The lungs may also be removed by drawing them downward and outward,
away from the root, while the bronchi and pulmonary vessels are
cut, the knife being directed against the vertebræ, care being
taken to avoid cutting the aorta and œsophagus. The lungs are then
lifted up toward the middle line, while the mediastinal pleuræ are
cut. The section of the lungs may be carried out, if so desired,
from the root, the main bronchus and then all of the branches as
far as the pleuræ being opened up by means of the probe-pointed
scissors. Other incisions may be made if desired.
As mentioned above, it is sometimes more convenient to remove the
thoracic organs _en masse_, either alone, or in association with
the neck organs. When this is done the dissection follows the
method of Letulle (see above), or the organs may be separated and
sectioned according to the methods just given.
The section of the heart usually precedes that of the lungs, in
order that the blood-content of the former may be more correctly
estimated. Under certain conditions it may be more convenient or
expedient to section the lungs first, beginning with the left one.
When the neck-organs are not removed the section of the thorax closes
with the examination of the =aorta, oesophagus=, =thoracic duct= and
=thoracic vertebrae=. The blood-vessels and œsophagus are opened
with the curved scissors, from above downward, the contents noted,
and the walls examined. The thoracic duct is best dissected out
from the right side, by cutting along the right side of the aorta
and turning the latter over to the left. The duct is more easily
recognized at its lower end. It may be inflated with the blow-pipe,
or opened with a probe and fine probe-pointed scissors. Sometimes
the duct can be most easily found by removing the left lung and
then turning the right lung over into the left pleural cavity. The
posterior mediastinal tissues are put on a stretch, so that the duct
can be recognized through the pleura. For the examination of the left
subclavian vein the left clavicle should be removed.
II. POINTS TO BE NOTED IN THE EXAMINATION OF THE THORAX.
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