MEDICAL AND SURGICAL LANDMARKS _By the same Author._ MANUAL OF DISSECTION OF THE HUMAN BODY. With numerous Illustrations. HUMAN OSTEOLOGY. Comprising a Description of the Bones with Delineations of the Attachments of the Muscles. _Sixth Edition in the press._ LANDMARKS MEDICAL AND SURGICAL BY LUTHER HOLDEN EX-PRESIDENT, MEMBER OF COUNCIL, AND MEMBER OF THE COURT OF EXAMINERS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND: CONSULTING SURGEON TO SAINT BARTHOLOMEW’S AND THE FOUNDLING HOSPITALS _assisted by_ JAMES SHUTER, M.A.CAMB., F.R.C.S. ASSISTANT SURGEON TO THE ROYAL FREE HOSPITAL: LATE DEMONSTRATOR OF PHYSIOLOGY, AND LATE ASSISTANT DEMONSTRATOR OF ANATOMY, AT SAINT BARTHOLOMEW’S HOSPITAL _THIRD EDITION_ [Illustration] LONDON J. & A. CHURCHILL, NEW BURLINGTON STREET 1881 [_All rights reserved_] TO THE STUDENTS PAST AND PRESENT OF SAINT BARTHOLOMEW’S HOSPITAL THESE ‘LANDMARKS’ ARE Dedicated BY THEIR SINCERE FRIEND THE AUTHOR PREFACE TO THE THIRD EDITION. In the present Edition the author adheres to his decision not to introduce Diagrams. Additional experience more than ever convinces him that they would frustrate his original object, which is to teach Students the habit of making the eye and the hand work together, and to educate the ‘touch’ upon the normal living body. Without such practical training, how can we reasonably expect to form a correct diagnosis when called upon to examine an injury or to detect a disease? In truth, the work is intended only for those who are desirous of acquiring the habit recommended. LONDON: _May, 1881_. PREFACE TO THE FIRST EDITION. These ‘Landmarks’ have already appeared in Saint Bartholomew’s Hospital Reports. They are now republished, with some additions, in the hope that they may be useful to others besides those for whom they were originally intended. My object has been to collect into a compact form the leading landmarks which help practical surgeons in their daily work. Those relating to the chest and abdomen have been ascertained, with as much precision as natural variations permit, by needles introduced in various directions. I have to express my acknowledgments to Mr. WALSHAM and to Dr. GODSON for their contributions. 65 GOWER STREET: _March 1876_. CONTENTS. PAGE THE HEAD 3 THE FACE 6 THE NECK 14 THE CHEST 19 THE BACK 25 THE ABDOMEN 29 THE PERINEUM 40 THE THIGH 43 THE BUTTOCKS 48 THE KNEE 49 THE LEG AND ANKLE 52 THE FOOT 56 THE ARM 59 THE FOREARM AND WRIST 64 THE HAND 67 PALPATION BY THE RECTUM 70 EXAMINATION PER VAGINAM 72 ‘CHIRURGUS MENTE PRIUS ET OCULIS AGAT QUAM MANU ARMATA.’