between the cords playing over the pulley at (o), to drop over the pulley (g), fixed in a post at the foot of the bed, and then attached to a sand-bag of sufficient weight to make the necessary amount of extension. The weight ordinarily required for an adult is from ten to fifteen pounds. A uniform traction is exerted upon the limb, in whatever position the body of the patient may be placed. Fig. 158, 159. Morgan's Fracture Bed. Fig. 158. Fig. 159. Represents the bed and a patient wdth fracture of the neck of the femur, Fig. 159. Part IV. 98 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. the thigh resting upon a plane, and extension effected bj weight and pulleys, while the sound thigh rests upon an inclined plane for the purpose of counter-extension. "While the fractured thigh remains in a horizontal position, the other is elevated and the leg raised above and on a line corresponding to the axis of the body. In this position the pelvis becomes fixed and counter-extension is maintained by the posi- tion of the sound thigh. Pig. 160, 161. Hunger's Splint. Price for the Set of Screws and Rods, $ 4.50. Price for Apparatus, complete, $ 6.00. Fig. 160. F F, Iron Rods three-eights of an inch in diameter and a foot or more in length, are fitted to the upper or body portion of the splint, these rods slide into grooves G G in the lower section B which are covered with tin to prevent displacement of the bandages. At the upper end of the lower segment, is attached an iron brace Fig. 161. G through the head of which runs a screw E, ten or twelve inches in length. The end of this screw strikes against a corresponding brace D attached to the upper seg- ment, and it is by turning this screw that the two portions of the splint are forced apart. By this means extension is made and kept up to any desired degree. Application. — Each section should be well padded, and the whole then applied to the limb in the same manner as Liston's splint, with rollers and perineal band, except the space between the sections, which is not to be covered by the roller, but with a light dressing separate from the rest. By this means the wound may be examined and cleaned as often as necessary without disturbing any other portion of the apparatus. The surgeon, with a few turns of the screw, easily forces the limb to its natural length. Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store. 107 East 28th St., N, Y. 99 Fig. 162. Depuytren's Splint for Fractured Fitula. Depuytren's Splint is constructed of a single board, about four inches wide, and must extend from the condyle of the femur to two or three inches beyond the foot. Upon this a long triangular pad must be laid, the thickest portion of the triangle corresponding to a point about an inch above the internal maleolus. The bone is then set, and the splint, with the pad resting upon it, lying along the inside of the leg, which is secured by roller bandage. The bandage not covering the site of the fracture. Fig. 163. Apparatus for Supporting the Patient while Applying Plaster-of-Paris in the Treatment of Fractured Femur. By P. A. HARRIS, M. D., Dover, New Jersey. (Extracted from The Medical Record, New York, Sept. 18, 1875.) The accompanying illustration represents the apparatus. It is over five feet long, two feet wide, and ten inches high. It consists of a long and short side, each being made up of two boards of equal width, placed one on the other edgewise, and held together by two bolts provided with thumb screws, which also serve to fasten the tenons of the two cross blocks, thus connecting the sides together ; of six slats form- ing the body-rest, placed across and secured at either end by a screw ; of a third cross-block, very short, which serves to support the rest on which the sound leg is placed. This short cross-block has two tenons, which pass through mortises in the long side, and are held in place by a wooden pin. The sound leg-rest is secured to tlie long side by a screw, and to the short cross- TXMT IV. 100 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. block in like manner. Tt is provided with a series of holes to adapt it to the length of the patient. The half circle-like opening in the long side, between the sound leg- rest and the body-rest, corresponds to that portion of the bodj around which the dressing must be carried to form the girdle. This opening is ten inches long, its maximum depth being six and one-half inches. A very short perineal band attached to two broad straps of thin leather will fur- nish counter-extension. Secure one end to a slat near the head of the apparatus, let it pass down over the slats fornjing the body-rest, between the thighs, up over the body and shoulders, and fastened again to one of the slats near the bead. A part of the apparatus which remains to be described is the folding-rest for supporting the in- jured leg until ready for operation. It consists of two boards, one much thinner than the other, held together by a screw which allows the part forming the leg-rest to be abdncted to any extent from the sound limb. When removed from its place, as it will be while the piaster-dressing is being applied, it can be folded together; hence named folding-rest. At the end of the under thicker portion of the folding- rest is a tenon which is made to pass between the slats forming the body-rest, and the upper edge of the first cross-block; it is provided with a spring which prevents it from being pushed out of the mortise. The folding-rest is valuable, particularly as a support for the injured limb during the administration of an anaesthetic. If the limb be firmly bandaged to it, it will prevent, to a large extent, the injury so often done to the soft parts by the violent, uncontrollable, muscular efforts so common in the beginning of anaesthesia. The apparatus is so construcred that it can be quickly set for either leg, or chang- ed from one to the other. To change it from left to right, or iiice versa, unscrew^ the four thumb-screws, re- move the bolts, and change the under half of side supports each for the other. In- sert the four bolts, and tighten the thumb-screws. Then remove the two screws which secure the sound-leg-rest, and withdraw the pin from the tenons at the end of short cross-block. Remove short cross-block, insert from the opposite side, and secure it with pin. Turn the sound leg-rest the other side up, and fasten by the two screws as before. When this is done, the folding-rest can be introduced as be- fore ; in fact, every part of the apparatus remains the same, except it has been chang- ed from loft to right, or vice versa. To render it more portable I have constructed it so that by removing the four bolts it can be folded together and made to occupy about one-third the space. Three minutes jvill suffice to setup the apparatus, or change it from side to side. Directions. — Before placing the patient on the apparatus, let the body-rest be covered with several folds of a blanket or coverlet, and provided with a pillow. Th(i leg-rest should also be padded by doubling a small blanket over it. Let one end of the strap attached to the perineal band be buckled on the first slat at the head of the body-rest, and carried down over the centre of the rest. Place the patient on the apparatus so that part of the body and .pelvis, around which the bandage must be carried, will correspond to the vacant space between the leg and body-rest. Continue the counter-extending band over the perineum and abdomen, and secure Paht IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28tii St., N. Y. 101 its straps to the slat at the head of the apparatus. Secure tlie sound leg to its rest by a few turns of a roller passed round the leg, under the rest, and through the slats near the upper edge of the long side. The patient's body and sound leg are now supported on a common plane sev^eral inches above the bed or table on which the apparatus rests. Every part to which the dressing should be applied i,s access- ible to the hand of the operator. The sound leg-rest may be abducted to any dis. tance compatible with a successful appliance of the bandage. The injured leg, of course, must be supported by an assistant, aided perhaps by the compound pulleys so often required for extension. Abduction to much extent causes the girdle to lit poorly. When the dressing is hard enough to warrant us in discontinuing the exten- sion, the straps attached to the perineal band may be drawn out from under tlie gir- dle, the bandage removed from the sound leg, and the patient transferred to the bed. Extracted from the New York Medical Journal, Oct. 1874. A New Method of applying Plaster of Paris for Fracture of the Bones of the Leg. By G. Wackerhagen, M. D., Surgeon to the Southern Dispensary of Brooklyn. As I have experienced considerable difSculty in removing plaster-of-paris dress- ings when applied by the roller bandage, and especially when obliged to remove them on account of pain caused by an increase of the swelling, I respectfully submit to the profession a method of application by which these disadvantages may be avoided • Having procured a woollen or cotton stocking sufficiently long to reach to the knee-joint, I cut from it, as a pattern, six layers of coarse red flannel (1), (one-quart- er of an inch larger to allow for shrinkage). The flannel is then soaked in water, pressed, and laid over the back of a chair ready for use. A one-quarter-inch cotton rope is now sewed to the posterior median line of the stocking. The plaster of paris being in process of preparation, the stocking is cut in the anterior median line, applied to the fractured limb, and laced up in front, mcluding the rope (2), extension and counter-extension being kept up by assistants, and the fracture adjusted. Each layer of the flannel is now separ- ately saturated in the plaster paste, and applied, three layers to each side of the limb, being careful to avoid covering the rope. After this is done, a layer of plaster paste is applied to the flannel, and, when this has become sufficiently dry, a coating of shellac varnish is applied, which produces an elegant finish, and also gives firmness to the splints. The varnish will dry in about fifteen minutes. Fig. 164. Paet IV. 102 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. ^ ^^^^^ Edward Pfarre. This dressing can be removed in from three to five minutes by loosening the rope from the plaster and cutting the thread which binds it to the stocking. The rope having been removed, the pkin stocking surface can be cat through with an ordinary pair of scissors. Tlie sy)lint is then removed in two lateral portions, each half of the stocking remaining attached to its corresponding splint (3). Extracted from the New York Medical Journal, Sept. 1875. An Improved Method of ohtaiiiing Sujyport for Fractured Bones of the Extrem- ities, with Flannel, Plaster of Paris, and Shellac. By G, Wagerhagen, M. D., Surgeon to the Southern Dispensary of Brooklyn, In the treatment of fractures of the long bones the surgeon is required to exercise great care and diligence, for the reason that patients generally expect tob^ dismissed with the limb perfect in contour, and as useful as before the injury. Every possible effort should be made to comply with these demands ; therefore, it is essential that he be prepared to employ material which will supply the following requisites, viz. : It should be lightly, easily and quickly applied and removed. It should readily adapt itself to the irregularities of the limb, and become sufinciently firm to retain the fractured bones in place as soon as extension and counter-extension are discon- tinued. It should not confine perspiration, nor'become unserviceable from increased temperature or moisture. In order to allay pain, and to faciliate a more complete adjustment of the frac- ture, I am of the opinion that anaesthetics should be more generally administered, thus preventing deformity which sometimes results because of the difficulty in overcoming spasmodic action of the muscles. During the past ten months I have practically tested nearly all the materials that have been employed for dressing fractures, and have found them more or less defec- tive, excepting plaster of Paris for the application of which I propose the following improved method : After replacing the fragments as accurately as possible (extension being maintain- ed by assistants) the limb is smoothly bandaged with cotton-wadding, prepared in the form of an ordinary roller; a flannel bandage spread with dry plaster of Paris, and rolled, is now soaked in warm water (to which I generally add about two fluid-ounces of saturated solution of sulphate of potassium), and applied to the limb, over the wad- ding, by circular and reversed turns. One layer of the flannel applied in this way is amply suflScient for support. When we wish to inspect the point of fracture, the dressing, which is only auout an eight of an inch thick, is easily cut through by a pair of curved scissors (1), man- ufactured for me by Messrs. Tiemann & Co. (Fig. 165.) If it is desired to employ lateral splints, the dressing should be cut in the median line of the anterior and posterior surfaces. If anterio-posterior support is preferred, it should be cut through the lateral surfaces. The splints should now be varnished on their inner and outer surfaces with shellac, or this preparation may be applied to the outer surface before removal. Part IV. 67 CHATHAM STREET, NEW YORK. 103 Branch Store, 107 East 28th St., N. Y. The shellac seems to permeate the dressing sufficiently to increase the strength of the splint, and at the same time renders it slightly flexible instead of brittle, as is the case when plaster of Paris is used alone. Fig. 165. Wackerhagen's Plaster Paris Shears. Price, $6.00. The lateral elbow splint (2), weighs only four ounces, the materials necessary foi use by this method can be procured in packages from Messrs. Tiemann & Co., New York. Fig. 166. Wackerhagen's Apparatus for Fixing the Pelvis in Inflammation of the Hip-Joint. In order to overcome some of the difficulties in the management of inflammation at the hip-joint, I have had an apparatus constructed by which I can keep the pelvis and affected joint fixed, and in position, and also apply counter-extension without producing excoriation of the integument at the groin. Pabt IV. 104 GEO. TIEMANN & CO.'S SURGlCAt, INSTRUMENTS, F. A Stohlmann. Edward Pfarre. The bed represented in Fig. 166 is made of iron and constructed for a child six years of age. It consists of a frame base, nieasuring twelve inches in its anterio- posterior diameter and seventeen inches transversely — four iron rods are fastened perpendicularly to each corner. The surface on which the pelvis is fixed is of Jeather, and is arranged to slide up or down on the perpendicular rods, and may be fastened by the screws. Anteriorly, the leather is slit up about five inches, and the under surface is supplied with straps and buckles. By this contrivance the aloine evacuations may be passed without soiling the apparatus. The leather surface having been padded with cotton ; the pelvis and affected joint are iirmly bandaged thereto. Extension is made by weight and pulley after Dr. Buck's method. Actual Cauterisation with Charcoal Pencils. — Pencils may l)e made of char- coal, nitrate of potash, and a little gum tragacanth, which light and burn like a cigar, and are very useful as an actual cautery. A mass should be made and rolled into cylinders about four inches in length, and of the diameter of a common pencil, (M. Bretonneau). Fig. 167. Eliodes Fracture Apparatus, or DoulDle-Inclined Plane. (Principles Covered by his Patent of Jan'y 6, I874.) Distinctive Features — 1st, Adjustibility as to size as well as to form. 2d, Correct position and action of knee and ankle joiuts. 3d, The novel application of the Spring power and Extension, &c. Fig. 168, 169. Hhodes' Fracture Bed. (Patented Jan'y 6, 1874.) Distinctive Features — 1st, Adjustability from chair to bed, or any desirable position of hmb or body ; also, the same apparatus fitting all normal adult persons. 2d, Concentric Action of Joint, with those of Patients, thereby allowing free joint action without displacement, in case of fractures, &c., &c. Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Stork, I07 k^st 28th St., N. Y. Fig. 108. 105 Fig. 169. See Operating Tables and Chairs, page 128, Part I. Ansestlietic Apparatus, page 114, Part I. Antiseptic Surgery Apparatus, page 119, Part I. Part IV. 106 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. TO REMOVE A RING- FROM SWOLLEN FINGER. Wind a reel of cotton evenly around, beginning at the extremity of the finger, and bringing each coil into close apposition with the preceding, until the ring is reached ; having then threaded a needle with the cotton, and passed it under the ring, care- fully unwind the thread from the finger, the ring follows each coil as it is successively unrolled, and by almost imperceptible degrees is brought over the knuckle and re- moved. SURGICAL USE OF LIQUID GLASS. This is a silicate of potash, which is soluble in hot water, but insoluble in cold. The solution is applied by means of a brush over the ordinary bandages. The advantages which this application is said to possess are the following : 1. It is sim- ple, and easy of application. 2. It dries and hardens rapidly, requiring for this pur- pose only five or six hours. Desiccation may be favoured by using a solution evap- _ orated to the consistence of a syrup. 3. It is very solid and impermeable. 4. It is readily removable by means of hot water. 5. It is very economical. Before put- ting on the bandages, a layer of liquid glass may be applied over the limb. Extracted from the American Journal of the Medical Sciences, Philadelphia. De. Henry M. Smith's Instruments for the Treatment of Ununited Fracture by Pressure and Motion. Since 1862 I have frequently heard from cutlers of orders given for the appara- tus, but have been unable to obtain a satisfactory report of the treatment from surgeons ordering it. Sufficient evidence has, however, been presented to show that the results of treatment by " Pressure and Motion " should not be forgotten, nor its advantages overlooked by the profession. Experience having led to some slight modifications of the original apparatus, and many of the cutlers having failed to manufacture it as described by me, often spoil- ing it in attempts to modify it to their taste, I here ofier drawings clearly showing the forms now applied to the femur, tibia, and humerus, in all of which it has been successfully employed. In the manufacture of all these limbs the cutler should use for the side hars, that are the main support, "cast steel" h; inch wide and -g- inch thick, which is strong enough to sustain any ordinary weight. For the back and front splints that surround the limb, and act as a ferule at the seat of fracture, take galvanized sheet iron, Xo. 6, stuffed with wool, covered by buckskin on the inside of the splint and morocco on the outside. The attempts of some cutlers to make lighter limbs, by using stiff leather and steel half rings, has not proved advantageous. Paiit IV. 67 CHATHAM STREET, NEW-YORK. lOY Branch Store, 107 East 28tii St., N. Y. Fig. 170. Smith's Artificial Limb for Uniiiiited Fracture of the Femur. Price $50 to $75. A, Pelvic band. £, Hip-joint, C, Conical thigh piece which supports the weight of the body, and makes pressure on the fractured ends of the bone, permitting sufficient friction to ex- cite periosteal action. D, Knee-joint in side irons. J^, Support at calf. F', Laced shoe and ankle-joint. Directions foe Measurement. 1. Patient's name. 2. Smith's Artificial Limb for ununited fracture of the femur, 3. Right or left side. 4. Position of false joint. Inches 5. Length from sole to ankle, . " (). Length from sole to knee . , " 7. Length from sole to crutch (perineum), " 8. Length from sole to trochanter major, " 9. Length from sole to iliac crest, , " 10. Circumference above iliac crest, " 11. Circumference of thigh close to groin, " 12. Circumference of middle of thigh, " 13. Circumference of middle of knee-joint, " 14. Circumference around the tubercle of tibia, '' 15. Circumference of middle of calf, 16. Circumference of ankle, •...." Patient will send us a shoe. If we are to furnish shoes the following additional measures are required : a Length of sole of the foot, . - . , " h Circumference of ball of foot, . . . , " c Circumference of instep, ^ . , , " Shoes are charged extra, according to quality. Price of Adhesive Plaster, per yard, " ^' Moleskin " on twilled goods, per yard, " " Roller Bandage, per lb., .75 1.50 1.50 Part IY. 108 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A. Stohlmann. Edward Pfarre. Fig. 171. Smith's Artificial LimlD for u nunited Fracture of the Tihia. A. Support at middle of thigh, B. Knee-joint in side irons. C. Main support of the body by. accurate adjustment below the tubercle of the tibia. D. Ankle- joint and boot. Directions fob Measurement : 1. Patient's name. 2. Smith's artificial limb for ununited fracture of the tibia. 3. Right or left side. 4. Position of false joint. Inches. 5. Length from sole to ankle-joint, . . " 6. Length from sole to knee-joint, . . . " 7. Length from sole to middle of thigh, . " 8. Circumference around ankle-joint, . . " 9. Circumference below calf, ..." 10. Circumference around middle of calf, . . " 11. Circumference around tubercle of tibia, » " 12. Circumference around middle of knee-joint, . " 13. Circumference around thigh above knee, . " Price $30. to $40. Patient will send a shoe. If we are to furnish shoes, the following additional measures are required : a Length of sole of foot, h Circumference of ball of foot, c Circumference of instep, d Circumference above ankle.^ The heel depends on the shortening from the fracture. In every application of the apparatus let it be remembered, 1st, that the pressure at the seat of fracture must be as great as can be borne without inflaming the skin ; hence the strap at this point nmst always be firmly drawn so as to make the appar- atus also act as a ferule around the ends of the fragments. 2d. That in the lower extremities, the weight of the body is sustained by the ripper part of the hollow splint, just as a stump is sustained in an artificial limb after amputation. The upper strap should, therefore, be firmly drawn when the patient is about to walk ; but it should be slackened, so as to be more comfortable, when the patient is in bed or sitting up in a chair. 3d. When worn for several months the inside lining and stuffing should be re- newed, so as to give accurate support. 4th. When from union occuring it is proposed to lay aside the splint, let it be taken off at night for ten days, or whilst sitting up in a chair, before any attempt is made to walk without it. 5th. It is useful in recent fractures, enabling the patient sooner to sit up. "Shoes are charged extra, according to quality. Part IV. 67 CHATHAM STREET, NEW-YORK, Branch STt)KE, 107 East 28tii St., N. Y. 109 Fig. 172. Smith's Artificial Lim"b for Ununited Fracture of the Humerus. ointed at Price $35. to $70.00, according to finish, cfec. Fitting close over the rotundity of the slioulder and forearm, accurately j the elbow. Directions for Measurement. 1. Patient's name. 2. Smith's artificial limb for fracture of the humerus. 3 Right or left side. 4. Length from acromion to point of external condyle. 5. Length from condyle to styloid of radius. 6. Length from internal condyle to styloid of ulna. 7. Circumference from point of shoulder to op- posite axilla. 8. Circumference around top of shoulder over deltoid. 9. Circumference around middle of arm. 10. Circumference at elbow-joint. 11. Circumference at upper end of forearm. 12. Circumference at middle of forearm. 13. Circumference at wrist. Be careful to take circumference at wrist, whilst the radius and ulna are parallel or between pronation and supination. Fig. 173. Smith's Artificial Limh for Ununited Fracture of the Forearm. Price, $35.00 to $ 60.00, according to finish, etc. A. Piece accurately embracing the arm. £. Joint for flexion and extension of forearm at elbow. £. Pivot-joint permitting rotation of head of radius in semi- pronation and supination. C. Ensheathing piece for forearm. D. A thick pad to press on styloid processes of uhia and radius at their carpal surfaces — so as to pre- serve the parallelism of these bonesr Directions for Measurements : 1. Patient's name. 2. Smith's artificial limb for ununited fracture of the forearm. 3. Right or left side 4. Length from middle of humerus to external condyle. 110 Part IY. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A Stohlmann. 5. Lengtli from condyle fo styloid of radius. 6. Length from internal condyle to styloid of ulna. 7. Circumference around middle of arm. 8. Circumference at elbow-joint. 9. Circumference at upper end of forearm. 10. Circumference at middle of forearm. 11. Circumference at wrist. Edward Pfarre- Ftg. 173. Pig. 174. Buck's Suspension Apparatus for Hospital Use. Price, $18. N"o. 1. For suspending the lower limbs is made of five-eight inch iron tubing bent in the manner shown by the picture. The horizontal portion overhanging tlie bed is supported by tM^o upright iron rods resting upon the mattress astraddle of the thigh. A row of screw heads inserted along the outer surface of the horizontal portion serves for fastening the ends of the canvas bands that suspend the limb. The upright portion of the apparatus is securely fastened to the two cross-rods at the foot of the bedstead by clamps and can be adjusted at any required height. The suspending bands are of stout sailcloth canvas, cut of any required length and width, and but- toned on to the screw heads by slits cut for the purpose. The canvas being very strong does not tear, and will sustain any weight it has to bear. No. 2. For suspending the upper limbs, is made of the same sort of iron tubing; its upright portion is fastened by clamps at the head of the bedstead and its lower portion overhangs the bed and holds suspended at its extremity a flattened strip of hard wood on the upper edge of which a row of screw heads serves for fastening the ends of the canvas bands that suspend the limb. The strip of wood that supports the limb plays horizontally on a swivel joint at the extremity of the iron tubing. Part IY. 67 CHATHAM STREET, NEW-YORK Branch Store, 107 East 28tii St., N. Y. Ill Pig. 175. Sayre's Long Splint for Hip-Joint Disease. Price, $25.00 to $45.00, according to size and finish. The pelvic band, perineal straps, knee cap, foot- piece, and contrivance for extension of this instrument corres- pond with analogous parts of Dr. Taylor's long splint. The modification consists in the addition of an endless screw, by which rotation is produced. Dr. Sayre descri bes it as follows. The long bar, reaching from the pelvis to the bottom of the foot, is hollow. Another bar, running inside of it, is furnished with a rack, by which, and a key, we make extension. It is locked in the same way as the short splint. The cross-bar at the bottom of the instrument is covered with leather, to keep from making noise on the pavement while walking. The ends of a strong leather strap are passed through slits in the footpiece for the purpose of buckling to adhesive strips upon the leg. Application of the Splint. Take two strips of strong moleskin adhesive plaster from two to four inches in width, according to the size of the patient and the entire length of the limb, divide the upper extremity of the plaster into strips, two or three inches Jong, and sew strong webbing with buckles attached on below. These plasters are then applied on either side of the leg in such a manner, as to leave the buckles a little above the ankie-pint, and are secured by a snugly adjusted roller, so applied as to leave the tags with the buckles hanging loose, the roller being carried up over the knee, and as far up the thigh as can be done with convenience, the upper split-ends of the piasters are reversed and braided in with the roller as it turns down the thigh, securing it smoothly. The stocking is then pulled up on the foot, holes haviuo- been cut on either side for the buckles to pass through, and the shoe applied, with holes cut through in the same manner. The instrument is now placed on the outer side of the leg, and the cross-bar at the bottom brought in front of the heel of the shoe, and securely buckled to the tags above described. The Pelvic-band is next brought around the hips, and secured by the buckle upon the opposite side, and the perineal straps attached as firmly as need be. The knee-pad-band is then slipped up or down, until it is made to rest opposite the knee, when it is passed around and buckled fast. Extension is now made by the key upon the ratchet until full compression is borne without pain. The abducting screw may then be used, and daily increased. If the limb be strongly flexed, an additional strap is applied at tlie posterior Part IV. 112 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. F. A Stohlmann. Edward Pfarre. part of the instrument at the knee, running up the back of the thigh, and secured to the posterior portion of the pelvic band, and made tighter as occasion may require for the purpose of extending the Hmb. This latter strap should be elastic for the purpose of keeping up a constant tractile force ; and, at the same time, allow of flexion when the patient wishes to sit down. By this means, matiy cases that have gone to the third stage of the disease, may, in the course of time, recover without exsection, with tolerably good form and a mod- erate degree of motion, without any further operative procedure. Directions for Measurement. 1. 2. 3. 4. 6. 6. 7. Sajres' Long Hip-joint Splint. Name of patient. Age of patient. Weight of patient. Right or left leg. Length from sole to crest of ilium, Circumference of pelvis at liiac crests, Inches. Dry Cupping. Fig. 176. Junod's Boot Price of Boot with Pump $15.00 to $25.00, according to size and finish. Dry Cupping was suggested about twenty-five years ago by Junod, of Paris, for the relief of rheumatic pains, paralysis, and atrophy of muscles. It is an excellent counter irritant, producing no painful sores, and is frequently more effective than blisters. It increases the circulation when, from any cause, there has been an obstruction — thus aiding and assisting nature in her efforts to convey a healthy current of blood to the different parts of tiie system. Fig. 176 represents a metallic receiver for the leg with a rub- ber band on the upper border, which, when fastened to the leg by a strap and buckle, renders the boot air-tight. In front of the boot is a stopcock ; this has a rubber tube attached, connecting it to an air pump, which, when worked, exhausts all the air from the boot. Pakt IV. 67 CHATHAM STREET, NEW-YORK. Branch 3tore. 107 East 28th St., N. Y. 113 Fig. 177. Junod's Arm. Fig. 1Y7 Represents Junod's arm, which is analogous to the boot and will readily be understood by the drawing. Price with Pump $16. to $25. Junod's Boot, Arm and Pump $25.00 to $35.00, according to size and style. Pig. 178. Straight Jacket. Made of Canvass, with Lock. Price $8.00 to $ 15.00. Although in the present day Lunatics are treated kind- ly and allowed all the liberty and favor consistent with their own welfare, it may sometimes become necessary to either separate them from their families on their sur- roundings, or confine them, to prevent them doing harm to others. This is the object of the straight jacket. Patients, however, should be treated with all possible kindness, and the jacket taken off as soon as they become docile. Fig 179. Buckle and Straps for Idiots. Price of Buckle, $2.50. Price for Wristlets, Belt and one Buckle, $ 6.00. This is a cheaper arrangement than the straight-jacket, for confining maniacs. It is intended for use in Asylums. After confining the patient in the straps and locking the buckle, the key is taken out and kept by the attendant. Dislocation Pulleys, (See Fig. 131), per pair, $7.00. Part IV. 114 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann.. Edward Pfarre. Extracted from the New York Medical Record, May, 15th, 1874. Use of Wanii and Hot Water in Surgery. By Professor Frank Hastings Hamil- ton, M D., New York. Effect in Submersio7i in Warm and Hot Water. No treatment hitherto adopted, under our observation, has been attended with e(jually favorable results. Under this plan the area of acute inflammation is exceedingly limited ; erysipel- atous inflammation has been almost uniformly arrested or resti'ained, when it has actually commenced and it has never originated after submersion ; gangrene has in no instance extended bej^ond the parts originally injured, and when progressing it has in most cases been speedily arrested (in gangrene hot water, or water at a temperature of irom 100* to llO*^ Fahrenheit, is to be preferred). Septicemia and pyaemia have not ensued in any case in which submersion has been practised from the first day of the accident. Purulent infiltration and consecutive abscesses have been infrequent, and always limited to the neighborhood of the parts injured, and of small extent. Traumatic fever, asually present after grave accidents, when other plans of treatment have been pursued, as early as the third or fourth day, has seldom been present when this plan has been adopted, and in no case has the fever been intense or alarming.. The phenomena usually observed in eases of recent lacerated or incised wounds, when submerged, are, a sense of comfort, yet not absolute relief from pain; on the second or third day the parts adjacent are swollen, but not much reddened ; the in- tegument generally assumes a white and sodden appearance, and with only slight tenderness. On the fifth, sixth, or seventh day the swelling is greater than usually accompanies other plans of treatment ; and, with the inexperienced, is likely to ex- cite alarm, but it is found not to be attended with increased tenderness, and it pits under pressure, showing that it is a condition of oedema chiefly. At this time the granulations are generally covered with lymph, or some exudate of a whitish color and which might easily be mistaken for a diphtheritic deposit. At the end of four- teen days, or thereabouts (the period at which, in most cases, we substitute fomen- tation for submersion), the limb is still oedematous, the granulations are abundant, sometimes presenting a fresh, red appearance, ar^d at others covered with the white exudate. To what Class of Cases Submersion is especially Applicable. Position of injury. — The lower extremities can only be completely and perman- ently submerged to. a point three or four inches below the knee, and the upper ex- tremities to a point a few inches above the elbow, consequently, submersion is limited to those portions of the extremities which are below the points mentioned. Character of injury — Submersion in warai water demonstrates its superiority over other plans, especially in the case of a laceration or contusion of the hand or of the foot, when the integument and flesh are extensively torn — provided the limb is submerged without closing the wound — that is, without sutures or bandages ; in deed, sutures are inadmissable when this plan is adopted, since the oedema which almost inevitably ensues would break away the sutures. Pakt IV. 67 CHATHAM STREET, NEW YORK. 115 Branch Store, 107 East 28th St., N.Y. Mere contusions, without external lesions, have been treated almost constantly at St, Francis' by this method ; and the results have been in all cases satisfactory, and occasionally they have progressed toward recovery in a manner to excite surprise. 8im/ple incised wottnds have seldom been subjected to immersion, since it inevit- ably defeats union by first intension. Nor have wounds caused by amjjutation been treated in this manner', partly for the reason just given, and partly because of certain apprehensions that the depending position might expose the patient to the dangers of a secondary hemorrhage where large arteries have been severed and are exposed in the wound. Value of Hot Water in Traumatic Gangrene. The power of hot- water baths, or water at or above the normal temperature of the blood, to arrest traumatic gangrene is remarkable ; and the writer entertains a hope that its efficiency may not be limited to traumatic gangrene alone, yet this remains to be proven. Method of Using the Warm- Water Bath. For the arm and hand we have an oblong zinc bath, 23 inches long by 8 inches wide and 8 in depth, with somewhat flaring margins where the arm is to enter, supplied with a movable cover, which leaves an opening for the arm, and provided Pig. 180. Bath for Arm, Forearm, and Hand. Price $13.00. with a stop-cock to enable us to draw off and renew the water. Along the upper and outer margin of the bath are arranged small wire-pins, upon which pieces of cloth may be fastened for the purpose of suspending the limb. Care must be taken not to allow the limb to rest against the edge of the bath, so as to interfere with the circulation, and it must be carefully adjusted upon a shelf, beside the bed, in such a position as will be most comfortable to the patient. For the lower extremity a zinc bath is used also, somewhat larger, the floor being in the form of an inverted roof, the apex of which is below; the base being repre- ented by the open top of the bath ; this latter is provided also with a movable cover. The apex is supported by a wooden frame and horizontal board. This bath is, like the arm-bath, provided with pins for suspension of the limb, and a stop-cock. In the case of the foot-bath, when it is found uncomfortable to project the foot from the side of the bed, the portion of the bed upon which the body reposes is el- evated by mattresses, and the bath is. placed on the floor of the bedstead. We have not thought it necessary to keep the water at an absolute uniform tem- perature, so that its management is left very much to the judgment of the patient 116 Part IV. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. or his attendant ; but usually it has been kept at such a temperatui'e as to feel warm to the hand of the attendent — and this is found to be about 95* Fahrenheit. Suffic- ient uniformity has been attained generally by changing the water three times daily- Fig. 181. Bath for the Lower Extremity. Price $15.00 In case of a recent wound, where secondary hemorrhage is at all liable to occur, the limb is dressed for a few hours with either warm or cold fomentations, and is left reposing in bed ; but neither sutures, adhesive plasters, nor bandages are applied. At the expiration of this time either the bath or the warm-water fomentations ai'o commenced, and thereafter employed systematically. The patient is at liberty at any time to lift the limb from the bath, and he generally does this pretty often, to see how it is progressing. Warm-ioater fomentations are regarded by us as always second in value to sub- mersion in the preventing and cure of inflammation, and they are reserved, therefore for those examples in which submersion for one or another reason cannot j^roperly be employed. Fomentations are employed by us after about the fourteenth day in all those cases in which we employ submersion at first — occasionally, when the patient is weaiy of the confinement of the bath, the limb is taken out and fomented during the night. We employ fomentations in amputations and other incised wounds when union by first intent is desired ; in lacerated and contused wounds which cannot be sub- jected to immersion; in most examples of idcers; in many syphilitic and cancerous sores; in some simple contusions and sprains. In short, to repeat what lias been al- ready intimated, with warm M^ater, either in the form of the bath or fomentation, we treat nearly all surgical accidents. Carbolic acid, the chlorinate of soda or lime, and other antiseptics being reserved for very rare and exceptional cases. In using the fomentations we envelop the wound and limb in several folds of sheet lint or soft old muslin, saturated with warm water, the Avhole being enclosed in oiled silk or vulcanized rubber. This is chauixed about once in four or six hours. Price of Adhesive Plaster, " " Moleskin Adhesive Plaster, (on twilled goods) " " Roller Bandage. per yard $ .75 per yard $1.50 per pound, $1.50 Part IV. 67 CHATHAM STREET, NEW-YORK. ^^ Branch Store, 107 East 28th St., N. Y. Extracted from the Philadelphia Medical Times, Sept. 4th, 1875. Fig. 182. Dr. Allan McLane Hamilton's Revulsor. Price, $8.00. Every neurologist is overrun by a class ot" patients that constitute a certain ojppro- hrium m-^diGorum. These are patients witli dysaesthesise, spinal irritation, and a few other maladies, confined chiefly to women, and dependent upon uterine diseas- es. After the employment of many remedies, and after finding hopeless results, constituted either by relapses or temporary improvement, the case is discharged. In these cases I found the alternate use of heat and cold to be followed by the most desirable effects, particularly in spinal irritation. Of twenty-six cases of this kind I have cured fifteen, and have greatly improved all the others. I had used phosphorus and electricity with indifferent success, but the alternate application of heat and cold to the spine produced a decided impression. I at first directed the patients to era. ploy icebags, and hot fiat-irons covered by fiannel, but subsequently made use of the instrument I will presently describe. In hysterical affections this mode of treatment was of great use, particularly those forms characterized by lividity of the surface and unconciousness, with rigidity. The surface became warmer and the circulation much more equable after ten or fifteen minutes' use of the revulsor. For the alternate application of heat and cold I have devised the instrument figured in the cut. It consists of two chambers of brass two and a half inches in diameter by one and a half inches deep. These have ^crew plugs inserted so that they may be removed and the chambers filled, one with cold water and salt, the other with hot water. These chambers are fixed on a rod, and separated by an insulating or non-conducting substance. The rod terminates in a handle. The fiat surface covered by thin flannel is placed against the bare back, on either side of the spinous processes of the vertebra, and the instrument is passed up and down quite rapidly. As the heated surface moves instantaneously to where the cold one was an instant before, the effect is quite marked. Dry heat and dry cold are much better as therapeutical agents than moist heat or moist cold. The effect is energetic ; the skin is influenced more quickly, as there is no fluid between to act as a non-conductor. In paralytic conditions, local application of the revulsor to the muscles themselves seemed to increase the circulation in the tissues much more vigorously and success- fully than did the faradic current. Heat and cold, I am convinced, are valuable remedies that have not been thor- oughly made use of. JPabt IV. 118 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Pig. 183. Denison's Extension Windlass. Price, $1.50. This little instrument is intended to serve surgeons in country practice, who, not being able to resort to an iustrnment maker in urgent cases, ai'e compelled to de- pend on tlieir own skill to devise means of treating frac- tures or deformities. It is a substitute for the screw-pow- er, or the rack and pinion and may be attached to wooden supports or splints. If attached by one screw it will be movable, swivel like, self-adjusting; if fastened by two or more screws it is made stationary. Extension Windlass. — A, £, and C, hole for screws or tacks : If, winding-rod, slotted at G, squared at ^^, for key /, and held in position by ratchet^ and pinion D, with spring-attachment J. Length of the winding-rod, two and one-quarter in- ches ; between the arm of the brackets, one and three-quarters inch. A A and B J^, extension and counter-extension windlass, s, each fastened by one screw to wooden posterior splint ; O O, fan-shaped adhesive plasters, crossing each other at C, and threaded through winding-rods F -F]' D, padded roller over liga- mentum patellae, the ends of which are threaded through winding-rods H JI,- E, reserve counter-extension to relieve D from uncomfortable pressure in front of knee II., point at which splint is bandaged to the limb. A, wooden foot-piece, about one-third inch thick, to which, at D and J J, the supports O B, of the extension windlasses, G F, are fastened. SI-, fan-shaped adhes- ive plasters in position. Braces to go over instep (after Dr. L, A. Sayre's apparatus) are fastened to slat (7, at F. The windlasses G F, are reversed and made stationary on the upper ends of the thin slats, so as to draw the adhesive plasters close to the limb, and over the winding-rods. Many other uses and methods of attachments will sug- gest themselves to the ingenious surgeon. Our space does not allow a fuller description for which we refer to " The New Yoi-k Medical Record May, 1875." Pakt IV. 67 CHATHAM STREET, NEW-YORK 119 Branch Store, 107 East '^Bth St., N. Y. Fig. 184. Esmarch's Tourniq^net. Extracted from Sammlung Klinischer VoRTR/iiGE, No. 58, Leipzig, 1873. Price, $3.T5. * * * * "I shall perform an operation (necrotomy, both legs) which would cause a much more profuse hemorrhage than that of yesterday, did I not adopt a method which will enable us to completely control the bleeding. "■While the ansesthetic is being administered, we envelop the lower portion of the limb in oil silk, to prevent soiling the bandage; then we bandage the legs tightly from the toes to above the knees with this elastic rubber bandage (A), which, by gradual compression, forces the blood out of the vessels of the limb. Immedi- ately above the knee, where the bandage terminates, we wind the rubber cord or tubing (B) four or five times around the thigh, and join the one extremity by means of the attached hook to the chain at the other end. The rubber tubing or cord compresses all the soft parts, including the arteries, in such a perfect manner that not a drop of blood can enter the bandaged portion of the limb. "This tourniquet possesses the advantage over all others, viz. : it can be adjusted to any portion of the limb, and the location of the principal arteries need not be considered. " We now remove the elastic bandaging and the oil silk, and you will notice that both legs, below the tourniquet, present the appearance of the limbs of a corpse, the pallor of the same forming a remarkable contrast to the rosy hue of the skin above. You will also notice that we will operate exactly as though on a cadaver. * * * * " After the operation, the rubber cord is slowly removed, the circulation restored, "and those arteries which have previously remained unnoticed, tied. * ■» * The slumbering patient presents the same appearance as before the operation, his pulse is full and strong, and convalescence will no doubt follow much more rapidly and surely than if we had performed the operation in the customary manner. " The tourniquet can be used with more or less complete success in nearly all operations on the extremities. In extii-pation of tumors, in the removal of scroful- ous sores or caries, and resections of small bones or joints, you can proceed in the manner I have just demonstrated, viz. : you need not loosen the tourniquet until the wound has been dressed." Part IV. 120 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A- Stohlmann. Edward Pfarre. Spine Bags FOR THE APPLICATION OF DRY COLD AND HEAT ALONG THE SPINE. Fig. 185. Spinal Ice Bag. Price, $4.50 to $10.25. Directions fok Preparing and Applying. Put ice (broken into pieces about the size of a nut or small walnut) into the opening of the bag, on the side nearest to the loops, until the contents of the lowest cell reach up to the bottom of the second cell ; then put ice in the middle opening until it reaches up to the bottom of the third cell ; and finally, fill the top cell. Then close the bag with the c\-Am-p, plaGi?ig it on the thickened, hand-like part around the mouth, and letting the screws be on the same side as the loops of the bag. When the clamp is properly applied, a very moderate pressure by its screws is needful to make the bag water-tight. All pressure beyond what is needful injures the bag. Care must be taken that each cell is not so filled as to cause it to become round, otherwise only a small portion of the bag will touch the back. It is also expedient that the contents of the several cells should only slightly overlap each other. In applying the bag, place the smooth side of it in apposition with the back, the side bearing the loops being turned outwards. The bag may be kept in its position in various ways. If it is intended to be used for only a short time, or if the patient be in bed, the best plan is to lie upon it, taking care that it is exactly along the centre of the back. If the patient should wish to move about, pass the elastic band round the head, in order that it may hold the upper cell close to the back of the neck, and sustain the bag by fastening the clothes tightly outside of it ; or pass a long tape through the lower loop, carrying each half of this tape over the shoulders, crossing one over the other in front of the chest, carrying them backwards round the waist, in order to clasp the bag closely into the small of the back, and then, bringing them forward, tie them in front. The bag will thus be sustained, and with- out allowing any of its weight to depend from the head. In this case the patient may move or walk about without any discomfort while wearing the bag. As ice contains a considerable amount of air, this air, as the ice melts, accumulates at the top of the bag, and being a bad conductor of heat, prevents the still unmelted ice which it surrounds from exerting its intended influence : it is therefore necessary to unscrew the clamp occasionally, in order to let the air escape, and, if the bag is to be worn for a considerable time, to replace the air by a little fresh ice. Part IV. 67 CHATHAM STREET, NEW-YORK. Branch Store, 107 East 28th St., N. Y. 121 Fig. 1851d. TurnMl's Ice Bag FOK THE APPLICATION OF COLJJ TO THE EYE TO SUBDUE HSTFLAMATION. Fig. 186. Andrew's Apparatus for Inflamed Ankle Joint. For some years I have used with the greatest satis- faction and excellent results the following simple device. The cut gives a correct idea of it. The top of the foot and the lower half of the leg con- stitute two cones, whose apices meet at the ankle. Now if any moderately firm and well fitting material surround these parts, and be laced together with some firmness, the two cones will be pressed apart, and extension of the ankle secured, or, to put it in diiferent terms, the in- verted cone laced to the leg is a counter extending force, while the lacing together of the hollow cone embracing the upper surfaces of the foot, tend to push that member downward, and thus makes extension upon the joint. To construct this a plaster cast should be taken of the foot and leg, with the foot hanging free and pointing somewhat downward. This position is found by experience to be much the best. A piece of wet russet harness leather is wrapped around the cast and crimj^ed to a perfect fit by winding a stout cord, or a piece of webbing all over it. The leather laps over itself in front. After a few hom-s drying in an oven, or on a stove, the leather hardens and retains its shape. Before applying the leather, a little building out of the malleoli of the cast should be done with plaster of Paris, that the leather may be well moulded out, and not press painfully on those prominences. Eyelets are set in the over- lapping edge, and in a strip of leather sewed to the part opposite it, so as to allow of lacing it up to any desired tightness. The eyeletted edges of the leather should be wider apart on the dorsum of the foot than elsewhere, as owing to the yielding of that member, the edges lace together more than on the leg. The brace is finished by pasting in a chamois leather lining. It fits the limb like wax, keeps up a gentle and desirable pressure on the joint, maintains immobility and pushes down the foot so as to make an effective extension of the ankle-joint. No screws, racks and pinions, nor even adhesive straps are required. The action of the in- strument has pleased me beyond measure by its simplicity, the ease with which it can be taken off and re-applied, and its efficiency in cm-ing the inflammation. The same principle can be temporarily carried out by means of a dextrine splint open behind, and compressed by an elastic bandage, or even by a common roller. Part IV. 122 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 187. Andrew's Brace for Inflamed Knee- Joint. If tlie knee can still be straightened, I apj)ly the follow- ing apparatus : The leather lacer at the top spreads its pressure over a wide surface, and also sj^reads out somewhat upon the bulge of the nates, so that hardlj a perceptible pressure is exerted upon the veins at any one point ; scarcely any, hence there is little or no tendency to that venous con- gestion and swelling of the parts below, which authors say the ordinary apparatus produces if no bandage is used, yet I think that the practice of employing a compression bandage is useful to the knee, even if no tendency to swelling exists. a. Leather, laced in front. h. Steel plate, rivetted to each side. c. Rod, terminating in slot s, A similar rod is on the other side of the limb. s. Slot, with a friction roller. g. Adhesive straps, to the lower end of which an elastic band is sewed. A. Elastic band, terminating in a leather strap, which is passed through the slot s, and turned up, and, being strongly stretched, is buttoned to a knob, d. The rod c is much slenderer than represented in the engraving, and is loosely jointed to the steel plate h. The broad perpendicular adhesive strap should ter- minate a little above the slot s. To the lower end a stout elastic band is sewn, a few inches long, and of the kind used by some wooden-leg makers for springs. A leather strap is sewn to the elastic. The opposite side of the limb is armed in the same way. The hip leather being laced on, the strap and elastic bands carried down to the slot s, whose upper border is made by a little friction roller that the band may run easily. The strap being drawn through the slot, is then stretched firmly upward by the hand and buckled to the knob d. It will be observed that while at first glance this may seem to be pulling up instead of downward, yet the fact is, the elastic in passing under the friction roller changes its direction, and in fact, pulls strongly down- ward on the adhesive plaster and the limb to which it is attached. The same man- oeuvre repeated on the opposite side doubles the force of the extension. The use of the elastic bands is not strictly necessary. A double tape carried through the slot and tied over the knob, is simpler, and, if properly attended to, is equally efiicient ; but the elastic is convenient, because in any yielding or stretching of the dressings its contractibility still keeps up the tension, without requiring so much watchfulness on the part of the surgeon. ■ Elastic bands were in common use fifteen years ago, but of late have been much neglected. If occasion demands Pakt IV. 67 CHATHAM STREET, NEW-YORK. 123 Branch Store, 107 East 38th St.. N. Y. it, the surgeon can easily constrnct an extempore form of t])is s])]int, using simply leather, wood, and a few screws, and putting them together with his own hands. It will be observed that there are no racks and pinions, screws, nor other me- chanical contrivances for increasing the power. The amonnt of extending force required on a straight inflamed knee is never very great, and never beyond what the hands can readily exert by simply pulling firmly first upon one strap and then upon the other. There is no ring or band surrounding, the limbs at the lower end of the instru- ment, because such a thing is useless. The slot is kept in place by the band which passes through it, and cannot possibly get away. If it is desired to remove the apparatus for any purpose, all that is necessary is to unbutton the two straps, when the brace can be slipped instantly off over the foot, and can be as easily re-applied. It is light, convenient, painless, and efficient. Directions foe Measurement. 1. Circumference of thigh close to bulge of nates. 2. Circumference of thigh one inch above top of patella. 3. Distance of these two circumferences from each other. 4. Distance from upper circumference to a point two inches* above lower end of malleolus. Andrew's Elbow and Wrist Splints. For chronic inflammation of the wrist^ I use the following easily constructed ap- paratus. A rectangle of thin brass or tin is bent into the form of half a cylinder, long enough to extend from the elbow to the tips of the fingers. At each side of the elbow is a slot and friction roller. At the other, end are two eye-holes in the end of the brass, half an inch in diameter. The hand being enveloped in rubber, adhesive plaster, with tapes attached, is secured by tying the latter into the eye-holes. Other plasters on the fore-arm above the wrist have elastic bands attached to their upper extremities, terminating in thin leather straps. The latter pass over the friction rollers at the top of the instrument, turn downward, and are buttoned to knobs on either side. This makes perfect extension. If the elhoio requires extension, either in a straight or bent position, the same principle is perfectly available by merely varying the form of the tin case. The friction rollers so often referred to are the simplest possible things, they consist of simple pieces of strong wire soldered to the brace, so as to cross the desired edge of the slot. A little cylinder of tin or brass loosely surrounds the wire, so as to revolve freely when the elastic band is drawn over it. These things are simple, easily made and easily managed. The whole complex system of screws, nuts, racks, pinions and extension bars of every description, are, in nine-tenths of the cases, cumbrous abominations compared with the less complicated plans. I confess to having used them in former years, but at present I only employ them in a few peculiar cases. Pakt IV. 124 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 188. Andrew's Splint for Inflamed Knee in the tent position. a. Leather laced in front, h. Brass splint, hammered to fit the limb. c. A knob. d. Leather strap, f. Elastic band. g. Slot and friction roller, k. Adhesive strap, to the lower end of which the elastic band is sewn, then passed through the slot, drawn strongly up, and its leather buttoned to the knob G. The adhesive straps must terminate somewhat above the slot. If, as often ha^ipens, the knee is not only inflamed, but also fixed in a hent position^ most surgeons hold that it is necessary to straighten the knee, before an apparatus can be worn. ISTow the straightening process itself is irri- tating, and tends to exasperate the inflammation. I have resorted Math decicled advantage to the following plan : A plaster cast is first taken of the posterior half of the limb, from the nates to the heel. To this a thin splint, 5, of hammered brass, is fitted. The upper part is completed by the addition of leathers, «, which lace in front, and by thus embracing the thigh and the lower portion of the hip in its hollow frustrum of a cone, makes a basis for counter extension. A slot, f Branch Storf,, 107 East 28th St., N. Y. Excising. TOOTH FORCEPS. Single Jointed. Straight. Curved. Splitting. Elevating. Part V. GEO. TIEMAXN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohi.manx. Edward Pfarre. TOOTH ITOItCEPS. Goodwillie's Goodwillie's Goodwillie's Plain Curved. Bicuspid. Plain Straight. Half Curved. Straight. II ^ 64. Spring Bolt (double). 05. Spring Bolt. 66. Rcmovnhle Fulcrum. Part V. 67 CHATHAM STREET, NEW YORK. Q Branch Store, 107 East 28th St., N. Y. TTJRIV ItETTS. 07. Ilotaliiig Fulcrum. HOOT EXTISACTOISS. 68. Stag-foot Elevator. 69. Screw 70. Root 71. Eoot Elevator. Extractor. Extractor. _ 72. 73. Curved 74. Angular Gum Lancet. Root Extractor. Root Extractor. 75. Gum Lancet. Part V. 10 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. UP r>o GUftAFF'S ST^iJPH:'yLOPiIlELAX»H:Y CASE. Fig. 76. Curved Bistoury. G. TIEMANN & CO. Fig. 77. Curved Needle. /^ Fig. 78. Blunt Hook. Fig. 79. Bent Needle. EIi]yi:ATOL.OOICAL. Fig. 80. Njbvus Needle. Blowpipe, to heat Needle, page 100, Part III. Paut v. r,7 CHATHAM STREET, NEW-YORK. 11 Branch Store, 107 East 28Ti£ St., N. Y. r>Ertivry\.TOLOOiCAL< Fig. 81. Piffard's Ooinorlonc Exl-niclor. Pig. 82. Piffard's Iiido-Platinnm Needle. Fig. 89. Piffard'.s Sharp Spoon. Fig. 83. Piffard'.s Milium Needle. -=»ffl li.-^Vt^Ak^^U EttQ. Fig. 84. Piffard's Scarifying Spud. Fig. 85. Piffard's Epilating Forceps. Fig. 86. Piffard's Grappling Forceps. Fig. 87. Skin Grafting Scissors. Fig. Piffard's Cutisector. Fig. 90. Hess' Glass Pleximeter. For observing the skin under pressure. IIGMAN'J-CC- Henry's Depilating rf)rccps, page 46, Part HI. Piffard's Cutisector, Platina Caustic Cup, Fine Scissors, Scalpels, , . fig. 296, Part II. tig. 309. Part III. figs. 110, 111, Part II. pages 6, 46, Part I. Microscopic Instruments, Counter Irritants, Vaccinating Instruments, Hypodermic Syringes, . page 90, Part I. page 63, Part I. . page 66, Part I. page 79, Part I. Part V. 12 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. IV^^JL ^^]VI> COK]V IlVSTIiXJiytElVTS. Fig. 91. Spring for Inverted Nails. ■'"'c/uann&co Fig. 92. Nail Nippers. Fig. 94. Corn Knife and File. iD Fig. 95. Van Buren's Sequestrum Forcep: Fig. 9G. Nail Cleaner and File. llil|:tlll||:l|.'ilW G.TIEMANN &C0. Fig. 97. Pocket Case Scalpel, for Corns. Fig. 100. Corn Knife (spring handle). Part V. G7 CHATHAM S'JREET, NEW-YORK. 13 Branch Stoke, 107 East ^Htii St., N. Y. Fig. 101. Emmctt's Counter pressure Hook., Fig. 102. Emmett's Euucleulor. Fig. 104. Emmelt's Ut)ul)lc Tuiiiiculum. j ^^^ l j^^ ^^^ &CO I ' Fig. 105. Emmett's Curette Forceps. Part V. 14 GEO. TIEMANiV & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 110. Enimett's Sponge Dilator. Fro. 116. Minor's Trachea Retractors. A substitute for the Tracheotomy Tube, de- .'iigiied to hold open a wound in the trachea, so that the air can pa.-s in and out of the windpipe through the same. A i.s a hollow rod, slightly curved, ha\ ing a screw at each extremity, B B, to set the refractors, D, D, which are then se- cured in the desired position by tapes adjusted at C, C. Fig. 117. Brown's Pessary. Supplement. Additions to the Armamentarium Chirurgicum, NAMES OF INVENTORS, AND CHEONOLOGICAL RECORD OF PUBLICATION. THE METRIC SYSTEM. Certain French scientists of tlie last century, in order to establish a universal cosmopolitan measure, proposed to base our conceptions of si7,e, weight and money on the well-known and beautiful Decimal System of mimbers — this being understood by all men alike, however dif- ferent in nationality or language. The terms applied to the length-unit, "Metre," and to the weight-unit, " Gramme," were taken from the Greek language. The names expressive of fractions of the above, are formed by combination with the following Latin words: Latin. Decern, ten. Decimetre, equal to 0.1 Metre. Centum, hundred, Centimetre, " O.Ul " Mille, thousand, Millimetre, " 0.001 " The terms applied to the upper divisions, expressing certain pluralities of the same, are formed of sj'nouymous '\\ords talcen from the Greek. Greek. SeX^i ''^"' Decametre, equal to 10 Metres. eXO'TOV, hundred, Hectometre, " 100 " Xt^toi, thousand, Kilometre, " 1,000 " fivpwt, ten thousand, Myriametre, " 10,000 " Gramme, the weight measure, is divided into- Deci- Centi- Milli-gramme. Deca- Hecto- Kilo-gramme. Arranged into a Table it reads thus: Litre, the capacity measure, is divided into- Deci- Centi- Milli-litre. Deca- Hecto- Kilo-litre. LENGTH. 10 Millimetres make 1 Centimetre. 10 Centimetres 10 Decimetres 10 Metres 10 Decametres 10 Hectometres 10 Kilometres 1 Decimetre. 1 Metre, equal to 39.368 American inches. 1 Decametre. 1 Hectometre. 1 Kilometre. 1 Myriametre. WEIGHT. 10 Milligrammes make 1 Centigramme. 10 Centigrammes 10 Decigrammes 10 Grammes 10 Decagrammes 10 Hectogrammes 10 Kilo<>rammes 1 Decigramme. 1 Gramme, equal to 15.433 grains Troy. 1 Decagramme. 1 Hectogranime. 1 Kilogramme. 1 Myriagramme. CAPACITY. 10 Millilitres make 1 Centilitre. 10 Centilitres 10 Decilitres 10 Litres 10 Decalitres 1 Decilitre. 1 Litre, equal to 2.118 pints American. 1 Decalitre. 1 Hectolitre. W"EIGHT or "WATER AT MAXIMUM DENSITY. Millier (or Tonneau) 1,000,000 Grammes, equal to 1 Cubic Metre. Quintal 100,000 Myriagrannnc Kilogramme (or Kilo) Hectogramme Decagranmie Gramme Decigramme Centigramme Milligramme 10,000 1,000 100 • 10 1 0.1 0.01 0.001 1 Hectolitre. rj Litres. 1 Litre. 1 Decilitre. 10 Cubic Centimetres. 1 " 0.1- " 10 " Millimetres. 1 " Square and Cubic Measures are deduced hy arithmetic rides : A Square Decametre is called Are" ; a Cubic Metre is called "Stere." SuPPLEMIiNT, 1876. Geo. Tiemann & Co.'s Surgical Instruments. JVo. 07 Chatham Street. Branch Store, No. 107 East 28th Street, NEW YORK. -c>->-« » < < Fig. 1. -OBSTETRICAL FOEOEPS. By W. II. Newman, M.D., Denver, Colorado, April 7, 1875. Price, $7.00. Fig. 2.-UEETHE0T0ME. By E. a. Banks, M.D., New York, April, 1875. Price, $20.00. Fig. 3.-THE NEW OBSTETEIO FOEOEPS. By Edward Warren Sawyer, M.D. Lecturer on Obstetrics and the Diseases of Children, Hush Medical College, Chicago, February 1st, 187C. Price, $7.00. F. A. STOnLSIANN. Supplement, 1876. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS. Edward Pfarbe. Fig. 4.-A DILATING UEETHEOTOME. - By James Andrew ]\Iilne, M.D., Oswego, N. Y. Medkal liecord, February 19, 187G. Price, $17.00. Fig. 5.-A NEW SPRAY CAUTEEY. By Jarvis S. Wight, M.D. Medical Society of the County of Kings. Stated Meeting, April 18, 1876. Price, $11.00. Fig. 6.-F0E0EPS FOE THE EXTEAOTION OF AEEOW HEADS. By J. H. Bill, M.D., U. S. A. Medical liecord, April 8, 1876. Price, $2.50. Fig. 7.-DE. H. T. HANKS' TENACULUM FOEOEPS. American Journal of Obstetrics, August 1876. Transactions of the New York Obstetrical Society. Price, $3.00. Fig. 8.-UTEEINE LEECH AND ASPIEATOE. By William W. Reese, M.D., Brookljm, N. Y. Medical liecord, Sex)tember 9, 1876. Price, $4.50. Supplement, 1876. 67 CHATHAM STRP]ET, NEW YORK. BuANcii Store, 107 East 28tii St., N. Y. KNIFE AND SAWS FOR SUBCUTANEOUS SECTION OF BONE. By Du, Adams, of London, England. September 19, 1876. Fig. 9 -ADAMS' SUBCUTANEOUS SECTION KNIFE. Price, $1.50. Fig. lO.-ADAMS' LAKGE SAW. Price, $4.00. Fig. 11 -ADAMS' SMALL SAW. Price, $3.50. 6.TIEMANN & C3 Fig. 12.-ADAMS' EHINOPLASTOS. For straightening the bones of the Septum Narium deformed by accident- Price, $3.00. Supplement, 187G. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoulmann. Edwaku Pparre. Fig. 13 -NASAL DOUOHE. Fig. 14.-AUT0-INSUFFLAT0E. By IIouATK) BiuDGE, M.D., New York, October, 1876. Fig. 13,— Price, 60 cents. Fig. 14.— Price, 75 cents. 1-^ 1=3 O H Ph O I — I E-l t— I pq o o r— I Ph o o oi Supplement, iSl'f]. ^ 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28tu St., N. Y. « Fig. 16.-TW0 NEW PESSARIES, 1, 2. By A. T. Woodward, M. D., Bnuidon, Vt. Neiv York Medical Journal, October, 187C. 1.— Price, $1.25. 2.— Price, $1.25. Fig. 17.-NEW EORASEUE. By J. H. Thompson, M.D., Washington, D. C. Price, $25.00. Fig. 18.-NEW BEISTLE PROBAlfa. By T. A. Stanford, M. D., Columbus, Ga. Price, $2.50. Fig. 19.-AUT0MATI0 SUTUEE. By A. H. Hope, M.D., U. S. A. Price, $5.50. x> x> Fig. 20.-A NEW NEEDLE HOLDEE. By Dr. Anatol de Gaine, St. Petersburg, Russia, January 17, 1877. Price, $4.00. SlTPPLEMKNT, 1877. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfaure. Fig. 21 -A NEW TRACHEOTOME. By II. T. Hanks, M.D., New York. American Journal of Obstetrics, January, 1877. Price, $9.00. ■ig. 22 -A NEW ATOMIZEE FOR USE IN ANTISEPTIC SURGERY. By H. T. Hanks, M. D., New York. Medical Record, January 13, 1877. Price, $15.00. Fig. 23.-INSUFFLAT0R FOR TREATMENT OF CATARRHAL INFLAMMATION OF THE MIDDLE EAR. By Samuel Sexton, M. D., New York. Medical Record, January 13, 1877. Price, $2.00. • Supplement, 1877. G7 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28tii St., N. Y. Fig. 24.-A NEW SAW. (Patent.) By F. A. Stoiilmann, (Tiemann & Co.,) New York. Ifew Remedies, February, 1877. Price, $6.00. Fig. 25.-ADJUSTABLE VEOTIS. By Thomas Rterson, Newton, N. J. February 17, 1877. Price, $5.00. C)."\\t.WKHU8"-^---^^^5^' Fig. 29.-A NEW WIEE TWISTEE. By Simon Fitch, M. D. Edin, St. John, New Brunswick, Canada. April 11, 1877. Price, $4.00. Fig. 30.-A NEW PEOSTATIC aUIDE. By F. N. Otis, M. D., New York. Medical Record, April 21, 1877. Price, $1.25. ^-.k^^ ^^wuw\ -A» VA-W\AJ vi\svJv--\-Vv;V^W\A=.\--'vsiT:AdF G.TIEMANN&CC Fig. 31.-UNIS0N EESONANCE IN AUSCULTATION. A NEW EESONATOE. By Edgar Holden, M. D., Newark, N. J. Medical Record, April 28, 1877. Improved. Price, $2.50. Supplement, 1877. 10 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. - ■» Fig. 32.-THE EEEOES OF EEFEACTION DEMONSTEATED BY A NEW AND OEIGINAL MODEL. By F. A. MuNSON, M. D. New York Medical Jorirnal, May, 1877. Price, $9.00. Fig. 33.-A NEW STAPHYLOEEHAPHY INSTEUMENT. By D. Prince, M. D., Jacksouville, 111. Price, $10.00. Fig. 34.-A NEW DOUBLE-BLADED LITHOTOME. By Jo. C. Hutchison, M. D. Froceedings Med. Soc. of the County of Kings, J'uly, 1877. Price, $8.00. A Supplement, 1877. 67 CHATHAM STREET, NEW YORK. 11 Branch Store, 107 East 28Tir St., N. Y. Fig. 35.-A NEW HEENIATOME, By Oscar II. Alt.ts, M. D. Philadelphia Medital Times, July, 1877. Price, $7.00. Fig. 36.-SUSSD0EFF'S TUPELO DILATOES, A New Material for Dilatation of the Cervix Uteri, and for other purposes. Medical Record, July 14, 1877. Hollow, price per doz., $3.00. _^ ^^^^$S$$$$$^j$SS^^^^$^V^$j^$$:;j$j$$^^^ Fig. 37.-A DILATING UEETHROTOME. By R. A. KiNLOCH, M. D. American Journal of the Medical Sciences, July, 1877. Price, $25.00. A. Instrument entire, with small bull) attachment. J?. Section, showing the blade projected and ready for use. G. Tunnelled end attacliment, with whalebone guide. D. Probed end or short elastic guide. E. Bulbous attachments, of different sizes. F. Blade, detaclied to show fomiation, shoulder, &c. G. Long elastic guide, bougie attachment. Fig. 38.-TIEMANN & OO.'S SOFT RUBEEE OATHETEE (Velvet Eye). Article by Joseph W. Thompson, M.D., Paducah, Ky. Patented June 12, 1877. Sir Henry Thomp.son says : " If, after twenty- four hours of agony, re- lief follows your dex- trous use of the cathe- ter, and the two or three pints which the patient was unable to void are withdrawn by your hand, he tells you that he is in heaven — a com- Aimerican Practitioner, August, 1877. Price, 75 cents. JAQUES'. mon expression with such patients^: and he will never doubt for a moment that you were the author of his trans- lations." I have repeat- edly been more wannly and gratefully thanked by the patient and fa- mily for relie^"ing. by the use of soft catheters, the retentions of urine, than for any other professional service. These catheters are especially suited to the wauts of country practitioners, where in sparsely settled sections they are frec^uently iinable to see the patient suffering with retention ft-oni prostatic obstruction, and atony from over-distention or paralysis of bladder, more than once in twenty-four hours, when in that length of tiine the operation should have ijeen repeated three or four times. Ton can easily instruct these patients to relieve them- selves with one of them. Thus the great advantage to that class of practitioners is evident. SupplrmeKt, ISt'?. 12 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarhe. Fig. 39 -A NEW ATOMIZER AND EYE DOUCHE. Bj^ F. A. Burrall, M. D. Medical liccord, August 25, 1877 Price, $1.75. Pig. 40.-A MODIFICATION OF THE SIMS' SPECULUM. By Blencowe E. Fryer, M.D., Surgeon U. S. A. Medical Beeord, September 22, 187' Price, $2.00. Fig. 41.-A NEW DILATOR. By J. A. Steurer, M. D., New York. Medical Record, September 22, 1877. Price, $8.00. THE COLD SOUND. ( Psychrophor. ) A New Instrument for Treating Pollutions, Spermatorrhoea, and Cliroiiic Gonorrliopa. By Dr. Winternitz, Vienna. Medical Record, September 22, 1877. Price, in Silver, $4.00. Price in Soft Hubber, $2.50. A double current Catheter without eyes, the two canals communicating near the point of the instrument. It is introduced into the urethra until its point has passed the pars prostatiea and it is then attached by rubber tubing to a reservoir containing water of the desired teni perature. On turning tlie stopcock, the water flows into one canal and out through the other. In this way the caput callinaginis and the entire nuicous membrane are exposed to the mecha- nical action of pressure and the .sedative action of told. Supplement, 1877. 67 CHATHAM STREET, NEW YORK. 13 Branch Store, 107 East 2Hti! St, N. Y. rig. 42.-A NEW DEVISE TOR SPREADmG- PLASTER OF PARIS AND OTHER SUBSTANCES UPON BANDAGES. Ey Dr. Greene. MedUal ICecord, October i:5, 1877. Price, $5.00. The apparatus is constructed to simply roll handar^es, or, if desired, to apply silicate of soda, dextrine or plas- ter simultaneously with the winding process. It is en- closed in a black walnut box, in which the materials are confined, therefore creating no dust. Fig. 43.-APPARIT0R AURIS. A POWERFUL AID TO THE DEAF IN HEARINa. New liem.cdien, October, 1877. Price, $6.00 a pair, in Case. They are sold in pairs, one for each ear, and are so shaped that they can be worn entirely within the con- cha, being almost unobservable on account of their close fit and flesh color. The advantage of this instrument over the well-known cornet consists in having the canal elongated and over- bridged, so that sound entering the apperture (^1) cannot dift'use, but is conducted within the tunnel through the meatus auditorius (i?) to the tympanum. Fig. 44.-A NEW OBSTETRIC FORCEPS. By M. Tarnier, M. D., France. Price, $24.00. Fig. 45.-M0DIFICATI0N OF A CERVIX UTERI DILATOR^ By John Ball, M. D., Brooklyn, N. Y. Price, $10.00. SurPLEMENT, 1877. 14 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, •F. A. Stohlmann. Edwakd Pfahke. Fig. 46 -A NEW TENAOULUM-NEEDLE, WIEE-TWISTER AND NEW MATERIAL TOR SUTUEES (Hard Ash). By C. J. Cleborne, M. D., Surgeon U. S. Navy, Medical liecord, October 13, 1877. Price, $7.00. Fig. 47.-A HANDY ASPIEATOE. By Simon Fitch, M. D. Edin, St. John, New Brunswick, Canada. New York Medical Journal, JVovember, 1877. Price, $5.00. A represents the dome aspirator-needle, with the cutting point projected, ready for puncture ; G, a magnified diagram of the same, after insertion, with the dome advanced so as to protect the interior of the cavity during aspiration ; £■, bulb in upright position, to insure the best action of valves ; C C, valves ; D, entrance-tube ; £, exit tube ; J^ -F, bits of glass tubing, through which to observe the presence or absence of fluid. Fig. 48.-ELASTI0 SPEINQ HEAD-EEST FOE TOETIOOLLIS. By J. R. Wood, M. D., New York. Medical liecord, November 10, 1877. Price, $5.00. Supplement, 1877. 67 CHATHAM STREET, NEW YORK. 15 Branch Stoke, 107 East 28tii St., N. Y. Fig. 49 -A STEAM SPEAY APPARATUS FOR THE ANTISEPTIC TREATMENT OF WOUNDS. By Robert F. Weir, M. D., New York. New York Medical Journal, December, 1877. Price, $15.00. Fig. 50.-TIEMANN & OO.'S HYPODERMIC SYRINGE BOTTLE. Neiv Remedies, December, 1877. Price, (see our List of Hypodermic Syringes.) Patented October 9, 1877. Supplement, 1877. 16 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoiilmann. ' Edward Pfaure. Fig. 51 -PEOBES FOR THE TREATMENT OP STRICTURES OF THE NASAL DUCT. By Samuel Theobald, M. D. Transactions of the Medical and Chirurgical Faculty of Maryland, Baltimore, 1877. No. 1. — I4 "'• ■"'• 2. — 1^ m. m. 'i. — % in. m. 4. — 1 m. m. 5. — 114 in. m. No. 6. — 11^ m. m. 7. — V^^ 1)1. 111. 8. — 2 wi. m. 9. — 2}£ m. m. 10. — 23^ in. m. 11. — 2^ in. m. No. 12.— 3 m. in. VS. — '6\£ m. m. 14. — 33^ ?/i. m. 15. — 33^ m. m. 16. — 4 m. in. Fig. 52.-A NEW MOUTH QAG. By Robert F. Weir, M. D., New York. Medical Record, January 5, 1878. Fig. 53.-A NEW INHALER FOR ANJESTHETIOS, &c. By A. Speirs George, M. D., Riclimond, Va. Virginia Medical Monthly, January, 1878. Fig. 54.-AN IMPROVED CATCH FOR SANDS' NEEDLE-HOLDER. By David E. Dudley, M. D., Maj^lla, P. I. Supplement, 1877. 67 CHATHAM STREET, NEW YORK. 17 Branch Store, 107 East 28Tn St., N. Y. pq W Fig. 55 -AN IMPEOVED ENUCLEATOR. By H. C. Yarrow, M. D., Washington, D. C. Mddical and Surgical licportcr, Philadelphia, March 16, 1878. Price, $4.00. Fig. 59.--A NEW UEETHRAL ENDOSCOPE. By Alexander J. C. Skene, M. D., Brooklyn, N. Y. March, 1878. Supplement, 1878. 18 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwaud Pfarre. Pig. 61.--EEFLUX OATHETEE. By Alexajmdku J. C. Skene, Brookljii, N. Y Fig. 62.-SXENE'S DOUBLE PEEFOEATED CATHETEE. „- '-5 S K ^ Fig. 63 -SKENE'S SELF-EETAINING CATHETEE. (Modification of Goodman's.) Fig. 64.-A NEW AETEEY FOEOEPS. By n. J. BiGELOw, M. D., Boston, Mass. Fig. 65.-SKENE'S OYSTOCELE PESSAEY. Fig. 67.-B0ZEMAN'S VAGINAL SUPPOET. ^ o fi y h s^ 1^ ji ^ -=■ ^ w ?= ^ o Q f^ H M W W O K Supplement, 1878. G7 CHATHAM STREET, NEW YORK. 19 BiiANCU Stoke, 107 Eaht a«Tii St., N. Y. Fig. 69.-A NEY/ RETROFLEXION PESSAEY. Ijy AiiFUED L. (iAUKOLii, M. I)., New IJrigliUjii, N. Y. Medical h'ccord, March :i(), 187H. 11 is constructed ol" a steel si)ring covered witli indi.i rubber, iunl its "liour-gliiss" sliape, us sliown iu the iiccoini);uiyiii;^' vvijod-eut, serves a double purpose. In tlie lirst place, the central constriction furnishes the same .sort of elastic extension as is given by the spring in Scatlergood's |)essary ; and, in the second place, the contraction of tlie vagina around tliis central constriction tends to increase the supporting power (;f the instrument, while eonchu'ing to the comfoit of the wearcj'. 'J'lie material is sufficiently i)liiil)le to be bent into the re({uircd curve for any given instance, and its elasticity in all directions ciialjJes it to yield, to a certain extent, to the patient's movements, without alto- gether relaxing its support. Fig. 70-NEW ATOMIZER FOR SPRAYINa THE THROAT. By H. T. Hanks, M. D., New York. Medical Record, March 30, 1878. The set consists of three straight tubes of strong glass, seven inches in length, tapering at the distal end to a point with only a small perforation. On the right side of this extremity a second little funnel-like tube is strongly cemented. This is for holding the few drops of the medicament to be used, and may be tilled from the bottle or with a pipette. As may be seen in the cuts, in one instrument the point of the medicine-tube is exactly in front of the air-tube ; this is for throwing the spray directly into the throat. In the other two a variation in the direction of the tube gives a corresponding direction to the spray, so that it may be thrown upward with one instrument and downward with the other. A common Davidson sja-inge or rubber air-bulb may be attached to the proximal end of the long tube for forcing the air through. Both tubes, for an inch from the distal end, are flattened on their under surface, and rough- ened, and serve the purpose of a tongue-depressor. The advantages claimed for these atomizers are as follows: 1. They are compact. 2. They are inexpensive. 3. Only the necessary cjuantity of medicine need be used. 4. The throat is surprised, not by a preliminaiy gush of air, but by the instantaneous application of the remedy directly to the aJiected parts, before any contraction can take place. Fig. 71.-A NEW URETHRAMETER. By SAJvruEL W. Gross, M. D., Philadelphia, Pa. Supplement, 1878, 20 GEO. TIEMANN & GO'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. Fig. 72.-URETHE0T0ME. By Samuel W. Gross, M. D., Philadelphia, Pa. Medical Record, June 15, 1878. ^^^^ ^p It is nothing more, as may be seen in the woodcut, than a metallic exploratory bougie, the slender shaft being provided with a handle, grooved for the reception of a steel rod, to one end of which is attached the blade, and to the other a button, through the retraction of which the former is thrown out of the under surface of the bulb, so that the incision may be made along the floor of the urethra. The extent to which the blade can be projected is regulated by a lateral screw near the handle. The length of the contrivance is eleven inches, of which three are taken up by the handle, button and screw. In actual practice I have found two such in- struments to be all that are required. In one, Avhich is intended for strictures of moderate calibre, the bulb is equal to No. 15 of the French catheter scale ; while, in the other, the bulb corresponds with No. 23, which suflices to define coarctations of much larger size. In excep- tional cases, still larger bulbs may be demanded. Fig. 73.-A NEW UEETHEAL DILATOR. By Samuel W. Gross, M. D., Philadelphia, Pa. ^ Medical Record, June 15, 1878. S.T\tM\M«^&C.O I have arrived at the conclusion that enlargement of the meatus is uncalled for when the relation between its size and that of the spongy urethra is normal. Hence, I have been trying for some months past tQ devise an instrument with which, after divulsion or internal incision, the several parts could alone be stretched during the healing process, without detriment to the remainder of the urethra, and I have finally succeeded, with the assistance of Messrs. Geo. TiEMANN &, Co., in perfecting the dilator shown in Fig. 2. It consists of a No. 16 steel sound, the terminal two-thirds of which are split into two" halves to form the blades. These are united at the vesical extremity, Avhere thej^ are carefully bevelled, and can be separated" laterally, so as to form a spindle-shaped body, by a flattened cone attached to a rod, which is acted upon by a wheel at the proximal end of the handle, the extent to which the blades can be parted being indicated by a register, marked in millimetres, attached to the handle. In using the instrument, the blades are expanded sufficiently to traverse the meatus without overstretching it, when its centre is made to correspond with the divided stricture, and the wheel is slowly turned until the register indicates that the desired degree of distention has been reached. By reversing the wheel, the blades are approximated and the dilator withdrawn. Fig. 74.-A NEW DOUBLE OANULATED NEEDLE. For Wire Sutures in Staphylorrhaphy, Vesico-Vaginal and Fistula in Ano. By D. A. CuRRiE, M. D., Englewood, N. J. StrPPIiEMENT, 1878. 67 CHATHAM STREET, NEW YORK. SI Branch Store, 107 East 28Tn St., N. Y. Fig. 75 -A NEW EOTATma UEETHEOTOME. By John A. Puitciiett, Ilayneville, Ala. Neiu York Medical Journal, July, 1878. It may be called a modification of Maisonneuve's, and consists of the following parts : First, we have a plain cylindrical rod or staff, fifteen inches long, two millimetres in diameter, and with the short curve of Bnmstead. The external extremity has attached on its under surface a ring to serve as a handle, while the internal extremity terminates in a screw for the attachment of filiforms. A tunneled screw-head (Gouley's attachment) is also provided to screw on for using the finest whalebone guides. Next, and in this consists the peculiarity of the instrument, we have three tubes, each seven inches long, and fitting the rod closely, and with a slit down its entire length so as to pass the ring-handle of the staff. At the external extremity of each tube are attached laterally two rings for handles; while each internal extremity is Ijeveled so as to pass strictures more readily. One tube carries at its internal extremity, attached superiorly, a triangular, probe-pointed "blade, nine millimetres in size; a second tube carries a similar l)lade, seven millimetres in size, also attached superiorly; while the third tube carries two similar blades, each four millimetres in size, attached laterally. The staff is made so long (fifteen inches) in order that the entire tube may pass the ring- handle before the blade enters the meatus. Fig. 76.-NEW mSTEUMENT FOE EAPID AND FOECIBLE DILAT- ATION OF THE OEEVIOAL CANAL. By H. D. Hanks, M. D., New York. Medical Record, July 27, 1878. (Hank's Rapid Uterine Dilators, set of ten.) Fig. 77.-A MODIFICATION OF HODaE'S OPEN-LEVEE PESSAEY. By Jno. S. Coleman, M. D. Medical Record, July 27, 1878. G.TVtMM*^ a^QO. It is made of copper wire, covered with soft rubber, and can be bent into any desired shape. Supplement, 1878. f)^ GEO. TIEMANN & CO.'S SURGICAL INSTRUME^TTS, F. A. Stoiilmann. Edwakd Pfartie. THREE NEW URETHRAL INSTRUMENTS. By Alexandek S. Hunter, M. D., Now York. Medical liecord, November 9, 1878. H l=> O" H- 1 (^ P o EH w W P^ P OQ P5 H EH |2i 1=) w Co- Jab Fig. 81.-A NEW DILATING UEETHEOTOME. Ry C. W. Stearns, M. D. Btjpplement, 1878. 67 CHATIIAM STREE^J\ NEW YORK. 23 Branch Store, 107 East 28tii Ht., N. Y. Fig. 82.-A NEW BOW PESSARY. By C. N. Fowler, M. D., Youngstown, O. ' Fig. 83.-A NEW CLUB FOOT EXTENSION APPAEATUS. By Newton M. Shaffer, M.D., New York. Medical Becord, November 23, 1878. Tlie club-foot extension apparatus, 1, consists of the ordinary uprights, ^,^, fastened to the conventional heel-piece, B, by a plain joint on one side, and an endless screw, C, on the other. This screw, C, allows us, by using the key, B, to place the foot-piece of the apparatus, as a whole, in any antero-posterior position we choose, and to alter it at will, either before or after application to the foot. The dotted line, P, P, is supposed to represent'the arc of a circle, the centre of which is the screw, C. That part of the foot-piece, E, which corresponds with the tarsus and metatarsus, is joined by a common extension rod, F (shown in 2), to the portion which lies under the os calcis. With the key, (7, we are enabled to extend the anterior part of the foot-piece, E, at pleasure. 2 shows the apparatus lying on its side, with a full view of Jj ^\^M,Km^ -"CO. the under surface of the foot-piece, E, and the extension rod, F. At K, K, ig a leather, or rub- ber heel, built up on either side of the extension cylinder, and L represents a wooden sole, which is elevated to a height corresponding with the rubber heel. So far as this apparatus is con- cerned, I may say that it presents no novelty, save the extension rod, and the modifications which this addition to the apparatus makes necessary. To apply this instrument, we first, by means of the key, D, place the foot-piece in a position that will exactly correspond with the antero-posterior position of the foot (whether tenotomy has been performed or not). We then secure the heel by tying the heel-strap, H, as represented in 3. We then bind the foot, anterior to the medio-tarsal joint, to the extension part of the foot-piece, E, by means of adhesive plaster, vide 3. We first apply four or five strips to the plantar integument, which are reversed as they pass over the end of the foot-piece, and are then fastened to the under part (wooden) of the foot-plate. Five or six strips are now passed longitudinally over the toes, and underneath, where they are also secured. Transverse pieces are then passed around the tarsus and metatarsus — also underneath the foot-plate— and secured at convenient points. (The plantar strips are not shown in the engraving, and the artist has placed key G too far forward). A bandage is then applied to protect the adhesive plaster. The key, D, is now used to flex the foot, in overcoming to the desii-ed extent the tendo A chillis resistance. SUPPT.EMENT, 1878. 24 GEO. TIEMANN & CO 'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pparre. Fig. 84 -MODIFICATION OF TAYLOE'S ANKLE SUPPORTS. By Newton M. Shaffer, M. D., New York. Medical Record, Novemher 23, 1878. I have deemed it be=;t as a matter of experience not to adopt tlie' club-foot extension appa- ratus to the purely lateral deformity, as mentioned before. It is, ordinarily, and especially in infants, a very easy matter to rectify this by any lateral support of gutta-percha, tin, or other flexil)le material. In obstinate cases it is well 4. to make subcutaneous sections to save time. 5. I have found a very useful lateral splint in a modification of Taylor's "ankle-support," which is represented in 4. My modification consists in the substitution of the lateral hinge, Ay and the endless screw, B, for the antero- posterior joint. The dotted lines show the movement acquired by using the key, O. This modification enables us to apply the appara- tus accurately to the extremes of varus (or val- gus), and to gradually, by means of the key, C, turn the foot to the desired extent. This splint is applied, as represented in 5, to that side of tlie foot toward Avhich the de- formity looks. It should be secured by a ban- dage (the bandage is omitted in the engraving, and two strips of adhesive plaster, Q, Q, are substituted, so that the application of the splint may be more easily shown). The counter-extension surface being large, and the resistance generally slight, the pressure may be very gradually applied. The foot can, under ordinary circumstances, be changed from the varus into a valgus position without any pain whatever. Fig. 85.-Dr. NEWTON M. SHAFFEE'S BALL AND SOCKET PIVOT. For the Treatment of Malpositions of the Head. 1. This apparatus, shown in the engravings, consists of a pivot, P, which maj^ be placed at any desired angle, eitlier lateral or antero-posterior, and held there by a clamp which is controlled by a screw operaling at X. The pivot fits into the chin-piece (Taylor's) at the point C, and, by means of the occipital uprights, E, E, and the chin-cup, i/, any position of the head may be maintained and changed at will, without removing the apparatus from the patient. The key, D, loosens the ball of the pivot, and, the head being placed by the hand in the desired position, the key again is used to tighten the clamp. The whole apparatus may be made to surmount the two uprights of Taylor's spinal brace or any otlier form of support which furnishes a reli- able pedestal. The chin-piece opens at F o\\ a hinge, and the slide at O secures the apparatus after it is applied to the head. It is an extremely useful instrument, both in Potts' disease, requiring a head support, and in torticollis. • Supplement, 1878. 67 CHATHAM STREET, NEW YORK. 25 Bkanch Store, 107 East 28tii St., N. Y. Fig. 86.-Dr. NEWTON M. SHAFFEE'S PLASTER ZONE APPARATUS, FOR POTTS' DISEASE. 1 and 2 represent this apparatus. It consists of two perfectly plain uprights of annealed bar steel, B, B, riveted to the hip band, A, with cross-pieces, E, E, and shoufder-pieces, D, I). There are no "pad plates," or •'cork" or "hard rubber" pads, no "hinges" or "screws," as in the Taylor spinal brace, from which this apparatus is moditied. F, F, F, F, represents a zone of plaster of Paris applied around the body and covering the uprights. P is opposite the deformity. The pads, C, G, are simple rolls of canton flannel, stitched to the uprights by transverse stitches, as shown iu the engraving. 2 shows the anteilor appearance of the apparatus. J" is a padded Avebbing strap, which buckles at O, 6, in 1. i'^, Pare two axillary straps, which are buckled to the shoulder-pieces, D,l) 1. X is a padded pelvic strap, which is inserted at either end in the buckles on hip band A. K, in Fig. 2, shows the anterior appearance of the plaster zone which takes the place of the yielding " apron" of the Taylor spinal brace. To apply this apparatus, the patient is placed upon two tables of equal height. The tables are then separated so that the part that is to receive the plaster zone shall be easily accessible from all sides. The head of the patient being grasped by one assistant, and the thighs by an- other, gentle but steady traction is made, while the operator, using a couple of monkey -^Tenches, bends the straight uprights to correspond with the outline of the transverse processes. The canton flannel pads are now sewed on and the apparatus is laid on. the back. The pelvic and thoracic straps are tightened : a strip of canton flannel is passed around the body, covering the deformity ; traction is steadily made, and, by means of the plaster roller bandage, ordinarily prepared, a zone of plaster is snugly applied, covering only two or three vertebrie above and belov/ the diseased bones. Supplement, 1870. 26 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stoiilmann. Edwaiid Pparke. Fig. 87 -A NEW SUBCUTANEOUS SAW, KNIFE AND BONE EASP. By George F. Shrady, M. D. Neio York Medical Record, January 4, 1879. Jla 1. Fig. 88.-A DOUBLE FOECEPS. By C. S. Cleborne, M. D., Medical Inspector, U. S. Navy. Nevj York Medical Record, January 25, 1879. (Artery, Bulldog and Tissue Forceps, and Needle Holder.) Fig. 89.-A NEW SPECULUM VAGINA. By V. Biakt, M.D., U. S. A. Supplement, 1879. 07 CHATHAM STREET, NEW YORK. 97 Branoii Store, 107 East 28tie St., K. Y. Fig. 90.-POLITZER'S UNIFOEM AOOUMETEE. "Politzoj-'s Acoumeter consiHts of a steel cylinder, four inillirnetres in diameter and twenty-eisj^lit niillinictrcs lonjj^, set in vibra- tion Ly tlie ])]()\v of a liamnier — also of Kt(;e]. "The cylinder is fasteney uj)- right rods two and a half inches in length, so as to raise the foot from the ground ; it is the shoe ordi- narily used for shortened leg. This elevated shoe and a pair of crutches constitute the apparatus. As the patient stands on his crutches the diseased limb is suspended ; the shoe is high enough to prevent the toes of the affected side from touching the ground, and the sole should be covered with leather, to avoid noise when walking. Extension is made by the weight of the suspended limb, which is equal in weight to one-fifth of the whole body, is greater than the weight ordinarily employed for extension, and is quite sufiicient to subdue the spasm of the muscles which crowd the head of the bone into the inflamed acetabulum, and is the chief cause of the pain which the patient experiences. To secure Jixatio7i of the knee-joint, I use splints made of hatters' felt. It consists of seven layers of cotton cloth saturated with shellac, and well rolled together while hot. That ordinarily sold consists of but five layers of cloth, which, for most cases, is not firm enough. To give effectual rest to the joint, the splint should be of sufficient length and wide enough to nearly surround the limb ; it should extend half way up the thigh, and to a corresponding point below the knee. A shorter splint, merely 'wide enough to cover the posterior part of the limb, does not secui-e the complete immobility which I have insisted upon in the treatment of diseases of the joints, where absolute rest is demanded. The splint having been cut of the proper length and width (the material is easily cut with a sharp knife), and the limb covered with a stocking, the felt made pliable, preferably by dry heat in an oven or before an open fire, or by immersion in very hot water, is applied to the limb, and covered quickly and firmly with a bandage from below upwards, so as to mould it to all the inequalities of the surface. While the splint is being- applied, an assistant should make extension from the foot so as to straighten the limb as much as possible, in cases where the joint is flexed ; but no vio- lent effort should be made to reduce the mal- position. So soon as the splint regains its inflexibility, and this it does very quickly, it may be removed, trimmed up and holes punched an inch or an inch and a half from the front edges for lacings. The object in punching the holes a little way back from the edges is to permit the splint to be made smaller by cutting off the edges, so that •*\ «K.^'5=\g=^^£;=;=' Supplement, 1879. 30 GEO. TIEMANN & CO 'S SURGICAL INSTRUMENTS, F. A. SruHhMANN. Edward Pfakre. pressure may be kept xip as the knee duniiiishes in size. The weight of tlie body is removed from the diseased joint by the use of tlie elevated shoe and crutelies. In tlie treatment of inflammation of the ankle- joint and its consequences, perfevt vast of the parts (mechanical immobilization), and \\\y the plastere.00 108. Dieulafoy's Aspirator 40.00 Dieulafoy's Aspirator 50.00 The same, camion shape 60.00 Instruments for Stone in the Bladder. 109. 110. 111. 112. lis. 114. 115. 116. 117. 118. 119. 120. 121. 122. 123. 124. 125. 126. 127. 128. 129. SEARCHERS. Steel Sound, cylindrical 1.00 Gouley's Searcher 2.00 Little's Searclier 3.50 Little's Searcher, plain 2.00 Andrew's Searcher 2.50 Otis' Exploriiig Sound 5.50 Bilroth's Sounding Board 1.50 Steel Sound 1.00 to 1.50 Thompson's Searcher 4.00 FOR LITHOTRITY. Handle of Teevan's Lithotrite. . . . Handle of Thompson's Lithotrite . Female Blade of Thompson's Li- thotrite Male Blade of Thompson's Litho- trite Jaws of Lithotrite Jaws of Lithotrite Heurteloup's Lithotrite 25.00 Ferguson's Lithotrite 35.00 Hunter's Trilabe 15.00, 20.00 30.00 Jacobson's Lithotrite 30.00 Reliquet's Lithotrite . . 9.00, 12.00, 15.00 Thompson's Lithotrite 35.00 Teevan's Lithotrite 30.00 Civiale's Lithotriptor 25.00 FOR LITHOLAPAXY. 1295. Bigelow's Lithotrite 40.00 129c. Bigelow's Evacuator 12.00 129d Bigelow's Evacuator and Stand . . 16.00 FOR LITHOTOMY. 130. Pritchard's Anklets and Wristlets. 6.00 to 8.00 131. Little's Staff 2.00 132. Markoe's Staff 2.00 133. Wood's Staff 2.00 Wood's Bisector 4.50 134. Steel Staff 2.00 185. Little's Director 1.50 136. Lithotomy Forceps, straight 3.00 137. Teevan's Forceps 3.00 138. Maisonneuve's Crusher 20.00 FIG. I'AKT III. PRICE 139. Blunt Gorget $2..50 140. ('urved Litliotomy Forceps 3.00 141 . Dolbeau's Lithoclast 7.00 142. Dolbeau's Guide 3.50 143. Scoop and Conduct oi- 2.50 144. Sharp-pointed Scalpel 1.75 145. Probe-pointed Scalpel 1.75 146. Depuytren's Scalpel 1.75 147. Blizard's Knife (American) , 1.75 148. Blizard's Knife (English) 2.00 149. Dowell's Gorget and Staff 5.50 149&. Little's Bistoury 2.00 149c. N. R. Smith's Lithotomc 12.00 UM. Rectangular Staff ■ 2.50 149c. Luer's Scoop 2.50 149/. Bush's Gorget 4.50 149^^, Lithotomy Forceps 3.00 150. Brigg's Lithotome 7.00 1505. Physick's Gorget 6.50 150c. Hutchison's Lithotome 7.50 151. Depuj^ren's Bistoury Cache 24.00 FOR SUPRA-PUBIC LITHOTOMY. 152. Hooked Gorget 3.00 153. Sonde a Dart 3.50 154. Keith's Tenaculum 1.25 155. Aponeurotome 2.0') 156. Gross' Artery Compressor 3.50 156. Little's Lithotrity Forceps. . 3.50 to 3.00 FOR PERINEAL LITHOTRITY. 157. Dolbeau's Dilator 24.00 1575. Duplay's Dilator 45.00 157c. Gouley's Hydro-Htemostat 2.50 158. Gouley's Lithoclast 10.00 1585. Gouley's Lithoclast, plain 6.00 FOR CLEARING THE BLADDER OF DEBRIS. 159. Nelaton's Evacuating Apparatus . 30.00 160. Thompson's Measure 12.00 161. Van Buren's Debris Syringe 3.50 163. Canula a Chemise l.oO 163. Glover's Evacuating Apparatus . . 14.00 164. Debris Tul^e 3.50 165. Mason's Catheter Staff 5.00 166. Van Buren's Evacuating Catheter and Bag 7.00 167. Double Current Catheter, silver . . 5.00 168. Nott's Double Current Catheter . . 4.00 169. Thompson's Urethral Forceps 2.00 170. Alligator Urethral Forceps 6.00 171. Alligator Urethral Forceps 5.50 173. Leroyd'Etiolle's Scoop.. 12.00 to 15.00 173. Reliciuet's Stone Crusher, 12.00 to 15.00 Price List. 20 GEO. TIEMANN & CO'.S SURGICAL IiNTSTRUMENTS, F. A. Stohlmann. Edward Pfarre. FIG. tart III. PRICE Scrotal Instruments. 17-4. Henry's Depilating Forceps 2.50 175. Lewis' Varicocele Clamps 4.00 176. Henry's Scrotal Clamps 8.00 177. Set 4 Trocars 6.00 178. Rubber Bag, Hydrocele 3.50 179. Miliauo's Suspensory 2.00 Trocars. 179J. 'Wood's Trocar 5.00 Harris' Trocar 5.00 179c. Trocar and Cauula 1 .50 (See Figs. 1815, c.) 180. Urinals for Incontinence. (See Figs. 47, 48, 49, 50, page 20, Part IV.) Fumigation Apparatus. 181. Lee's Lamp 3.50 Bumstead's Lamp 3.50 181^^. (Little's Trocar) 2.00 181c. (Folker's Trocar) 2.50 182. Van Buren's Lamp 1.50 to 2.50 183. Maurj^'s Apparatus 12.00 For Injecting the Bladder. 184. Keye's Bladder Washer 5.00 Gynaecological Instruments. 185. Gynaecological Bag 186. Obstetrical Bag Specula Vaginae. 187. Weber's 7.00 1875. Fryer's 187c. Grave's 6.00 187d. Jenk's 8.00 187e. Hornby's 9.00 188. Ferguson's, Tubular, glass 50 Ferguson's, English 1.50 Ferguson's, hard rubber 1.00 189. Blakeley's, Resilient 3.00 190. Meadow's, Trivalve 10.00 191. Meadow's, Quadrivalve 12.00 192. (Buttle's Case) 23.00 193. Nelson's 6.00 194. Thomas' Cusco's 5.00 195. Emmett's 20.00 196. Segala's 8.00 197. Woodward's 6.00 198. (Gardner's Case) 46.00 199. Nott's, with chain 8.00 200. Thomas', Tubular 3.00 201. Thomas', Telescopic 5.00 802. Bozeman's 12.00 fig. 203. 204. 2045. 205. 206. 207. 208. 209. 2095. 210. 211. 212. 213. 314. 215. 216. 217. 218. 219. 220. 221. 222. 223. 224. 225. 226. 227. 228. 229. 230. 231. 2315. 231c. 232. 233. 234. 235. 236. 237. 238. 239. 240. 241. 242. 2425. 243. 244. 245. 246. 247. part III. price Nott's, plain 5.00 French's .................. .k. . . 1.50 (Emmett's Tenacula) 1.25 Storer's 5.00 Hunter's 6.00 Storer's Sims' 5.00 Brewer's 6.00 Brewer's Sims' 6.00 (Skene's Reflux Catheter) ... . 2.50 T. & Co.'s, Quadrivalve 10.00 Dickens' 9.00 Thomas' Latest 20.00 Steel Bivalve 6.50 Byrne's 11.00 Wackerhagen's .... 12.00 Thomas' 10.50 Thomas' Sims' 10.50 Ferguson's Mirror. .50 Stohlmann's 8.00 Dawson's Sims' 7.00 Bozeman's Duck Bill 3.50 Ashton's Fenestrated 1.00 Dome Top 75 Greensville Dowell's 1.50 T. & Co.'s Trivalve, steel 12.00 Weiss' 16.00 Sims' Duck Bill 2.50 Bath 3.00 Baxter's 5.50 Sims' Bivalve 5.50 Howard's 7.00 (Turner's Applicator) , 1.50 (Skene's Instillation Tube) 50 Schlotterbeck's Speculum 10.00 Ball's 11.00 Barnes' Neugebauer's 2.50 Labia, wire 2.00 Sims' Vaginal Dilator, glass 50 Bivalve Speculum 6.00 For Vesico-Vaginal Fistula. Dawson's Sims' Speculum 5.00 Sims' Wire Adjuster 1.50 Sims' Pulley 1.25 Sims' Blunt Hook 1.25 Sims' Speculum 2.50 Skene's Probe and Knife 75 Sponge Holder, German silver ... 1.00 Sponge Holder, iron 75 Bozeman's Button Adjuster 2.25 Bozeman's Depressor 2.75 Sims' Sigmoid Catheter, metal ... .75 The same, hard rubber 1.00 The same, plated 1.50 The same, silver 2.00 Pkice Liht. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28Tir St., N. Y. 21 FIG. PART III. PRICE 248. Sims' Depressor 1.50 249. Bozeman's Wire Adjuster .... 2.00 250. Bozeman's Tenaculum 1.50 251. Bozeman's Blunt Hook 1.50 252. Bozeman's Angular Scalpel 1.75 253. Bozeman's Straight Scalpel 1.75 254. Nott's Depressor 1.50 255. Sims' Scalpel 1.50 256. Sims' Tenaculum 1.25 257. Sims' Seizing Forceps 4.00 258. Nott's Twisting Forceps 4.00 259. Sponge or Seizing Forceps 3.00 Vesico-Vaginal Fistula and Uterine Scissors. 260. Bozeman's Angular 4.50 •361. Bozeman's Curved 4.50 262. Sims' Curved 3.50 to 4.50 203. Emmett's Curved 4.50 264. Sims' Straight 3.50 265. Emmett's Double Curved 4.50 266. Haywood Smith's 12.00 267. Bozeman's Double Curved 4.50 2676. (Jenk's Uterine Probe) 1.75 Bozeman's Buttons and Needles. 268. Bozeman's Button, silver 1.00 269. Bozeman's Button, metal 50 270. Twisting Forceps 4.00 Scissors, for cutting wire . . 2.50 to 4.50 271. Bozeman's Buttons 272. Bozeman's Needle Carrier 8.00 273. Bozeman's Button Shaper 3.50 374. Sims' Needle Forceps 2.50 Bozeman's Needle. 25 Sims' Needle .12 Emmett's Needle 12 Uterine Probes, Sounds, and Dressing Instruments. 275. Thomas' Hard Rubber Probe .... 1.25 276. Silver Uterine Probe 1.25 277. Sponge Tent Expeller 75 278. Emmett's Applicator 1.75 279. Thomas' Elastic Probe 1.25 280. Silver Uterine Probe 1.25 AUuminium Probe 1.25 381. Leaden Probe 40 282. Chapman's Probe and Sound 4.00 383. Nott's Set of Uterine Instruments : 1. Needle Holder 4.50 2. Applicator and Expeller 1.00 J. Sponge Holder. 1.25 4. Leaden Sound 40 J-. Scarifying Knife 1.00 FIG. PART Iir. PRICE 6. Simpson's Sound 1.00 7. Uterine Probe, silver 1.00 284. Whalebone Probe 50 285. Bozeman's Dressing Forceps 3.00 286. Sims' Caustic Forceps 4.00 287. Uterine Dressing Forceps 2.00 288. Curved Uterine Knife 1.50 289. Newman's Metrorganon 3.00 290. Whalebone Probang 25 291. Uterine Knife 1.50 293. Probe Uterine Knife 1.50 293. Gardner's Caustic Holder 2.50 294. Sims' Curette, blunt ] .50 Sims' Curette, sharp 1.75 295. Siemon's Curette 2.50 296. Buttle's Scarifyer and Tenaculum, 2.50 297. Edward's Caustic Holder 3.00 298. Gardner's Caustic Forceps 3.00 299. Siemon's Curette 2.50 Uterine Sounds and Elevators. 300. Sim.s' Uterine Elevator, No. 1 6.00 301. Gardner's Manifold Instrument . . 12.00 302. Emmett's Uterine Elevator 4.50 303. Simpson's Sound, graduated 1.50 Simpson's Sound, plain 1.25 304. Stowe's Elevator 4.50 305. Guernsey's Uterine Elevator 1.50 306. Skene's Uterine Sound 6.00 307. Noeggerath's Uterine Elevator . . . 9.00 308. Sponge Tent Expeller 75 309. Lente's Platina Cup 3.50 310. Lente's Caustic Probe 1.75 311. Sliding Uterine Sound 3.00 312. Hunter's Uterine Sound 1.25 313. Gidding's Uterine Sound 2.00 314. Folding Uterine Sound 2.50 315. Elliott's Uterine Sound 7.00 316. Sims' Redressor, No. 2 6.00 Uterine Dilators. 317. Sims' Uterine Dilator 12.00 3176. Wackerhagen's Applicator 08 318. Barnes' Dilators 6.00 319. Sponge Tents, per doz 1.50 Seatangle Tents, per doz 2.00 Tupelo Tents, per doz 2.00 320. Simpson's Dilators 9.00 321. Hank's Uterine Dilators 1.00 332. Chamber's Stem-Pessary 3.00 3226. Peaslee's Uterine Dilators 6.50 323. Climax Uterine Dilator 15.00 3336. Emmett's Uterine Dilator 3.00 334. Thomas' Dilating Forceps 3.50 335. Ball's Uterine Dilator 10.00 Price List. GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Ppahke. FIG. PART III. PRICE 837. Wylie's Cervical Speculum and Wylie's Probe 3.50 327/^ Alice's Uterine Dilator 2.75 328. T. & Co.'s Uterine Speculum 7.00 329. Jenk's Uterine Sound 3.50 330. Ellinger's Uterine Dilator 10.00 331. Miller's Uterine Dilator 10.00 332. Palmer's Uterine Dilator 5.00 332;*. Hunter's Uterine Dilator 14.00 333. Nott's Uterine Dilator 3.50 334. White's Uterine Dilator 4.50 335. Thomas' Uterine Dilator 5.00 336. Simpson's L^terine Dilator 4.50 337. Vanderveer's L^terine Dilator 5.50 For Division of the Os Uteri and for Scarifying. 338. Chapman's Uterine Scarificator . . 2.50 339. Buttle's Uterine Scarificator 1.25 340. White's Hysterotome 12.00 341. Stohlmann's Hj^sterotome 7.00 342. Sims' Rotating Knife 4.50 343. Storer's Uterine Scarificator 6.00 344. Simpson's Hysterotome 7.00 345. Emmett's Uterine Knife 5.00 346. Skene's Sound and Scarificator. . . 6.00 347. Laenneck's Uterine Knives, each . . 2.50 348. Chapman's Scarificator 1.50 349. Amputating Scissors 7.00 350. Clark's Toothed Scissors 6.00 351. Thomas' Punching Forceps 6.00 352. Peaslee's Uterotome 4.50 Peaslee's Uterotome, 2 blades .... 6.50 353. Ktichenmeister's Scissors 6.00 354. Sims' Knives and Holder 10.00 355. Thomas' Dry Cupper 1.50 For Injection of the Vagina and Uterine Cavity. 356. Lente's Ointment Syringe 3.50 357. Barker's Ointment Bougie 1.50 358. Long Pipe Uterine Syringe 1.25 359. Nott's Double Catheter, long 4.00 Nott's Double Catheter, short 3.00 360. Hutchinson's Ointment Syringe, in case 11.00 361. Davidson's Sjalnge, No. 1 2.00 Davidson's Sp-inge, No. 2 1.50 362. Syphon Syringe 3.00 363. Byrne's Reflux Catheter 2.50 Byi-ne's Adjuster 2.00 364. Reliquet's Double Catheter 2.00 365. Lallemand's Port Caustic 4.50 366. Parker's Caustic Syringe 3.50 367. Bodeuhamer's Irrigator 3.00 368. Lente's Ointment Syringe 6.50 FIG. PART III. PRICE Lente's Ointment Syringe, in case . 8.00 369. Braun's Uterine Syringe 2.50 370. Lawson's Applicator 4.00 371. Nott's Uterine Syringe 2.50 372. Nott's Applicator 5.00 373. Dick's Caustic Syringe 3.50 374. Maw's Enema Pump 3.50 375. Woodward's Syphon Douche .... 2.50 376. Clay's Insufflator 2.25 377. T. & Co.'s Universal Syringe 11.00 Rubber Bag Syringe 2.00 to 3.50 French Irrigateurs 6.00 to 10.00 For Displacements of the Uterus. 378. White's Uterine Repositor 5.00 (See also Figs. 300 to 316.) Pessaries. 379. Hornby's 6.00 380. T. & Co.'s Supporter 6.00 381. Babcock's Pessary 15.00 382. Davie's 8.00 383. Cutter's, with Belt 2.50 384. Rozer's 8.00 385. Thomas' Anteversion 1.25 386. Thomas' Retroversion 1.00 387. Smith's 50 388. Thomas' Anteversion 1.25 389. Thomas' Cutter's 1.50 Thomas' Cutter's, with Belt 2.50 390. Thomas' Cutter's, with Belt 2.50 391. Smith's 50 392. Chamberlain's 1.25 393. Buttle's 75 394. Noeggerath's 2.00 395. Emmett's Metal Ring 40 396. Grajdy Hewit's 1.25 397. Sleigh 75 398. Frazer's 4.00 399. Hoffman's 1.50 400. Zwank's 2.50 401. Buttle's 75 402. Hank's 1.50 403. Buttle's 75 404. Globe, silver 8.00 to 10.00 Globe, hard rubber 1.00 405. Kinloch's Retroflexion 1.25 406. Kinloch's, for Prolapsus of Bladder 2.50 407. Kinloch's Anteversion 1.25 408. Ball's Stem 1.25 409. Kinloch's Retroflexion 2.00 410. Thomas' Retroflexion 1.00 411. Thomas' Stem, for Anteflexion. . . 2.50 412. Thomas' Anteflexion 2.00 413. Thomas' Anteversion 1.25 414. Thomas' Anteversion 1.35 Price List. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 28th St., N. Y. 0'> PIG. PART III. PRICE 415. Thomas' Anteflexion 2.00 41G. Hitchcock's Anteversion 1.00 417. Perry's Flexion Instrument 5.00 418. Hewitt's Pessarj^ 50 419. Hodge's Closed Lever 50 420. Braun's Colpeurynter 3.00 4205. Trask's Dumb Bell Pessary 1.25 420c. Trask's Dumb Bell Pessary 75 421. Coxeter's Stem 1.25 422. Conant's Stem 3.00 423. Hurd's, soft rubber 1.50 Kurd's, hard rubber 2.00 424. Thomas' Galvanic Stem 1.50 425. Stem Pessary 75 426. Sponge Tents, per doz 1.50 427. Edward's Pessary 3.00 428. Stem 75 4285. Weber's 4.50 428c. Cutter's Ring 2.50 429. Hewitt's 1.25 429&. Hodge's Horse-shoe 50 430. Peaslee's Stem 1.50 431. O'Leary's 5.00 4315. Thomas' Anteversion 1.25 431c. Fowler's 2.00 431d. Skene's Urinal Cup 2.50 432. Sims' Pessary Introducer 8.00 For Uterine and. Ovarian Tumors. ECRASEURS AND LIGATORS. 483. Van Buren's Ligator 7.00 434. Emmett's Ecraseur 35.00 435. Chassaignac's Ecraseur 25.00 436. Edward's Ecraseur 18.00 437. Smith's Wire Ecraseur, curved .. . 6.00 438. Braxton Hick's Ecraseur 15.00 4385. Braxton Hick's Ecraseur, impi'oved 15.00 438c. Smith's Wire Ecraseur, straight . . 5.50 AS8d. Barnes' Wire Ecraseur 5.50 438c. T. & Co.'s Long Chain Ecraseur. . 20.00 438/. Cintrat's Ligator 2.50 438^. Thompson's Ecraseur 25.00 Sims' Port Chain Ecraseur (Fig. 470) 35.00 CLAMPS. 439. Gueride's Clamp 5.00 440. Noeggerath's Clamp 7.00 441. Dawson's Clamp 8.00 442. Nott's Rectilinear Ecraseur 12.00 443. Thomas' Clamp 4.50 444. Spencer Well's Clamp 6.00 4445. Spencer Well's (Torsion Forceps) . 8.00 445. Spencer Well's Pedicle Clamp 25.00 4455. Byford's Clamp 15.00 446. Darby:s Clamp 7.00 PIG. PART III. PRICE 447. Atlee's Clamp .' 6.00 4475. Spencer Well's Clamp Forceps. .. 8.00 447c. Thomas' Sac Foi-ceps 3.00 44:7d. Thomas Tissue Forceps 4.50 448. Storer's Clamp Shield 12.00 449. Spencer Well's Sac Forceps 4.50 450. Baker Brown's Clamp 12.00 451. Nelaton's Tumor Forceps 3.50 452. Nelaton's Pedicle Forceps 3.50 TUMOR FORCEPS. 453. Greenhalg's Tumor Forceps 8.00 454. Byrne's Tenaculum Forceps 6.00 455. Byrne's 456. Campbell's Tumor Forceps 8.00 457. Byrne's Vulsellum 3.00 458. Byrne's Vulsellum 3.00 459. Luer's Polypus Forceps 6.00 460. Nott's Tenaculum 25 461. Double Tenaculum 3.50 462. Double Tenaculum 2.50 463. Byrne's Uterine Fixator 2.50 464. Sims' Vulsellum Hook 5.50 465. McClintock's Polypus Forceps . . . 6.00 466. Sims' Enucleator Blunt Hook 3.50 467. Sims' Enucleator 3.50 ■468. Sims' Tampon Screw 1.25 469. Aveling's Polyptome 8.00 470. Sims' Port Chain Ecraseur 35.00 For Cautery. 471. Actual Cautery Irons, each 1..50 472. Blowpipe 4.00 473. Byrne's Battery 474. Cautery Sling 18.00 475. Cautery Irons, set 5.50 476. Cautery Irons, set 4.50 (Paquelin's Thermo-Cautery, page 134, Part I.) (Dawson's Battery, page 112, Part I.) For Paracentesis and Drainage. (Aspirators, page 131, Part I.) 477. Chassaignac's Drainage Trocar . . . 4.00 4775. Rubber Drainage Tube, large, per yard 40 The same, medium, per yard 40 The same, small, per yard 40 477c. Ellis' Drainage Spiral, silver 75 477d. Callender's Drainage Canula 3.00 (See page 101, Part III.) Paracentesis Abdominis Trocars. 478. Emmett's Trocar 4.50 479. Fitch's Dome Trocar (1, 2, 3), and Tubing 14.00 Price List. 24 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pparre. FIG. part III. PRICE Fitch's Aspirator Needles (4, 5) . . . 3.50 Fitclrs Clamp Forceps (G) 4.50 480. Spencer Well's Trocar 10.00 Spencer Well's Trocar, curved . . . 11.00 481. Thomas' Trocar 30.00 483. Flint's Trocar 3.50 Flint's Trocar and JBulb 5.00 483. Thomas'Clamp.forvaginalwounds 8.00 Obstetrical Forceps, 484. Hodge's 7.00, 8.00 485. White's 8.00 486. Miller's, jointed 15.00 487. Buzzle's 10.00 488. Denman's 7.00 489. Loewenthal's 30.00 490. Elliott's 9.50 491. Simpson's, long 8.00 Simpson's, short 7.00 493. Budd's 8.00 493. Robertson's 8.00 494. Vectis 3.50 495. Davis' 7.50 496. Bedford's 8.00 4965. (Scholler's Cord Carrier) 4.00 497. Tarnier's 34.00 498. McLean's 8.00 499. Nsegeli's 8.00 500. Roller's 8.00 501. Blake's 8.00 503. Ives' 7.50 5035. Draper's 8.00 503. Hunter's 9.00 504. Thomas' 7.00 505. Tarsitani's 13.00 506. Brickel's, large 8.00 Brickel's, small 7.00 507. Comstock's 8.00 508. Osborn's 8.00 509. Taylor's 13.00 510. Robinson's 8.00 5105. Hale's 7.00 510c. Jenk's 8.50 510(-?. Trueheart's 13.00 510«. Tedder's 13.00 510/. Bethel 8.00 5105-. Rockwell's 8.50 510h. Mathew's 8.00 Mathew's, with screw 9.50 510*. Newman's 7.00 510/c. Sawyer's 7.00 510Z. Gillette's 9.50 510m. McFerran's Forceps 13.00 olOft. Reyerson's Vectis 5.00 olOo. Robinson's Insufflator 3.00 FIG. PART III. PRICE Placenta and Embryotomy Instruments. 511. Dewee's Hook and Lever 1.00 513. Embryotomy Forceps 3.00 513. Placenta Forceps 3.50 514. Bachelder's Embryotomy Forceps, 13.00 515. Pulling's Funis Clamp 40 For Obstructed Labor. 516. Holme's Perforator 5.00 517. Bedford's Perforator 3.00 518. Simpson's Perforator 3.00 519. Smellie's Perforator 3.50 530. Ntegeli's Perforator 4.00 531. Bachelder's Perforator 5.00 533. Blott's Perforator 6.00 533. Thomas' Perforator 8.00 (See Fig. 533, &c.) 534. Taylor's Blunt Hook 3.50 535. Bedford's Guarded Hooks 6.00 536. Blunt Hook and Crotchet 1.50 537. Decapitating Hook 3.50 538. Guarded Hook and Crotchet . 4.50 Brickell's Blunt Hook 5.00 Brickell's Crotchet 5.00 539. Meig's Craniotomy Forceps 4.00 530. Tliomas' Craniotomy Forceps. . . . 6.00 531. Lusk's Cephalotrite 18.00 533. Simpson's Cranioclast 10.00 533. Van Huvef's Forcep Saw ........ 35.00 5335. White's Perforator 4.50 533c. Braun's Perforator 15.00 5'ddd. Trueheart's Perforator 8.00 534. Braun's Munde's Cephalotrite. . . . 30.00 5345. Simpson's Cephalotrite 15.00 Brickell's Craniotomy Forceps . . . 4.00 For Lacerations of the Female Perineum. 535. Ashton's Perineum Needle 1.00 536. Helical Needle 1.75 537. Agnew's Forceps 3.50 538. Agnew's Needles and Holder 4.50 539. Shot Compressor 3.50 540. Skene's Needle 1.57 541. Brickell's Suture Stay 75 5415. Munson's Suture Stay, per pair . . .75 543. Peaslee's Needles (3), straight .... 3.00 5485. Peaslee's Needle, right 1.75 Peaslee's Needle, left 1.75 543. Parker's Perineum Needles 5.00 544. Usual Perineum Needle 75 Anal and Rectal Instruments. 545. Bodenhamer's Reflector ..... 80.00 546. Ashton's Speculum 1.00 547. Trellis' Speculum 16.00 Price List. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 Eaht 28tii St., N. Y. 25 FIG. PART III. PRICE 548. Bodenhamer's Endoscope 7.50 549. Gorget Anal Speculum 2.50 550. English Rectal Botfgie, cylindrical, 1 .00 551. English Rectal Bougie, conical .. . 1.50 552. Bodenhamer's Sounds, set of 10 . . 10.00 553. Syphon Syringe 2.50 554. Small Bivalve Speculum 4.50 555. Rectal Dilator 12.00 556. Whitehead's Dilator 3.00 557. Bodenhamer's Irrigator 3.00 558. Suppository, hard rubber 1.50 559. Bivalve Speculum Ani 6.50 560. 3 Cautery Irons and Handle 4.50 561. Munde's Rectal Irrigator 2.50 5(>3. 2 Cautery Irons, each 1.50 563. Anal Dilator 10.00 564. Thebaud's Anal Dilator 12.00 565. Artery Forceps 3.00 566. Rectal Insufflator 2.50 567. Smith's Pile Clamp 6.00 568. Ashton's Pile Clamp 3.00 569. Byrne's Double Tenaculum 6.00 570. Rectal Dressing Forceps 2.00 571. Rectal Sponge Holder 1.00 572. Rectal Curette 2.00 573. Silver Probe 1.25 574. Silver Probe 1.25 575. Stomach and Enema Pump 16.00 576. Hutchinson's Syringe 11.00 577. Rectal Port Caustic 3.00 578. Maw's Enema Pump 3.50 579. Amusat's Cautery Clamp 8.00 580. Rectal Brush Holder 2.50 581. Verteb rated Colonic Sound 8.00 583. Elastic Probe 50 583. Curved Bistoury 1.75 584. Rectal Bistoury Cache 7.00 585. Blandin's Knife 8.00 586. Cooper's Knife 1.25, 1.50 5866. Probe Bistoury 1.25, 1.50 586c. Sharp Bistoury 1.25, 1.50 58Qd. Blunt Fissure Knife 1.25, 1.50 5866. Sharp Fissure Knife 1.25, 1.50 587. Bodenhamer's Fissure Knife 5.00 588. Bistoury Cache, Fistula ......... 7.00 589. AUingham's Scissors and Director, 7.00 590. Rectal Scarificator 1.50 591. Bodenhamer's Bistoury, for fistula inano 10.00 592. Gooche's Canula 5.00 593. Camel's-hair Brush 10 Glass Brush 30 FIG. 594. 595. 596. 597. 598. 599. 600. 601. 602. 603. 604. 605. 606. 607. 608. 609. 610. 611. 612. 613. 614. 615. 616. 617. 618. 619. 619&. 620. 621. 622. 623. 624. 625. 626. 627. 628. 629. 630. 631. 632. 633. 634. P.\RT II r. PRICIi, Carroll's Knot Tycr 2.00 Silver Director 1.50 Bodenhamer's Curvilinear For- ceps 5.00 Van Buren's Ligator 7.00 Lent's Platina Cup 3.50 Plastic Pin, glass head 25 Lent's Ligature Carrier 1.25 Bodenhamer's Spring Forceps . . . 4.50 Sims' Needle Forceps 2.50 Hutchinson's Needle 2.50 Skene's Needle 1.75 Helical Needle 1.75 Port Mesche 75 Needles, straight and curved. . .05, .15 Exploring Trocar 1.50 Angular Pile Needle 1.00 Bush's Pile Needles 3.00 Perineum Needle 1.00 Pile Supporter 8.00 Angular Scissors 1.50 Gibson's Port Ligature 3.00 Trousseaux' s Pile Supporter 2.75 Bush's Pile Scissors 1.50 Pile Bougie 1.25 Bolton's Pile Bougie 1.25 Reed's Pile Bougie 1.25 Depuytren's Enterotome 5.00 Verona's Winch 3.00 -to 3.50 Sims' Anal Dilator 4.50 Adam's Pile Syringe 4.50 William's Rectal Speculum 4.50 Wale's Rectal Bougie 1.50 to 4.00 AUingham's Ligature Carrier .... 3.50 Elastic Ligature, per yard 25 Hernia Instruments. Agnew's Instrument 6.00 Wutzer's Instrument 12.00 Hinge Director 1.50 Levis' Director 1.50 Heaton's Syringe 4.00 Redfern Davis' Instrument 15.00 Dowell's Needle, straight 1.00 Dowell's Needle, curved 1.00 Cooper's Knife, sliding 2.00 Stewart's Knife 5.00 AUis' Herniatome (Supplement, page 11) 7.00 Stanley's Director (Part I., page 44) 2.50 Peter's Director (Part I., page 48) . 2.50 Hernia Knife,plain(PartI.,page 46) 1.00 Price List. 26 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, - F. A. Stohlmann. e Edward Pfarre. I>ait lA^. FIG. 1. Orthopgedic Apparatus. Shoulder Braces. price Elastic Brace $2.00 Elastic Brace 3.50 Elastic Brace 3.00 Elastic Brace 2.00 Elastic Brace 2.50 Elastic Brace 3.00 Steel Back Brace 4.00 Steel Back Brace 5.00 Spine Braces. T.& Co.'s Brace for Pott's Curvature 30.00 The same, large 35.00 Lateral Curvature, small 30.00 T. & Co.'s Lateral Curvature Brace, 35.00 T. & Co.'s Lateral Curvature Brace, large 40.00 AYashburn's Spine Brace 15.00 Washburu's Spine Brace, large. . . . 20.00 Markoe's Torticollis Brace, small. . 35.00 ]\Iarkoe's Torticollis Brace, large . . 40.00 Torticollis Brace 5.00 Davis' Apparatus for Caries of Spine 20.00 Davis' Apparatus for Caries of Spine 24.00 Taylor's Apparatus for Caries of Spine, small 24.00 Taylor's Spine, large 30.00 Sayre's Plaster Paris Jacket Andrew's Spine Brace (Fig. 192). . . TJmbilical Bandages. 17. Umbilical 5.00 Umbilical 6.00 ^ Umbilical 8.00 18. Chase's Umbilical Truss 4.C0 19. Bow Umbilical Truss 5.00 20. Bow Umbilical Truss 2.50 Bow Umbilical Truss, large 3.00 21. Children's Truss 2.50 Children's Truss 3.00 Children's Bandage 2.00 Children's Bandage 3.00 Trusses. 22. Bow Truss 3.50 23. Ratchet Truss 4.50 24. Best French, single 4.00 Best French, single 5.00 25. Best French, double 6.00 26. Chase's 4.00 27. French Adjustable 4.50 PIG. PART IV. PRICE 28. German, single $3.00 German, double 4.50 29. Best Common, double 4.00 30. Hull's 2.00 31. Self- Ad justing, single 3.00 Self -Adjusting, single 5.00 32. Self -Adjusting, double 6.00 Self -Adjusting, double 8.00 33. French Adjustable, double 8.00 34. T. & Co.'s Finger-Pad 5.00 35. Folsom's 20.00 36. Schuppert's Galvanic 15.00 to 25.00 Abdominal Supporters. 37. Bow Spring 4.00 Bow Spring 5.00 38. Fitch's 5.00 Fitch's 6.00 39. Eugene 6.00 40. London 4.00 41. Bandage, Abdominal 6.00 42. Noeggerath's 6.00 43. Thomas' 8.00 Thomas', Cedar Pad 2.50 Boston 5.00 Abdominal Belts. 44. Silk, Elastic 12.00 Cotton, Elastic 8.00 Riding Belt 5.00 Canvas Belt 4.00 Satin-jean Belt 6.00 Prolapsus Ani and Pile Supporters. 45. Pile Supporter 8.00 Mathieu's (Fig. 207) 5.00 Suspensory Bandages. 46. Miliano's 2.00 Cotton 50 Linen 75 Silk 1.25 Silk, Elastic 2.50 Rawson's U. S. A., No. 1 1.50 Rawson's U. S. A., No. !}{ 1.75 Rawson's U. S. A., No. 2 2.00 Rawson's U. S. A., No. 3 3.00 Rawson's U. S. A., No. 4 4.00 "Urinals for Incontinence. 47. Extrophy 25.00 Extrophy 50.00 48. India Rubber 2.50 Price List, 67 CHATHAM STREET, NEW YORK. Branch Store, 107 Eaht 28T1I St., N. Y. 27 FIG. PART IV. PRICE 49. India Rubber $4.50 India Rubber COO 50. India Rubber 2.50 Apparatus for Deformity and Debility of the Upper Extremities. 51. For Ununited Fracture of tlie Hu- merus 35.00 to 70.00 52. Prince's Artificial Hand 60.00 58. Elbow, Anchylosis Apparatus 18.00 54. Paralysis Glove 20.00 55. Shoulder, Dislocation 6.00 Shoulder, Dislocation 8.00 56. Cooper's Apparatus, Dislocated Cla- vicle 5.00 Apparatus for Deformity and Debility of the Lower Extremities. FOR SHORT LEGS. 57. Leg Extension 9.00 (Shoe extra.) 58. Leg Extension and Ankle Brace. . . 18.00 (Shoes extra.) 59. Bigg's Short Leg Apparatus 35.00 FOR PLAT FEET. 595. Flat Feet Sole 2.50 Flat Feet Sole, per pair 5.00 FOR WEAK ANKLES. 60. Weak Ankle Brace, small, each . . . 6.00 Weak Ankle Brace, medium, each. 8.00 Weak Ankle Brace, large, each. . . . 10.00 Weak Ankle Brace, small, per pair. 12.00 Weak Ankle Brace, nied., per pair. 16.00 Weak Ankle Brace, large, per pair. 20.00 (Shoes extra.) 61. For Talipes Equiniis : 62. Tendo Achilles Brace, small, each . 8.00 Tendo Achilles Brace, medium, each 10.00 Tendo Achilles Brace, large, each. . 12.00 Tendo Achilles Brace, small, per pair 16.00 Tendo Achilles Brace, med., per pair 20.00 ■ Tendo Achilles Brace, large, per pair 24.00 (Shoes extra.) FOR TALIPES VARUS ^T VALGUS. 63. T. & Co.'s Clubfoot Shoe, small, each " 10.00 T. & Co.'s Clubfoot Shoe, med., each 12.00 T. & Co.'s Clubfoot Shoe, large, each 14.00 T. & Co.'s Clubfoot Shoe, per pair. 20.00 T. & Co.'s Clubfoot Shoe, per pair. 24.00 T. & Co.'s Clubfoot Shoe, per pair. 28.00 Barwell's Shoe (Fig. 143) 64. Sayre's Shoe, small, each 10.00 FIG. PART IV. PRICE Sayre's Shoe, medium, each $12.00 Sayre's Shoe, large, each 14.00 The same, per pair. . . 20.00, 24.00, 28.00 65. Talipes Valgus 66. For Tajjpes Calcaneus : 67. Talipes Calcaneus Apparatus, eacli, 10.00 Talipes Calcaneus Apparatus, eacli, 12.00 Tlie same, per pair 20.00, 24.00 08. Talipes Calcaneus Apparatus, each, 10.00 Talipes Calcaneus Apparatus, each, 12.00 The same, per pair 20.00, 23.00 69. Support for Weak Legs : For Adults 35.00 For Adults 50.00 For Adults 75.00 For Children 25.00 For Children 35.00 PARALYSIS APPARATUS. 70. For Leg and Thigh, small, each . . . 25.00 For Leg and Thigh, medium, each. 30.00 The same, per pair 30.00, 60.00 (Shoes extra.) 71. Hemiplegia Apparatus, .small 30.00 Hemiplegia Apparatus, medium . . . 40.00 (Shoes extra.) 72. Paraplegia Apparatus, small 35.00 Paraplegia Apparatus, medium .... 50.00 Paraplegia Apparatus, large 70.00 (Shoes extra.) FOR BOW-LEGS. 73. Bow-Leg Braces, small, per pair. . . 25.00 Bow-Leg Braces, medium, per pair, 30.00 (Shoes_ extra.) FOR GENU-VALGU3I OR KNOCK-KNEE. 74. Knock-Knee Braces, small, per pair, 30.00 Knock-Knee Braces, med., per pair, 35.00 Knock-Knee Braces, large, per pair, 40.00 Trueheart's-Knee Brace (Fig. 197). . FOR CORRECTING ANTERIOR CURVATURE OF THE TIBIA. 75. Tibia Curvature Brace, small, each, 12.C0 Tibia Curvature Brace, med., each. . 15.00 Tibia Curvature Brace, large, each. 18.00 Tibia Curvature Brace, per pair . . . 24.00 Tibia Curvature Brace, per pair . . . 30.00 Tibia Curvature Brace, per pair . . . 36.00 barwell's attachments and artificial muscles, for adjusting cli^-feet. 76. Barweirs Eyes, each 10 Barwell's Tin Plate, each 20 Price List. 28 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. FIG. P.\RT rv. PRICE Barbell's Rubber, per foot $0.13 Mole-sldn Plaster, per yard 1.50 FOR E^-ERSION AND INVERSION OP FEET. 77. Eversion of Feet 5.00 Eversion of Feet 10.00 Eversion of Feet, with Pelvic Band, 30.00 APPARATUS FOR BUNIONS AND HAMMER TOES. 78. Bunions, each 8.00 Bunions, per pair 16.00 79. Overriding Toes, each 7.00 Overriding Toes 10.00 to 15.00 Overriding Toes, for both feet 14.00 Overriding Toes, for both feet .... 30.00 APPARATUS FOR FALSE JOINTS. 80. Leg and Thigh, small 25.00 Leg and Thigh, small 30.00 Leg and Thigh, for adults 40.00 Leg and Thigh, for adults 75.00 (See also Figs. 51, 170, 171, 172, 178.) Apparatus for the Treatment of Joint Diseases. 80i. Hooper's KneeExtension Apparatus 35.00 HIP-JOINT SPLINTS. 81. Davis' 15.00 82. Sayre's, small 15.00 Sayre's, medium 16.00 Sayre's, large 18.00 Moleskin Plaster, per yard 1.50 84. Hamilton's, Gauze 15.00 85. Bauer's 25.00 86. Bauer's Breeches, small. 15.00 Bauer's Breeches, medium 18.00 Bauer's Breeches, large 25.00 87. Taylor's, small 25.00 Taylor's, medium 30.00 Taylor's 35.00 Taylor's, large 40.00 88. Washburn's 7.00 89. Hutchison's, small 25.00 Hutchison's, fine 30.00 Hutchison's, large 35.00 Hutchison's, fine, large 40.00 Sayre's Long Splint (Fig. 175) Andrew's Splint (Fig. 191) KNEE-JOINT SPLINTS. 90. Long, for Anchylosis 35.00 Long, for Anchylosis, large 40.00 (Shoes extra.) 91. Short, for Anchylosis 25.00 Short, for Anchylosis, large 30.00 FIG. PART IV. PRICE 92. Anchylosis Apparatus $18.00 Anchylosis Apparatus, large 24.00 93. Sayre's Knee-SpHnt 20.00 (Mode of Applying, Fig. 93.) Andrew's (Fig. 187) ANKLE-JOINT SPLINTS. 98. Sayre's, Extension 22.00 Andrew's (Fig. 186) Elastic Hose. SILK. Leg and Thigh, best, each 11.00 Knee, best, each 8.00 Calf or Three-quarter, each 4.50 Fine Knee, each 6.00 Three-quarter or Calf, each 3.50 COTTON. Leg and Thigh, each 5.50 Knee, each 3.50 Three-quarter or Calf 2.00 Knee Caps. Silk, best 3.50 Silk, fine 3.00 Cotton 1.75 Anklets. Silk 8.00 Cotton 1.75 (Wristlets and Armlets to order.) Elastic Belts. Silk 12.00 Silk, with Stays 14.00 Cotton 8.00 Fracture Apparatus. FOR THE THIGH. 102. Smith's Anterior Splint 2.00 103. Byrd's Smith's Splint 5.00 104. Skinner's Bed 25.00 105. Hewit's Femur Apparatus 40.00 106. Buck's Apparatus 10.00 lOQIi. Buck's Weights, &c 5.50 107. Femur Apparatus 10.00 Femur Apparatus 25.00 108. Lente's Hospital Splint 18.00 109. Burge's Apparatus 50.00 110. Listen's Mclntyre's Splint 16.00 111. Henry's Shears,for Plaster Bandage 7.50 FOR THE PATELLA. 112. Turner's Apparatus 12.00 113. Lewis' Apparatus 6.00 114. Boisnot's Apparatus 12.00 115. Hartshorn's Apparatus 7.00 Price List. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East SSth St., N. Y. 39 FIG. PART IV. PRICE 116. Hamilton's Apparatus $8.00 Plamilton's Apparatus 10.00 117. T. & Co.'s Knee-Cap 5.50 118. Spring and Cup 6.00 FOR THE TIBIA AND FIBULA. 119. Hodgen's Apparatus 6.00 120. Smith's Anterior Splint 2.00 121. Raphael's Pott's Splint 5.00 FOR THE LOWER MAXILLARY. 123. Hamilton's Bandage 5.00 Hamilton's Bandage, extra fine. . . 12.00 FOR THE CLAVICLE. Fox's Apparatus (Fig. 147) 123. Levis' Apparatus 5.00 124. Richardson's Apparatus 6.00 125. Sayre's Dressing 126. Sayre's Dressing 127. Sayre's Dressing Mayor's Apparatus (Fig. 150) FOR COLLE'S FRACTURE. 128. Hewit's Splint 7.00 129. Shrady's Splint 2.00 SUSPENDING APPARATUS. 130. Hodgen's 5.00 Clark's (Fig. 1.57) Sayre's (Fig. 193) Buck's (Fig. 174) Smith's (Fig. 120) Salt's (Fig. 156) CARVED WOOD SPLINTS. Double Inclined Planes. . 7.00, 8.00, 9.00 Lining Splints, set of 20 5.00 Leg and Ankle Splints, per pair . . 2.00 Forearm Splints 1.25 Elbow Splints, plain 1.50 Elbow Splints, jointed 2.50 Patella Splints 1.50 Radius Splints 1.25 Bond's Splint, for fracture of radius 2.25 Clavicle Splint 4.00 Condyle and Humerus Splint 1.00 Large Extension Splint, Bar and Garter 7.00 Short Extension Splint, without screw 3.00 Interosseous Splint 75 Joint Arm Splint 8.00 Dressing Splints, per pair 1.25 BASSWOOD SPLINTS. Set of 12 Radius Splints l.OO Set of 12 Radius Splints 1.25 PIG. PART IV. PRICE hatters' board, FOR SPLINTING. Per yard $4.00 GUTTA PERCHA, FOR SPLINTING. Thick, per pound 3.00 Thin, per pound 4.00 (Plaster Paris Splinting.) (Wire Splints made to ordci-.j Roller Bandage, per pound 1.50 Styptic Cotton, per box 35 Adhesive Plaster, per yard 75 Moleskin Plaster, per yard 1.50 Dislocation Apparatus. 131. Pulleys, per pair 7.00 134. Levis' Splint 1.50 136. Luer's Luxation Forceps 8.00 137. Charriere's Forceps 9.00 Counter-Extension. 138. Stanchion 5.00 Stanchion 10.00 Crutches. 141. Whittemore's, lancewood, per pair, 12.00 Whittemore's, maple, per pair. . . . 11.00 Plain Maple, per pair 7.00 Plain Hickory, per pair 4.00 Hickory, rubber bottom, per pair. 5.00 Children's, per pair 3.00 Children's, per pair 5.00 Sockets, for Crutches, per pair . . . 4.00 Crutch Rubber 45 LITTERS. 142. Folding (Other styles.) Miscellaneous Apparatus. FOR CLUBFOOT. 143. Barwell's Shoe, each 15.00 Barwell's Shoe, per pair 30.00 144. Shaffer's Lateral Screw FOR JOINT DISEASE. 145. Holthouse's Extender 10.00 Holthouse's Extender 15.00 146. Shaffer's Knee Splint FRACTURE APPARATUS. 147. Fox's Clavicle Splint 5.00 148. Hamilton's Elbow Splint 149. Gutta Percha Splint, per lb . . 3.00 to 4.00 150. Mayor's Clavicle Apparatus 5.00 152. T. & Co.'s Arm Sling 4.50 Plain Arm Slings 3.50 153. Clark's Olecranon Apparatus 5.00 PiiicE List." 30 GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarke. FIG. TART IV. PRICE Clark's Olecranon Apparatus |8.00 15i. Smith's Anterior Splint 2.C0 155. Shrimptou's Forceps 3.50 156. Salt's Cradle 12.00 157. Clark's Apparatus 30.00 158. Morgan's Bed ' 159. Morgan's Bed 160. Muuger's Rods 4.50 161. Munger's Splint 6.00 163. Depuytren's Fibula Splint 163. Harris' Apparatus 164. Wackerhagen's Splint 165. Wackerhagen's Shears 6.00 166. Wackerhagen's Fixator 167. Rhode's Inclined Plane 168. Rhode's Fracture Bed APPARATUS FOR FALSE JOINTS. 170. Smith's Artificial Femur. . 35.00 to 50.00 171. Smith's Artificial Tibia. . . 30.00 to 40.00 172. Smith's Artificial Humerus, 35.00 to 70.00 173. Smith's Artificial Forearm . 35.00 to 50.00 SUSPENSION APPARATUS, FOR HOSPITAL USE. 174. Buck's Suspension 18.00 FOR JOINT DISEASE. 175. Sayre's Long Hip Splint 25.00 Sayre'sLong Hip Splint. 30.00 to 45.00 FOR DRY CUPPING. 176. Junod's Boot, small . : 15.00 Junod's Boot, large 25.00 177. Junod's Arm, small 15.00 Junod's Arm, large 25.00 FOR SECURING THE INSANE. 178. Straight Jacket 8.00 Straight Jacket 10.00 Straight Jacket 15.00 179. Buckle 2.50 Belt and Buckle 6.00 FOR USE OP HOT WATER IN SURGERY. 180. Bath for Arm 13.00 181. Bath for Leg 15.00 FOR ALTERNATE APPLICATION OP DRY HEAT AND COLD. 182. Hamilton's Revulsor 8.00 FOR EXTENSION. 183. Denison's Windlass 1.50 FOR BLOODLESS OPERATIONS. 184. Esmarch's Tourniquet 3.75 FOR APPLICATION OF COLD. 185. Spinal Ice Bug 4.50 FIG. PART IV. PRICE Spinal lee Bag $10.25 185^. Turnbull's Ice Bag 2.50 FOR JOINT DISEASES. 186. Andrew's Ankle Splint 187. Andrew's Knee Splint 188. Andrew's Knee Splint 189. Sayre's Shears 7.00 190. Andrew's Knee Instrument 191. Andrew's Hip Splint 12.00 FOR SPINAI; CURVATURE. 192. Andrew's Spine Brace 20.00 193. Sayre's Suspense, plain 8.00 The same, double-hooked beam . . . 9.00 The same, with brass pulleys 15.00 Sayre's Tripod '. 10.00 Cross-barred Muslin, per j^ard 22 Seamless Shirt 2.50 Seamless Sliirt 3.50 194. Sayre's Jury Mast 12.00 .KNEE AND ANKLE COMPRESSORS. 195. Sayre's Compressor, Knee ■. 6.00 Sayre's Compressor, Ankle (i.OO FOR FRACTURE OP ARM AND HAND. 196. Coover's Splint 1.50 FOR KNOCK-KNEE. 197. Trueheart's Brace for Knock-Knee 35.00 FOR writer's cramp. 198. Writer's Cramp Apparatus 10.00 199. Writer's Cramp Apparatus. 6.00 FOR UMBILICAL AND ABDOMINAL HERNIA. 200. Walker's Supporter 12.00 APPLIANCES. 201. Stillman's Ratchets (Send for pamphlet.) Plaster Bandage Shears. 202. Szymauowsky's 9.00 203. Brun's 10.00 204. Esmarch's 4.50 Henry's (Fig. Ill) 7.50 Wackerhagen's (Fig. 165) 0.00 Sayre's (Fig. 189) 7.00 FOR HERNIA, SEMINAL CORDS AND PILES. 205. Wood's Truss 206. Doisnot's Compress 4.00 207. Mathieu's Pile Support 5.00 Martin's Rubber Bandage. 207^*. 10 feet long, 3 inches wide 2.00 Price List. 67 CHATHAM STREET, NEW YORK. Branch Store, 107 East 2STn St., IST. Y. 31 FIG. PART IV. PRICE Bulkley's Rubber Bandage. 12 feet long, ?> inehes wide $1.25 CONTRACTED WRIST APPARATUS. 208. Contracted Wrist Apparatus . 20.00, 30.00 SPINAL CURVATURE. 209. Spine Brace 40.00 210. Spine Brace 40.00 PIG- PART IV. PRICE PATKI.I.I': sri'POItT. 211. Bacon's Artificial Nose. 218. Artilicial Nose, from. . . $.50.00 to 125.00 according to workinansliip. Artificial Eye. 214. Artificial Eye 10.00 Fart V. Tooth Forceps. PIQ BEST, WARRANTED. PRICE 1. Bayonet-shaped Wisdom . ". $2.75 3. Lower Wisdom 2.75 3. Bayonet-shaped Stump 2.75 4. Upper Bicuspid 2.75 5. Upper Molar, right 2.75 6. Upper Molar, left 2.75 7. Upper Molar, Cowhorn, right 2.75 8. Upper Molar, Cowhorn, left 2.75 9. Upper Molar, Cowhorn, either side, 2.75 10. Upper Molar, right or left 2.75 11. Upper Molar, bayonet-shaped, left . 2.75 12. Upper Molar, bayonet-shaped, right, 2.75 13. Harris' Upper Molar, left 2.75 14. Harris' Upper Molar, right 2.75 15. Harris' Lower Molar, right 2.75 16. Harris' Lower Molar, left 2.75 17. Harris' Lower Molar, either side. . . 2.75 18. Cowhorn Lower Molar, right 2.75 19. Cowhorn Lower Molar, left 2.75 20. Cowhorn Molar, either side 2.75 21. Harris' Lower Molar, right 2.75 32. Harris' Lower Molar, left 2.75 23. Harris' Lower Molar, either side. . . 2.75 24. WolYerton'sLowerMolar,eitherside 2.75 35. Wolverton's Upper Bicuspids 3.75 36. Wolverton's Lower Bicuspids 3.75 37. Wolverton's Lower Root, left 8.75 38. Wolverton's Lower Root, right 8.75 39. Universal Root 8.75 80. Straight Root 2.75 31. Lower Root, bent handles 2.75 32. Straight Root, narrow 2.75 33. Half-Curved Root 2.75 34. Full-Curved Root 3.75 35. Narrow -Beak Root, bent handles . . 3.75 36. Narrow-Beak Root, straight 3.75 37. Narrow-Beak Root, half-curve 8.75 38. Narrow-Beak Root, full-curve 3.75 FIG. PRICE 39. Narrow-Beak Root, bayonet-shape . $2.75 40. Narrow-Beak Root, right 3.75 41. Narrow-Beak Root, left 3.75 43. Universal 8.75 43. Universal Root, narrow beak 8.75 44. Parmly's Straight 3.75 45. Parmly's Half -Curved 8.75 46. Parmly's Full-Curved 3.75 47. Parmly's Bayonet-shaped 3.75 48. Parmly's, left 3.75 49. Parmly's, right 8.75 50. Straight Excising : . . 3.75 51. Curved Excising 3.75 53. Splitting ■ 3.75 53. Elevating 8.75 54. Single- Jointed, Straight or Curved. 1.35 55. GoodwilIie'sUpperMolar,warranted 3.75 56. Good Willie's Spicula, warranted . . . 3.75 57. Goodwillie's Root and Children's . . 3.75 58. Goodwillie's Splitting, warranted. . 8.75 59. Third quality, double-jointed 1.50 60. Goodwillie's Bicuspids, w^arranted. 8.75 61. Single- Jointed, Curved or Straight . 1.25 63. Goodwillie's Half-Curved, warranted 3.75 63. Goodwillie's Straight, warranted . . 8.75 Second quality, of above patterns. . 8.00 Also Tooth Forceps.at 1.50, 1.35 (See Figs. 54, 59 and 61.) Turn Keys. 64. Spring Bolt Turn Key 3.00 65. Spring Bolt Turn Kej^, double-eye hooks 3.00 66. Turn Key, with removable fulcrum, 2.50 67. Turn Key, with rotating fulcrum . . 2.50 Root Extractors and Gum Lancets. 68. Stag Foot Elevator 1.00 69. Screw Elevator 1.00 70. Root Extractor 1.00 Price List. 32 GEO. TIEMANN & CO'.S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edward Pfarre. «>iG. part y. price 71. Root Extractor fl.OO •73. Gum Laucet 1.00 rs. Curved Root Extractor 1.00 74. Angular Root Extractor 1.00 75. Gum Lancet, tortoise-shell handle, with .spring catch 2.00 The same, .slide-catch 2.00 The same, without catch 1.00 Staphylorrhaphy Instruments. UP DE Graff's staphylorrhaphy case. 76. Curved Bistoury 2.00 77. Curved Needle 3.00 78. Blunt Hook 2.00 79. Bent Needle 2.00 Figs. 76, 77, 78, 79, put up in a neat case 9.00 Dermatological Instruments. Nsevus Needle Piffard's Comedone Extractor Piffard's Irido Platinum Needle. . Piffard's Milium Needle Piffard's Scarifying Spud Piffard's Epilating Forceps Piffard's Grappling Forceps Skin Grafting Scissors Piffard's Cutisector Piffard's Sharp Spoon, each Hess' Glass Pleximeter SEE ALSO : (Henry's Depilating Forceps, page 46, Part III.) (Platina Caustic Cups, Fig. 809, Part III.) (Fine Scissors, Figs. 110, 111, Part n.) (Scalpels, pages 6, 46, Part I.) (Microscopic Instniments, page 90, Part I.) (Counter Irritants, page 66, Part I.) .75 1.00 1.00 1.35 1.35 1.50 3.00 6.50 5.00 2.25 .50 FIG. PART V. PRICE (Vaccinating Instruments, page 66, Part I.) (Hypodermic Syringes, page 79, Part I.) Nail and Corn Instruments, 91. Spring, for Inverted Nails $0.25 92. Nail Nippers 2.50 93. Nail-extracting Forceps 2.50 94. Corn Knife and File 75 95. Van Buren's Sequestrum Forceps, 3.00 Van Buren's Sequestrum Forceps, 3.50 96. Nail Cleaner and File 35 97. Pocket Case Scalpel 1.00 98. Dissecting Scalpel 60 to .75 99. Splinter Forceps 1.00 100. Corn Knife, spring handle 1.00 Sundries. GYNECOLOGICAL. 101. Emmett's Counter-pressure Hook . 1.35 103. Emmett's Enucleator 1.50 103. Emmett's Needle Forceps 3.00 104. Emmett's Double Tenaculum .... 5.00 105. Emmett's Curette Forceps 3.50 106. Wallace's Spring Tent 75 107. Bozeman's Perineal Elevator 5.50 108. Uterine Dressing Forceps, slide- catch 3.75 109. Emmett's Twisting Forceps 3.75 110. Emmett's Sponge Dilator 2.50 111. Emmett's Uterine Tourniquet .... 113. Emmett's Cystitis Eyelet 35 113. Bache Emmett's Fistula Tube 30 114. Stimson's Needle & Cutting Forceps 3.50 115. King's Pelvimeter 4.00 TRACHEAL. 116. Minor's Trachea Retractors 4.50 117. Brown's Pessary, hard rubber 50 Brown's Pessary, soft rubber 75 Sn-pplement. FIG. SUPPLEMENT. PRICE 1. Newman's Obstetrical Forceps $7.00 3. Bank's Urethrotome 30.00 3. Sawj-er's Obstetrical Forceps - 7.00 4. Milne's Urethrotome 17.00 5. Wight's Cautery 11.00 6. Bill's Arrow Extractor 3.50 7. Hank's Tenaculum Forceps 3.00 FIG. SUPPLEMENT. PRICE 8. Reese's Leech $4.50 9. Adams' Subcutaneous Section Knife 1.50 10. Adams' Large Saw 4.00 11. Adams' Small Saw 3.00 12. Adams' Rhinoplastos 3.00 13. Bridge's Nasal Douche 60 14. Bridge's Auto-Insufflator 75 Price List, 67 CHATHAM STREET, NEW YORK. Bkanch Store, 33 107 East 28Tir St., N. Y. FIG. SUPPLEMENT. PRICE 15. Schuyler's Speculum $12.00 IG. Woodward's Pessiuy, No. 1 1.25 Woodward's Pessary, No. 2 1.25 17. Thompson's Ecraseur 25.00 IS. Stanford's Prohang 2.50 19. Hoff's Automatic Suture 5.50 20. Russian Needle-Holder 4.00 21. Hank's Tracheotome 9.00 22. liank's Antiseptic Atomizer 15.00 2'6. Sexton's Insufflator 2.00 24. Stohlmann's Bead Saw 6.00 25. Ryerson's Vectis .... 5.00 26. Wales' Rectal Dilator 1.50 to 3.50 Wales' Explorer, No. 3 2.00 Wales' Irrigator, No. 5 3.50 27. Thomas' Tumor Scoop 3.50 28. Patent Thermometer 3.50 29. Fitch's Wire Twister 4.00 30. Otis' Prostatic Guide 1.25 31. Holden's Resonator 2.50 32. Munson's Model 9.00 33. Prince's Staphylorrhaphy Needle. . 10.00 34. Hutchison's Lithotome 8.00 35. AUis' Herniatome 7.00 36. Sussdorf's Tupelo Tents, hollow, per doz 3.00 The same, solid, per doz 2.00 37. Kinloch's Urethrotome 25.00 38. Patent Velvet Eye Catheter 75 39. Burrall's Atomizer 1.50 40. Fryer's Sims' Speculum 2.00 41. Steurer's Dilator 8.00 Cold Sound, silver 4.00 Cold Sound, soft rubber 2.50 42. Plaster Paris Spreader ... 5.00 43. Apparitor Auris, per pair 6.00 44. Tarnier's Obstetric Forceps 24.00 45. Ball's Uterine DiLator 10.00 46. Cleborne's Tenaculum, &c 7.00 47. Fitch's Handy Aspirator 5.00 48. Wood's Torticollis Apparatus 5.00 49. Weir's Antiseptic Atomizer 15.00 50. (Hypodermic Syringes, see List, Fig. 213, &c.. Part I.) 51. Theobald's Probes ............... 4.00 52. Weir's Mouth Gag 7.00 53. George's Inhaler 3.50 54. Sand's Needle-Holder, improved . . 4.50 55. Yarrow's Enucleator 4.00 56. Bates' Psychrophor 4.00 57. Bigelow's Evacuator 12.00 Bigelow's Evacuator, with Stand . . 15.00 PIG. 58. 59. CO. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94a 94ff 94&. 94c. dM. 95 a 955, 96. 97. 98. SCl'I'LK.MENT. PRICE Bigelow's Litlioti'ite $35.00 Skene's Endoscope 2.75 Bates' Urethrotome 15.00 Skene's Retlux Catlieter 2.50 Skene's Double Peiforatcd Catlie- ter 2.00 Skene's Self-i'ctaining Calheier. . . . 2.00 Bigelow's Artery Forceps 3.00 Skene's Cystocele Pessary 2.00 Otis' Perineal Tourniquet .... . . 5.50 Bozeman's Vaginal Support ... ... 2.00 Weir's Urethrameter 18.00 Carroll's RetroHexion Pessary 75 Hank's Throat Spray, each . . .... 1.00 Gross' Urethrameter 20.00 Gross' Urethrotome 6.00 Gross' Urethral Dilator 14.00 Currie's Double Canulated Needle. 7.00 Pritchett's Urethrotome 25.00 Hank's Rapid Uterine Dilators .... 5.50 Coleman's Pessary 40 Hunter's Divulsor and Urethi'O^ome 32.00 Hunter's Urethral Tourniquet 5.50 Hunter's Filamentous Wedge, sach, .75 Steam's Dilating Urethrotome .... 12.00 Fowler's Bow Pessary 3.00 Shaffer's Clubfoot Shoe 10.00 Shaffer's Clubfoot Shoe 12.00 Shaffer's Ankle Splint 6.00 Shaffer's Ankle Splint 8.00 Shaffer's Head Rest Shaffer's Spine Brace 10.00 Shradj^'s Subcutaneous Saw 7.00 Cleborne's Double Forceps 3.50 Biart's Speculum Vagina? 20.00 Politzer's Uniform Acoumeter .... 3.50 Marsh's Respirometer 10.00 Fryer's Sims' Speculum and Attach- ments 11.00 Leonard's Uterometric Sound 3.25 , b, c, d. Hutchison's Apparatus for Treating Hip-, Knee- & Ankle- JoiNT Disease . Crutches, per pair 3.00 to 12.00 Leg Extension 6.00 to 7.00 Hatters' Board, for Splinting, per yd. 4.00 Roller Bandage, per pound 1.50 , Stillman's Knee Brace 30.00 c. Stillman's Bracket for Knee- Joint, 9.00 Schweig's Stricture Dilator 10.00 Lincoln's Cautery Electrode 20.00 Skene's Uterine Sector lO.OC PiiicE List 3-1: GEO. TIEMANN & CO.'S SURGICAL INSTRUMENTS, F. A. Stohlmann. Edwakd Pfakre. Emmett's Set of Instruments for Vesico-Vaginal Fistula. 1 Sims' Hospital Speculum. 1 Sims' Virgin Speculum. 1 Emmett's Depressor. 1 Emmett's Sponge Holder. 1 Sims' Catheter, soft metal. 1 Emmett's Uterotome. 2 Emmett's Tenacula. 1 Perry's Tenaculum. 6 Emmett's Scissors. 1 Emmett's Wire Pressing Forceps. In a three-fold morocco case lined Avith chamois— red or drab. In the middle compart- ment are placed the scissors and other instruments which would be injured by being twisted in the rolling or folding of the case. Beneath these is space for the speculum and sponge holders $80.00 2 Bistouries. 1 Scalpel. 1 Emmett's Needle Forceps. 1 Emmett's Dressing Forceps. 1 Emmett's Wire Twisting Forceps. Sims' Blunt Hook. Sims' Shield. Sims' Wire Carrier. Coil Silver Wire. Doz. Emmett's Needles. Geo. Tiemann & Oo.'s Velvet Eye Catheter. There are three varieties of soft rubber catheters in the market. The French, known as Nekton's, the English, called Jaques', and Tiemann's. The eyes of the French and English catheters are punched, leaving the edges sharply de- fined, which causes irritation and pain on introduction, Avhereas those of our make can do no possible injury, and are more durable because there is no cut surface to be acted upon by the urine. Patented June 12lh, 1877. {Extract from '■'■The Medical Advance,'' January, 1879.) This catheter (see cut above) is one recently introduced to the profession by Messrs. George Tiemann c% Co., of New York. The chief excellence of this catheter is, that the eyes are -perfectly smooth, hence its name, "velvet-eyed," in contradistinction to the English and French make, which have their eyes punched out, thus giving square cut edges to the opening. Sometimes an irritated bladder that shuts down tightly upon the end of a catheter will force some folds of the granular raucous membrane into the eyes, thus making it painful and hard to withdraw. Villous masses, springing from the bladder, are sometimes caught in the eyes of the catheters generally used, and it would seem that these smooth-eyed catheters would avoid this entirely. In enlarged prostates, no catheter is so easy of introduction as the " flexible," and none less irritating to the bladder. These, with the guide of Dr. Otis, just described, will be of great use to the country practitioner, especially in relieving victims of an enlarged prostate. Price. — Tiemann's Velvet-eyed Catheter, marked with both American and English Numbers $0.75 We also have in stock : Jaques', marked with English Numbers 75 Nelatons, marked with French Numbers .- 50 (N. B. — A card scale with American and French Catheter and Bougie Guage and Measure, metrical and in inches, will be mailed on application.) JPiiiCE List. 07 CHATHAM STREET, NEW YORK. 35 Branch Store, 107 East 28Tir Street, N. Y. a,lCTE0»lilBICilX/ AFWARA'SjIIS. CoMLSBftani: ^ inches, and Aveighs, Avhen charged, only five pounds. Price, $15.00. IVo. ITaratlic Battery A little larger and more powerful than No. 1, and with the ad- dition of a commuta- tor for reversing the polarity of the elec- trodes during applica- tion. It is sufficiently powerful for nearly all cases where the Faradic current is required, though for a physician in general practice we would recommend the more complete and powerful No. 3. Put up in a polished walnut case, metallic work nickel i^lated. Price, $20.00. IVo. 3. ir'ax'aclio Battery. This Battery is provided with a slow and a rapid rheotome, or current interrupter ; a com- mutator, or polarity changer ; scales, by which the primary and secondary currents may be graduated to the utmost delicacy or the greatest power ; and with our new patent galvanic cell. This cell, which is charged with a solution of bi-chromate of potash, is so made that when not in action the zinc is taken out of it altogether and placed in a vulcanite cell provided for the purpose. The aperture through Avhicli it passes is covered by a rubber hydrostat, making the cell perfectly fluid tight, and saving both the fluid and the zinc from the effect of splashing in transportation, or of im- mersion in case of upsetting. By this plan, also, the cell can be filled nearly to the top and the zinc be made twice the usual length; it will thus produce a stronger current, and last a longer time. It is enclosed in a handsome walnut case, l}^. x73^x83^ inches, has all its metallic parts finely nickel plated', and Aveighs, when charged, ten poimds. Price, $30.00. TWO SILVER MEDALS AND ONE BRONZE MEDAL INTERNATIONAL EXHIBITION, PARIS, 1867. Parties wishing our instruments and finding it more convenient to obtain them through dealers, are requested to order " Tiemann's manufacture/' as otherwise inferior goods are sometimes substituted. TWO SILVER MEDALS AWAKDED BY THE PARIS EXPOSITION OF 1867. Being the only Silver Medals granted to American Exhibitors of Surgical Instruments. Parties wishing our instruments and finding it more convenient to obtain them through dealers, are requested to order "TJ.emann's manufacture," as otherwise inferior goods are sometimes substituted. EXTRACT FKOJI OENEKAL REPOTIT OF 'J'HE JUDGES OF GKOri' XXIV. INTERNATIONAL EXHIBITION, 1876. "The largest collection of instruments was exhibited by Messrs. Tiemann & Co., of ISIew York. It embraced almost every instrument used by the surgeon in general or special practice, and some, entirely new. In material, workmanship, and exquisite finish, thej^ could not be excelled. They Avere complete in mimite detail so essential to the formation of a perfect instrument, and gave evidence of scrupulous care and nice appreciation of the wants of the surgeon." JUDGES REPORT ON THERMOMETERS AND GALVANO-CAUSTIC APPARATUS. " Commended for excellent construction, worlcmanship, and applicability of Clinical Ther- mometers and Dawson's Galvano-Caustic Apparatus." "The most complete Battery presented for competition, was one exhibited by Tiemann & Co:, invented by Dr. Dawson." TWO FIRST MEDALS AND HONORABLE MENTION SANTIAGO, CHILI, 1875. Parties 'wishing our instruments and finding it more convenient to obtain tliem through dealers, are requested to order "Tiemann's manufacture," as otherwise inferior goods are sometimes substituted. COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the rules of the Library or by special ar- rangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE H^ ^- 2 1843 czed i4o)Mioo