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 BIOLOGICAL BASIS of
The
MODERN SURGICAL PRACTICE
20TH EDITION

COURTNEY M. TOWNSEND, JR., MD B. MARK EVERS, MD

Professor Professor a nd Vice-Chair for Research, Deparunent of Surgery
Robertson-Pot h D istinguished C hair in General Surgery D irector, Lucille P. Ma rkey Cancer Cente r
Depart1nent of Surgery Markey Cancer Foundation Endowed Chair
University ofTexas Medical Branch Physician- in-Ch ief, Oncology Service Line UK Healthcare
Galveston, Texas Un iversity of Kentucky
Lexington, Kentucky

R. DANIEL BEAUCHAMP, MD
J.C. Foshee Distinguished Professor and Chairn1an, Section of KENNETH L. MATTOX, MD
Surgical Sciences Professor and Vice Chairn1an
Professor of Surgery and Cell and Developn1ental Biology and M ichael E. DeBakey Departn1ent of Surgery
Cancer Biology Baylor College of Medicine
Vanderbilt U niversity School of Medicine Chief of Staff and Chief of Surgery
Surgeon-in-Chief, Vanderbilt University Hospital Ben Taub General Hospital
Nashville, Tennessee Houston, Texas

ELSEVIER
ELSEVIER
1600 John F. Kennedy Blvd .
See 1800
Philadelphia, PA 19103-2899

ISBN: 978-0-323-29987-9
lrue.rnacional Edition ISBN: 978-0-323-40162-3
Copyright © 2017 by Elsevier, Inc. All rights reserved.
Copyright 2012, 2008, 2004, 2001, 1997, 1991, 1986, 1981, 1977, 1972, 1968, 1964, 1960, 1956 by
Saunders, an imprint of Elsevier Inc.
Copyright 1949, 1945, 1942, 1939, 1936 by Elsevier Inc.
Copyright renewed 1992 by Richard A. Davis, Nancy Davis Reagan, Susan Oku1n, Joanne R. Arn, and
Mrs. Mary E. Arn.
Copyright renewed 1988 by Richard A. Davis and Nancy Davis Reagan.
Copyright renewed 1977 by Mrs. Frederick Christopher.
Copyright renewed 1973, 1970, 1967, l 964 by W.B. Saunders Con1pany.
t\IJ rights reserved. No part of dus publication rnay be reproduced or transn1 ieted in any forn1 or by any n1eans,
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studencs to purchase Sabiston ii:xtbook ofSurgery by Courtney M. 'fownsend, Jr., MD, may reproduce the contents
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Copyright © 2017 by E lsevier Inc.
This book and the individual contributions corHained in it are protected under copyright by rhe Publisher
(other than as may be noted herein}.

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Practirioners and researchers rnusr always rely on d1eir own experience and knowledge in evaluating and
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Library of Congress Cataloging-in-Publication Data
Sabiscon cexcbook of surgery : the biological basis of n1odern surgical practic I [edited by] Courcney Iv!. To\vnsend,
Jr, R. Dartiel Beauchamp, B. Mark Evers, Ken nech L. Mactox.-20th edition.
p. ; cn1.
Textbook of surgery
Preceded by Sabiscon textbook of surgery I [edited by] Cou rtney M . Townsend Jr.... [er al.]. 19th ed. 20 12.
Includes bibliographical references and index.
ISBN 978-0-323-29987-9 (hardcover : alk. paper)-ISBN 978-0-323-40162-3 (incernational ed ition: alk. paper)
I. 1ownsend, Courtney M., Jr., editor. ll. Beauchan1p, R. Daniel, edicor. lll. Evers, B. Mark, 1957-,
editor. IV Ma ttox, Ke nneth L., 1938-, edito r. V Title: Textbook of su rgery.
[DNL/v!: I. Surgical Procedures, Operative. 2. General Surgery. 3. Periopera tive Care. \VO 500]
RD 31
6 17-dc23
2015035365
Executive Content Strrltegist: /v{ichael Houston
Content Development Specialist: Joanie Mil nes

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Last digit is the print nusnber: 9 8 7 6 5 4 3 2 I
This page intentionally left blank

SECTION I SURG ICAL BASIC PRINCIPLES, I
1 The Rise of Modern Surgery: An Overview, 2
lraRutkow
2 Ethics and Professionali sm in Surgery, 20
Cheryl E. Vaiani and Howard Brody
3 The Inflammatory Response, 25
Puja M. Shah, Zachary C. Oietch. and Robert G. Sawyer
4 Shock, El ectrolytes, and Fluid, 44
PererRlleeandBclla/Josep/1
5 Metabolis m in Surgical Patients, 98
Joshua Carson. Ahmed Al-Mousawi, Noe A. Rodriguez,
Celeste C. Finnerty, and David N. Herndon
6 Wound Hea ling. 130
Mimi Leong, Kevin 0. Murphy. and linda G_ Phillips
7 Regenerative Medic ine, 163
Michael S. Hu. Graham G. Walmsley, H. Peter Lorenz, and
Michael T. Longaker
8 Evidenc e-Based Surgery: Critically Assess ing Surgical
Literature, 173
Vlad V. Simianu, Farhood Farjah. and David R. Flum
9 Safety in the Surgica l Environment. 187
Warren S. Sandberg, Roger Dmoehowski. and R. Daniel Beauchamp
SECTION II PERIOPERATIVE
MANAGEMENT, 20 1
10 Principl es of Preoperative and Operative Surgery, 202
Leigh Neumayer and Nasrin Ghalyaie
11 Surgical Infections and Antibiotic Use, 241
PhilipS. Barie
12 Surgical Complications, 28 1
Mahmoud N. Ku/ay/a/ and Merril T. Dayton
13 Surgery in the Geriatric Patient. 327
Heather Yeo. Jeffrey lndes. and Ronnie A Rosenthal
14 Anesthesio logy Princi ples, Pain Management, and
Consc ious Sedation, 360
Antonio Hernandez and Edward R. Sherwood
15 Emerging Technology in Surgery: Informatics, Robotics,
El ectronics,393
Carmen l. Mueller and Gerald M Fried
SECTION Ill TRAUMA AND CRITICAL CA RE, 407
16 Management of Acute Trauma, 408
R. Shayn Martin and J. Wayne Meredith
17 The Difficult Abdominal Wall, 449
Oliver L. Gunter and Richard Miller
18 Emergency Care of Musc uloske1etal Injuries, 462
Daniel K. Witmer. Silas T. Marshall, and Bruce D. Brow11er
CONTENTS
19 Burns, 505
Marc G. Jeschke and David N. Herndon
20 Bites and Stings, 532
Lillian F. Liao. Robert L. Norris. Paul S. Auerbach, Elaine E. Nelson.
and Ronald M. Stewart
21 Surgical Critical Care, 547
Andrew H. Stephen, Charles A. Adams, Jr., and William G. Cioffi
22 Bedside Surgic al Procedures, 577
Addison K. May. Bradley M Dennis. Oliver L. Gunter, and Jose J. Diaz
23 The Surgeon's Role in Mass Casualty Incidents, 586
Michael Stein and Asher Hirshberg
SECTION IV TRANS PLANTATION AN D
IMMUNOLOGY, 597
24 Transplantation lmmunobiology and
lmmunosuppression, 598
Andrew B. Adams. Mandy Ford. and Christian P. Larsen
25 liver Transp lantation, 637
Nancy Ascher
26 Kidney and Pancreas Transplantation, 649
Yolanda Becker and Piotr Wirkowski
27 Small Bowel Transplantation, 666
Aparna Rege and Debra l. Sudan
SECTION V SU RGICA L ONCO LOGY, 676
28 Tumor Biology and Tumor M arkers, 677
Dominic E. Sa11ford. S. Pew Goedogobuure, and Timothy J. Eberlein
29 Tumor Immunology and lmmunotherapy, 705
James S. Economou. James C. Yang, and James S. Tomlinson
30 M elanom a and Cutaneous Malignant Neoplasms, 724
Charles W. Kimbrough. Marshall M Urist. and Kelly M. McMasters
3 1 Soft Tissue Sarcoma, 754
Carlo M Contreras and Martin J. Heslin
32 Bon e Tumors, 773
Herbert S. Schwartz. Ginger f. Holt. and Jennifer L. Halpern
SECTION VJ H EA D AND NEC K, 788
33 Head and Neck, 789
Robert R. Lorenz. Marion f. Couch. and Brian B. Burkey
SECTION VII BREAST, 8 19
34 Diseases of the Breast, 820
Kelly K. Hunt and Elizabeth A. Mittendorf
35 Breast Reconstruction, 865
Karen l. Powers a11d Linda G Phil/1ps
xx iii
CONTENTS

SECTION VIII ENDOC RI NE, 880 55 Exocrine Pancreas, 1520

Christein. EricH.Jensen. and
36 Thyroid, 88 1
Philip W. Smith, Laura R. Hanks, Leslie J. Salomone, and
JohnB. Hanks 56 The Spleen, 1556
Benjamin K Poulose and Michael 0. Holzman
37 The Parathyroid Glands, 923
Courtney E. Quinn and Robert Udelsman
38 Endocrine Pancreas, 94 1 SECTION XI CH EST, 1572
Rebekah WhireandTaylorS Rial/
57 Lung, Ch est Wall, Ple ura, a nd Me diastinum, 1573
39 The Adrenal Glands. 963 Joe 8 Putnam. Jr.
Michael W. Yeh, Masha J. Livhits, and Quan-Yang Duh
58 Cong e nita l Heart Disease, 1619
40 The Multiple Endocrine Neoplasia Syndromes, 996 Charles O_ Fraser. Jr_ and Lauren C Kane
Terrye. LairmoreandJeffreyF.Moley
59 Acquired He art Dise ase: Coronary Insuffici ency, 1658
Shuab Omer, Lorraine O_ Cornwell, and Faisal G. Bakaeen
60 Acquired Heart Disease: Va lvular, 1691
SECTION IX ESO PH AGUS, 1013 Todd K. Rosengart and Jatin Anand
41 Esophagus, 1014
Jonathan 0. Spicer, Rajeev Dhupar, Jae Y. Kim, Boris Sepesi, and
Wayne Hofstetter SECTION XII VASC ULAR , 172 1
42 Gastroesophagea l Reflux Disease and Hiatal Hernia, 1043 61 The Aorta, 1722
Robert 8. Yates. Brant K. Oelschlager, and Carlos A. Pellegrini Margarete. TracciandKennerhJ. Cherry
62 Peri pheral Arterial Disease, 1754
Charlie C. Cheng, Faisal Cheema. Grant Fankhauser, and
SECTION X ABDOMEN , 1065 MichaelB. Silva, Jr

43 Abdominal Wall, Umbilicus, Peritoneum. Mesenteri es, 63 Vascular Trauma, 1808

Omentum, and Retroperitone um, 1066 Michael J. Sise, Carlos V.R. Brown, and Howard C. Champion
Richard H. Turnage, Jason Mizell, and Brian Badgwell 64 Venous Disease, 1827
44 Hern ias, 1092 Julie A Freischlag and Jennifer A Heller
Mark A Malangoni and Michael J Rosen 65 The Lymphatics, 1848
45 Acute Abdomen, 1120 /rak/is I. P1pinos and B_ Timothy Baxter
Ronald Squires. Sreven N. Carter, and Russell G. Postier
46 Acute Gastrointestinal Hemorrhage, 1139 SECTION Xlll SPEC IA LT IES IN GENERA L
Ali Tavakkoli and Stanley W. Ashley
SU RGERY, 185 7
47 Morbid Obesity, 11 60 66 Pediatric Surgery, 1858
Williama. Richards
DaiH_ Chung
48 Stomach, 1188
67 Neurosurgery, 1900
Ezra N. Teitelbaum, Eric S Hungness, and David M Mahvi
Juan Ortega-Barnett, Aaron Mohanty, Sohum K Desai. and
49 Smal l Intestine, 1237 JoelT. Patterson
Jennifer W. Harris and B. Mark Evers
68 Plastic Surgery, 1938
50 The Appendix, 1296 Mary H McGrath and Jason H Pomerantz
Bryan Richmond
69 Hand Surgery, 1975
51 Colon and Rectum, 1312 David Ne tscher, Kevin 0. Murphy. Nicholas A. Fiore II
70 Gynecologic Surgery, 2027
Howard W Jones Ill
52 Anus, 1394
71 Surge ry in the Pre gnant Patient, 2053
Amit Merchea and David W Larson
Dean J Mikami, Jon C Henry. and E. Christopher Ellison
53 The Liver, 141 8 72 Urologic Surgery, 2068
Vikas Dudeja and Yuman Fong
Thomas Gillispie Smith Ill and Michael Coburn
54 Biliary System, 1482
Patrick G. Jackson and Stephen RT. Evans Index, 2107

xx iv
 VIDEO CONTENTS

SECTION I SU RC ICA L BASIC PRINC IPLES 50 The Appendix

Video 50 - 1 l..aparascopic Appendectomy
5 Metabolism in Surgical Patients
Jonathan Carter. MD
Video 5- 1 lndircc1 Calorimc1ry
Vid eo 50-2 l..aparascopic Appendectomy in Pregnant Paliem
Noe A. Rodriguez. MD
Lawrence W. Way, MO
Video 5-2 Body ComPosi 1io n and DEXA
Video 50-3 SJLS App<ond<ocwrny Across a Spectrum of
Noe A. Rodriguez, MO
Disease Severity
Video 5-3 Treadmill
Kazunori Sato. MD; Beemen N. Khalil, MD. Ranna Tabrizi. MD.
Noe A. Rodriguez, MO
Jonathan Carter, MD
55 Exocrine Pancreas
Video 55- 1 LaparoM:o pic Splce n-Prc5c rvin g D i5tal
SECTION II PER IO PERATIVE MANAGEM EN T
Pancrea tcclo my
15 Emerging Technology in Surgery: Informatics, Robotics, EricH.Jensen,MD
El ectronic s Video 55-2 LaparoM:o pi c Vessel- Prese rving, Spleen- l're5erv ing
Video 15- 1 Robot-Assistc<! Rc5ccr ion Disrnl Pancrea1ectomy
Guillermo Gomez, MD EricH.Jensen,MO
Video 55-3 Laparoscopic Cy5t Gastroston1 y
EricH.Jensen,MD
SECTION Ill T RAUMA AND C RITI CAL CARE
17 The Difficult Abdomin al Wall
Video 17- 1 Novel Management of an Entcroatm osphcrk
SECTION XI CHEST
Fistula Using a "Floating Stoma" 57 lung , Chest Wall, Pleura, and Mediastinum
Oliverl. Gunter Video 57- 1 Pleural Effusion
Christopher J. Dente. MD. Grace S. Rozycki, MD, ROMS, FACS
Video 57-2 Pleural Sliding
Chrisropher J. Dente. MD. Grace S Rozycki. MD. ROMS, FACS
SECTION IV TRANSPLANTATION AN D
Video 57-3 Pneu rnothorax
IMMUNOLOGY Grace S. Rozycki, MD, ROMS, FACS
24 Transpl antation lmmunobiology and lmmunosuppression
Video 24- 1 Rcsuhs of the Wo rld '• Fi rst Successful Ha nd
l f ansplant SECTION XII VASCULAR
r.
Darla K. Granger. MO, Suzanne l/dstad. MD
61 Aorta
Video 6 1- 1 Total Ao rti c Replacement
Hazim J. Safi. MO. Anthony L. Estrera, MD, Eyal E. Porat, MD.
SECTION VIII ENDOCR INE Aliz Azizzadeh. MD. Riad Meada, MD
40 The Multiple End ocrine Neoplasia Syndromes 64 Venous Disease
Video 40- 1 Parat hyro id Autotransplantatio n Video 64- 1 TRI VEX 1
JeffreyF. Moley,MO Jennifer Heller, MD
Vid eo 4 0-2 l..:lparoscopic Adre nalccwmy for Video 64-2 TRI VEX 2
Pheochromocywma in Pa1iems wi(h MEN 2A Jennifer Heller, MD
JeffreyF. Moley,MD

SECTION XIII SPEC IALTIES IN GEN ERAL

SECTION X ABDOMEN
SU RGERY
47 Morbid Obesity
70 Gynecologic Surgery
Video 4 7- 1 Laparoscopic Roux-en-Y Gastric Bypass Surgical
Video 7 0- 1 Total U.pa roscopic Hysterecto my with Right
l~chnique
Salpi ngo-Oophorcctomy
William 0. Richards. MO
Amanda Yunker, OD. MSCR, Howard W. Jones Ill. MD
Video 47-2 U.paroscopic Adjusrable Gastric Band Surgical
Video 70-2 1..:lparoscopic Right Salpingo-O op horectomy
'[Ccl1nique
Amanda Yunker. DO. MSCR. Howard W. Jones Ill, MD
William 0. Richards. MO

xxv
This page intentionally left blank
 INDEX

Page num ber> fol lowed by 'f" ind icate figures, "b" ind icate bo~cs. and 'r" ind icate tabl es

A Abdo rnjn al pctincal reS<"<'.! ion, in Acuicabdomcn (Cbntinued)

Aaron sign , 1126t rcctala ncn, 1379 amebk.;uA rn cbicabscess nonsurgical cau><-sof, __!_!l_Q,
Ahl>< Haps. 121, 795/ Abdominal trauma, 1895- 1896 breast , fil 1121b
Ah l>rcviatcd injury5Calc (AIS) , Alll Abdominal vascular injury. incomplicaie<ldivcrticulitis , in[><'diatrics,1 132- 11 3 3
Abei~imab , 719< 1818-1820, 1819/ \333- 1334 p hysical exa m inat ion of,
ABC1of1raum a, 1894-1895 Abdominal wall , 449-461 intra-abd ominal. inCrohn's 1124-1125, 11 25/ 1126r
AbJ01nen, injutiesw, 432-444 1065-109 1 roliti s,1351 - 1352 in pregmncy, 113 1-1 132, 1131/
cvJ luacionof -- alxlomin al closure, assessi ng lung, 1595 1132i, 2057
blumabdomina l irauma, rcad incssfor,4 52 rrogc~fe !'yogenicab>ecss summary of, 1135
432-434. 433/ abdom inalfascialdehi scenu, splenic,1562 , 1564 surgiuilcondi tionsof, 1120,
pmctr>ti n gabdomi nal tra uma , 4 49 -45 0,450b Ab'°rpt ion, in colon , 1323 11 2 1b -
43( 434/ abno rm ali ties of, 1071 - 1072 Ac;ctabulum , 475, 47(>/ Acuteacak 11louscholccy>titis , 1508,
ru anage-;-;;e;;-tof, 434 -444 adju11mtorcpair, 456-458 , 4 58[ Acetaminoph-e,;:- -542 1508/
immediatc. fil
- biologicmcsh ,453-454,454{ Acetate, 1323 Acuicblccding,218.219,2191
Abdominal aorta, 964/965/ dosure techn iquein ,44 9 Acha lasia. 1016- 1019, 10 17/ 10 18/ Acutecakulou scholecysti tis
Ah<lomiml ao nicancury<rn conditions. 188 .~-1884 Acidosis. 2J..:2.1 1493- 1494 , 1493/
computc<lwmogrophyfor. ~ abdom inal wa ll dcfcct>. Jl!1li, Acid, Arntcchola ngit is, 1507
1724/ 1883/ "'causeofnkcr, 119<) Acutecholcx;y5t it is ,J 46
<l iagnosisof, 1723- 1724, gamoschisis , 1883- 1884 inchemicalbums, 527-528, 527/ lv!urphysignof,1 125
172Jfl~ hernili, 1884- - Adnelbbtulfrbt1u>mmniicornplex , Acuiecomp att1ne111 syn<lromc,
ingcriatricpaticnts,35 1.352/ o mphalocelc . _!fil!2 264-265 485·487
ind dcnccof, 1722 . 17 B. 172 31 defects of, 1883 , 1883/ Acinus. 14 28-1429 d iagnosisof, 486, 4 86/
rnagncticrc.<onancc imagingan<l ddiniti,·crcpair, 455 -456 An1uirc<l hcn ign<li><irdcr<,of fascioto myot:4"87.4H7(
magnetic resonance dcsmoid, _!_QU csophagu, , 1025-1027 pathogcnc,ho~
angiography for. ~ hcmiaof.350-35! . Juafr,, Acquire<lesophagealdisease, surgica ltreaunem of, ~ 4881
1724/ -1il25..:lQ2Z 11ssue pressure1neasuretntnt
mc<lical thcrapyof. 1724-1725 openaorticsurgery, Acq u ired heart disease techn ique, 486-487, 487(
open su rgjcalrcpairof, 17 27- co mplicat io ns of. coronaryinsu fficicncy, 1658- 1690 Acute coronary syndrome, 1661
1731. 1728f1729/ 1742 - 1743 "• lv nbr, 1691 - 1720 Acute fatty liver, of pregnancy,
preoperative evaluation in , intra-abdom inaldisca.'C, An1uirc<l im munity, 601 -616 .2ll6l..=2llG2.
1725-1727, 1726/ !727/ symptoms o f, 107 4- 107 5 ccllul • rrom po nentsof. 604-616 Acutefractures , 462, 463[
riskofmpturcin , 1723, 172}t malignamneoplasmsof, hum anh i.iocompa tibility Acu1egasuicvor;;;;f;;s, l.QB
rnpturedweurys m~ agement 1072- 1074 complex . 601 ·604,602/ Acute gastrointestinal hctllorrhage ,
of,1 7 31 modified Rives-Stop pa and Acquired immu nodeficiency l..l.li1.!22
scrcr ning and <u rvdllancc transvcrsus alxlom inis rdc.sc syn<lromc (A IDS) , 1410 fromanobs.:urcsource ,
recommendationsfor, _ll21 tcchni<iuc>. 456 ,45 7/ Ac'luirc<lintcrrdhcrnh-;:-- 1155-1157. l l 56b
surgicaltreatmcmfor, 1725-17}3 reromuuc1ion , prep.rationfor, ~ d iagnosisof, 1 155 -1156
tcx;hn iqucofopcn><irgical rcpair 4 55,455/4561 Acquire<! umbi lical herni a, 1071 S[><'cificcauscsof, 1157
o( 1727- \7}1. 1728fl730/ sarcoma of, 1074 Acral lentigi nous mcbnoma , nQ, trcatmcn t of. 1156- 1157
17 32/ seromaof. 454-455.4 54{ 730/ lowcr, ll2.!.:..l__!22
Alxlon1iml co mparunc111 syn<lromc, skin n<"<'.tosis , 454-455,454{ Ac1j11ickcrawses, 748 rn anagcrncn1 of patients wit Ii,
70.70/5 55- 556. 581 suturcmatcr ial for,449 Aclinomycosis , 1597- 1598, 1597/ 1139-1142. 1140/
ac;:;;-0, 1QZ222 - syntheticmeshfailure, 4 53, 45 3b Activated proiein C, 571 h istoryan dphysical
canscof, J.QZ:l!!!:! tempornryabdom inaldosure, Activewarming, 55 -~561 examination, l140 - ll4l
di agnos;,of, ~ 450-45 2 , 450b,450<, ActivitiCiofd aily livin g, 338 ini tial assess ment , 11 40
pre,·emionof. 309b 451f4 52/ Acute abdomen , 1!20-1U8 locali-tat ion ,11 4 1- 1142,
ttc~miem of, l!lli:2.Q2 an<lutnb ilicus, 1066 -1075 algori1h rns in , 1134, 1134f1136/ 1141/
Abdominal foscial dchisccnce , anatomy of, 1066-1068, 1067/ anawrn y andphysiologyof, rcsusciialion , 1140
449 -4 50, 45 0b embryology ~ t 120-1121. ll2 2b, 1122/ riskstrat ification , l.!1b
ri,;kfactorfor,450b "csse!sandner"csofabdominol ><ypicalpa1ientsof,1 131 - 1134 l l42b
wall , 1068-1071 common pitfall, in , 1135 scvcrity of. 1140
VCisels and nerves of, J..Q&lQZ! incrit ical lyil l, 1133 nppcr, 1142-1 151, 11 4 2<
jnnervatio nof, 1069- 107 1, d iagno;i iclaparoscopyof, 1130 Acuie licartlailu rc, man"gcm cnt of,
1070/ d iffere11 1ia l d iag11osisof,1130, 556-55 7
Abdominal pain , 1120 vascularsupplyo( 1068- 1069 , 1130b Acute hydrocephalus, 192 7
c&u scs of, in imm unocompromiscd 1070/ -- emergoncyopem tton s. prcpar:H 1o n Acute ilcitis,Crohn'sdiseasea nd ,
pa tirn1 ,1134b Al>dominal -based A:ip>, for breast for, l \3 0- 1131 llli
chronicap[><'ndici1isascau,.,of, rcconst m ction , 1!ZQ_,j!Z.!_ historyof,1121 - 1124, Acute iliofcmor:ilvcnousthromfm,is,
1305 Abdom jtwpla;iy, 1960 - 196 1, 197 1 1123fll24f inpregna11cy. .2l.!M::Zill.i5
digitalrectale>;am ination for, Ab!a1iu" imagingstu<l iesof, 1 126- 1129, Acuie inflanunation , 2.S..:J.5.
11 25 forhigh-grad e dysp lasia , 1127fl129/ - - carlyman ifesta tionsof,.21.
gyn<"<'.ologk health and , 1124 lQlil!!l1 immunocom p romisedpatients Acutckidn ey injury (AKl) . ]1J_
intrnsi tyand .<cvc ri1 yof:--- fccll , Ji:lli wi1h , J.!.11. 11331 Acute limb i.\.chcmia , 1777- 1779.
l\21 - l l22 1\f>btivc lcsion , 1924 intra-abdomi nal prc.,urc 1779/
obstctticrompl ica1ionsresuhing Abla1 ive 1herap ies ,i mage-guide<l , mon iwringof, 11 2 9, 11291 Acute lung injury, 293-294 , 293b
in , 204'1-2050 laboratory;iudiesof, 1 126, dcscripiionof,5~
in prcgnancy, I J}l - 11.12 . ~ 1771, 1126b - Acute tllesen teric lymphadeni tis.
2057 b in mor bi dl)'obese , 1133-1134 1082- 1083

2107
INDEX
Acutcpancr<ati1is , 90 , 1524- 153L
2lliil - pulmona ryinjuries , 428-429,
assessment of severity, 1527-1528,
1527b-152/lb,15-2'-, -
d in ical manife>t>tiomof, 1526
complica1ionsof, 1529- 1531
pa11cre>1icas.:i1~
pancrcaticopku r.il fistulas,
153L l 53l/
pancrc.ikn<"1'.rosisandirif<"<'.1cd
nccro•i< , 1529-1530,
1529f15.30/
pancreaiicpseudocysts ,
1530-1531. 1530/
p.,ncrcatocutancollS ~mda ,
i2.ll
'1crilcandinfcc<e<l
peripancreat icfluid
collec!ions, J.212
vascubr, _!21!
diagnosisof. 1526-1527
imaging<1udic<, 1526-1527
inddrnccof, J.15.
pa!hophysiologyof,1524 -1525,
1525/
ri,kfuctorsfor, 1525-1526
akohol-induccd injury.
-1.5.2.i:.l.5.2
amtornkobstruction ,1526
biliarylgallstonepancreatitis,
Jill
drug- induce<!pancrcat itis,
1526
cndoscopicrc1rugradc
d10langiopancrca1ograpl1y-
induced pancreatitis , l526
metabolic factors, l526
misccllancot»condi1ion>, 1526
treat ment o( I ~28-1 ~29
<J>ffial c.:rnsi<lermions,
Vi28 - Vi29
Acute rejection , 620-622.620/
Acute respiratory distress syndrome
(ARDS)
mu lt iorgan fa ;lurc;n , 560
surgicalcri1icalcareand, 559 -561
Acutcsplenic sequestrai io1» 1562
Acute stress response, 106. 106/
Acu te trauma - pcrioperat i•·e mortal ity in,
ahdmncn,injuric<to , 432-444
brai n i n j uric>. 417-42~
chest injuries , TI4=ill
damagecomrol principles, All
e>: t remiri es, injuries to , 444-446,
445/
injury «:oring, -1.!Q:fil
4 \ 0t-4111
managememof. 407-448
abdom in algreatvessdinjuries,
443-444, 444/
urdi.>c injuries, 429-4 .~0
~'.:~::, 7,~j ~::~.~r~~2.:!~'. :~s;;.
1 Adenomatouspolyposiscol i (APC) ,
d iaphragmaticinjuries , 432.
432/ - Adenosisofpregnoncy,1!23_
d 110<knal injt1rie>, 439-440
esophageal injuries, 431 -432
gamicinjuries, 439
gcnitoutinaryinjurics , 444
hepaticinjuries , 4 37-439,
437f438/437r
initialasscS>mrntand , i.!1.:±!L
4 14/
pa11creaiicinjurics , 440 -441,
440/44 2/
plellra l spaccinjurics, .12.li, 428/
2108
Acutetrnucna (Continued)
429/
>mall howcl injuric>. 441-442
'pccillcinjurics , 417-~
splenicinj uries . ~, 435/
4361 --
thorocicaorticinjuries,
430-43 1. 430/
trachcohronchbl injuries , 431
maxil lofacial rcgion , 421-423
neek injurie" 423-4: r . r - -
overview and him>ry of, 408-409 ,
40% --
pclvicinjllrics,441 -446 . 445/
prehospitalcarc , 4 11-413,
412f413/ - -
rehabilitat ionof,446
spinalcordinjuries, 420-421 , 420/
•ystcmso( 409-410 , 409/4 10b
vcrtcbr>l colu mn injuric"
420-421 .420/
Acute tuhul.r nc..:rosi; (ATN). 5(,4
AcU!euncomplicotcd oppendidtis,
treatment of, 1300 - 1302,
1301} 1302/
Acute vascular rcject ion ,620-621
Adalimumab, 7 191
.
~:~:: :::~~·~!:;~~: ;~;~284
forukemi,·ecolitis, 13H
Ad<li'°ndiseasc , 2Z!
Adcnocarcinoma
ofanalarnal , 14 15
ofcolon , lJ.22
ofexocrincpancreas,154 1- 1552
clinical p r=ntationof, 1544,
15441
controvcrsicsof,1549 - 1550
diagnosisof,1544 - 1545
eiwironrnemal riskfactor>fot,
154 1- 1542
epidem io logyof.1541
hcrcditaryriskf.cwr<for,
I ~4 2-1 ~41 . 1542t
imaging>1u<liesof,I544 - l545
lahora10ryevalua1ionof, 1544
mo rbidity in . 1547- 1549. 15481
l54 7, 1548t
>tagingof, 1545,1545t
treatment of, 1545 - 154 7
oflungs, ! 583
in•mall intestine . 1276-1277
\ 277/
Adenoidcysticcarcinoma , 803/
.fil!Z:1illlL. l5')2 , 16(H)
Aden om a
brea>t , -83!i
in s mall intestine , 1270- 1271 ,
\ 2701.1271b
H59-H60
Adcnosinetri 1>hosphate (ATP) , -9l!.
Adcnosquamouscarcinoma, 804/
Adipose triglyceride lipase (ATGL) ,
iilll
Adif>0SC·dcri,•c<lstemcdls (ASCs) ,
10.,ill
Adipose-derived mo ma I cells , i l l
Adjuvant t herapy
forg:>striccanccr, 1225- 12 26
forgaS!roirueS1inalstron.al
tumor;, 1230, 1230/
melanoma treated with . Z1Jlm
Adrcnalcortex,diseascsof, 972-980 Affordable Cote Aci (ACA) , 1165
adrenocortiolcarcinoma
979-980, 9 80/
Cushing•yndromc, 976-979
primaryhypcraldostcroni>m ,
.'.!12=-22S_
sexS!eroidexccss , 979
Adrenalcrisis . 971-972
Adrenal disorder. in pregn ancy.
2062-2063
Adrc;~~%~/ 84-85. 963-995,
ana tomy and embryology of.
963-964, 964/965/
biochemistry and physiology of,
~
catecholaminchiosynthcsi;and
physiology, 968-970, 97 0/
generalanddevelopmemal asp<cts
of. 2fil, 965/
histopathologyof. 964, 968/
historyof,..:&3_ -
mct a>tascsi n , 986-987 allllse , 2ll1
clinica l evaluation and surgical asriskfactorforsquamouscell
managemcm , 987 , 988/ carcino n» .102 7- 1028
cpidc miologya nd J;;;ical withdrawal, in critical c>rc
fc.>tu resof. -9l!.ll
va.scohtureof, ~
Adrenal insufficiency, 303-304, 569 •
.2Zl:2Z2 ---
causes of. J_QJ_
incriticallyill , ..2ll
d iagnosiso( 972, 972/
periopera1iveSltro id
administrotionfor, W
presentation and d iagnosis of,
Ji!.B!M. 304b
trcatm cntof, 304,3041, fil
<ypcsof, 971-97!
Adrenal meJ;;1!0,206 8
disca.s.csof, 980-9 85
phcochromocytoma , 980-985
Adrenalsexsteroids, -2@
Adrcnalsicroid hiosynthcsis,
965-%6, 969/
Adre~ l 72 8f 1 729/
Ad..,nalectomy, 1echnical aspeetsof,
m.:22.1
complicotionsandpostopcrat i•·e
carc, 22.!_
laparo!<copic b1cr•l
1ransabdominal
adr~nalectomy,988- 990
open anteriortr:rnsabdominal
odren.>lectomy. 99 1-993,
991/ --
opcr>th·c>pproach,choiccof,
987-988
po>ter1orre1roper1toneoscop1c
adrcnalcctomy, 990-991,
990}99 1/ --
a ,-adr<:n crgicagon ist , 387
Adrcnocortic& l carcino~ 9 79- 980,
980/
Adrenoconicotropin adenoma, 1915
1\dsontcst, 1604
Adult resp iratorydistrc»syndromc ,
1599
Adult stern cells , 166.167, 166/
miscellaneous, ~
muh ipotem , i l l
Advance<!Trauma Life Support , 50 ,
1Z!l -
Advanccmcru flaps, 1940
Ad,·~ruitial cyS!ic di sease, 1782
Afferent loop syndrome, 1213

2034
Amcric•nAssoci•tion for1heSurgery
of "!faum• (AAST) . 408 -409
Amuican College of Surgeons . IQ
Code of Professional Con d uct, 2Q
found ingnf. ..2!:!
Natio nal TraumaDaiabank ,
789-790
mdanomascagingby, 731 -732.
7311-7321. 733/- -
.scvcnth edi tion stagi ng,ystc m of,
1586. 1587t- 1588t,1 588b.
1589/
staging for GIST, 7681
T NM scagingsysccm , for
co!o rectalc•ncer,
1J74t- l375t
Amui can So.:;ietyforMcubolicand
Bari atricS urgcry (ASMBS),
""'
Amcrion Society of
Aneschesiologists(ASA),
phy•ical >1 attiscbssifica tion ,
338
American 'lhyroid Association (AJA)
nodulesonograph icpanerns
andriskofmalignancy, 896/
Amino acids, 1021
p<K>Lrcgulationof, ~
Aminoglyco>idco. 261
Aminosa!icyla1es -
forCrolrn's<li>ca<e , l261
for ukcrativecol it is, 1343
AmphomicinB . 2701
Arnpull.ofVatcr, 1482
Amput>tion , ?S I , 1996
roleof, 18 ~
Amrinone, 556-557
Amvand,Cla ud ius, 1296- 1297
Ana l canal
anatomyof, 1394, 1395/
di.<o rdcr<of, 1394- 1395
historyof, 1395
lcngthof. 1394
ma lign ant neoplasms of.
14 \ 4- 1415
physi<'."dlexaminationof, 1395
physio!ogyof,1394 - 376-377
sphincterapparatusof,1394
Anal cncirdcmem,for reetal
probpse, 1387
Anal fissures, 140 2- 1406
cvalua1io11of, 1402-1403, 1404/
padiogcncsisof, 1403-1404
presentationof. 1402-1 403 ,
1404[
treatment of, 1404-140( 1405/
medical management of. J..'.!Qi
surgical ma11agemcruof,
1405 -1406, 1405/
Anal in traepithdial neopla sia , 1413
Anal margin (petianal) !un\ors,
!4 12- 1414
Analpain,ocrnrrmceof, 1395
An algesia - scrccn ing and survd lla nce
intra>·cnou.patient-controllcd ,
..lS&.18..2
umhodsof.385-389, 386/
neur>xial, 2§.!!
nonsteroidal ami-inAammamry
drngs , 386-387
opioids , 38s:Jil6
postopNai ive,sdeet ionof
methodsof. l§.2_
Analgesic thcrapy. J.B..8.
Anaphylaxis, 231
Anal'la>t ic ast;:;;Cytoma, 1911 , 19 11/
An apla>tic 1hyroidc& rcino m>, 910
Anastomoticleak, ll.l:.il§ -
causesof, 3 13-3 14 , 3131
prescntationanddiagnosiso(
lli.:..ill_
trcatmcntof, 315-316
Anaswrn mk pscudoancurysm , 1743
Ancillarytests, 2037-2038 - complec;on,1787
cervicovaginalcu hures , Gram
staining. and vagin al wet
mo unt . 20J8
irnagin g, 2037-2038
lower genita l cytology. 2038
pregnancytests , 2038 -
An~;~:n h:~:~~:1::,:~:~· l~~-;
8 Amibody-do pendemcell-med iatcd
oxygenat io nmon itori ng,J67
temperarnremon imring, 367,
367 b
vent ilat ionmonitoring, 367
ph arm>cologicprinci plcs, 360-365
regional. Ju Regiona l ancsthe>ia
ri skof,J77
safctyconcerns,inpregnancy.
2056-2057
spinal. 380-381,3801
Anesthesiologrprinciples, 360-J92
Anc<!hctic tcchn iquc>,selenionof,
Ancurysmal bonecyst, 20!3
Aneurysmald isease. 1722-1738,
1723r
d iagnosis of. 1723- 1724.
1723/ !724/
endova>cuh rrcpa irof, 1733-1 735.
1734r
me-dical 1herapyfor. 172<l- 1725
prcopcr:uivccvahiat ionof,
1725-1727, 1726/1727/
preopcra ti ve1na11agen1Cm of,
1731 - 1733
riskofruptureof, _!_lll_, 1723r
Ancurym1al disc.SC (C,m1h1ued)
ruprn re<lan eurysm,managemc nt
of, 173 1
recommendat ions for, 1724
>1..rgical treaunemof, !725-1 733
1echniqueofopensurgicalrepair
ofabdom inalaonic
aornc aneurysm
coron>ry >rter iovenousfistnlaand ,
1653
Angio<ly>pla>ias , 1153, 1157
Angiohhrnma , 80J-804, 804[
Angiogenesis - -
inducing, 685
inwound ~li ng, 136- IJ7
Angiographiccatheterjzation, for
ma«ivc hcmo p<y>is, 1598
Angiography
forgastroiruest in alhemorrhage,
illl
Angiosa rco ma , 766. 842
curnneous,75 0 -
Angle of Hi s, 1188
Angulai ion,offracture. 464·465
An idulafungin,270t - -
An imal bites, 535-5J6, 2002
riskfactorsfo rinfoction in , 5J6b
Auk!e. 476-477 . 477/
Ankle-brachia! inde<, C"~lcula1io11 of,
17591
Ankylosingspo nd)'litis, 134 1
Annelid worm,, ill
Annubrpancrca,, 1522
Annulus inguinalissubcurnneous,
1067/
Anogen ital wart, 1412
Anoma!ouslef1 roronaryarteryr ising
from the pulmonary artery
(ALCA PA) , 1652- 1653, \ 65Jf
Anoma!oussy<!emicvenous
drainage, 1633-1634
Anorectalangl ~
Anorectaldiseasc. 1154.1154/
Anorccial mal format ion , 18 77- 1879,
1877 b, 1878/
Anoreetalphysiolob')' laboracory
lCS!ing ,1381 - 1382
Anorectal511p pur><io n, 1406- 1407,
1406/ --
al>.>ecsses, various t~· pcs nf, cl inical
prcscn1a1 io ns of, l406
tre>1memof, 1406- 1407. 1407/
Anoreetllm,Crohn'sdiseaseof,
14 11- 1412, 1411/ 1412r
Anosco py, ofan11s . __!l22
Antacids, for peptic ulce r di<e~'-" .
1200
Anterior abdom inal wall hern ias,
1072
Anterior co mponen t separation ,
11 \ 2, 1113/
Amcrior intercosrnl branches, 1672/
Anterior mesh repai rs, for rectal
prolapse, 1383
Anterior papillary muscle , 1694/
Anterior procto,igmoidccto my, witb
colo recta lanast omosis ,
1379- 1380
1925,
INDEX
Anterior1ibi . l ,•eins, 1829/
Anthropometry, J.2Z:.!Q!!_
Antibiotic activity spectra , 258·262
Antihiotics ,25 1-256 --
choiceof. 255 -256,255b-256b
incoloreei alsurgery.1326
forCrolrn's d ikase , 1261
cytotox ic . lli
dllrat ionof,25 5-256
cmp irkal therapy. 255, 255b
IJ-lac<am . >ulJ-lacta m an tihiot ie>
pharmacodynamicprinciplesof,
'"
pharmacokineticsof. 25 1
principlesof,253 -255
prophylaxis ,224-225 . 2251-2291,
251 -253
ofdeansurgery,252
for splen~cwmi zeJ pati oru , 1568
toxicirieso( lli:lfil -
avoiding, 263.26Jb
P-lacrnrn all crgy,_262
ncph rotoxkity, 262-263
oto!Oxicity, lli- -
rcd man syndrome , 262
ux:of,>tirgical infcctio-;;;-;_ nd ,
241 -280
Antibio1ic-specificcon>idera1 io11s ,
256-262
Antibody, 708
cytotoxici ty(ADCC) , 701!
Ant ibo<l y-dcpcndcnt cel lular
cywwxici1y, 60I
Antibody-rnedia1<.xl rejceiion (AMR) ,
620·621
Amicoagulationmanagement, in
no ncard iac>urgcryp.:nicn1>,
2 19-220,2211
Amicoagula tio n r<versal , 568
Aruicywkinetherapy.forCrohn\
d iscase ,1261 - 1262
Antidiuretic hormonc , _8_5_
Antifung:il agents , 2701
Antigcn . 6 0 1
Aruigen - pr~"'ming cells (Al'Cs),
600. 707-708
Antil)' mphocyteglobu lin , 625-626
Antiox idanttherapy,forcriticallyill
pat icnts ,-122
Antipb1det managemen t , in
noncardiacsurg~l)· pa1i cms,
2 19. 220/
Antiprolifcra tiveagents . 624
Antipyrine, inevaluatingl iver
function , 1436
AntireAuxrnrgcry
dinicalow comesof. 1054- 1055,
10551
failed , 1057. 1057/
gastroesophage.>l reAux d isease
and , 1046
op<:rAtivccom p!icado ns of,
1055-1056, 10561
side effects of. 1055 - 10'~6
Antithymocytcglobulin , 6231
Antithyroiddrn gs, 89 1
Aruivonom
for rnarine><ings ,-212_
forsnakebitcs, 5J4·535
Amrectomy. trnnca l vagornmy and ,
1206- 1207, 1207f 1201lf
AnLllus, 1694[
Anus , 1394- 14! 7
diagnostic evaluation of,
1394- 1395
2109
INDEX
Aori~ .1721 -1753
Aorca ahdom inalis , 1086/
Aoniccannula , 1675/
Aortic coarctation , J (>'i~- 1644 .
l (Yl'if
Aortic <li ><ection.1 7 46- 1750.
1746fl 749/
Ao rtic graft infection, surgical
treatment of, 1744-1745
Aort icinsufl'idcncy, 1708-1709
dbgnm isof, 1708~
d iagnostictesting for, 1709
medical managcmenc ;:;r.1709
naturalhistoryof. 1709 -
physicalcxamination for.
-1Z!.IB:.l.1ill
su rgical trca! mcntof, 17051-
l 706r, !709
sym p tomsandsignsof, 1708
trc.nm ent of. J1Q2
Ao rticmi tralcu rtain , 1694/
Aoriics inu scs , 1694/
Aorticstcnosis, 17 051- 17061 ,
1706-1 708
d iagnosisof, 1707
diagno,,ictcst;;;gfor, 1707
medical m anagement of.
-1Zl.1Z:lZll..8
naturalhistoryof, 1707, 1708[
physicalcxaminati OlllOr, 1707
surgical t reatmencof, ! 70~
1705r-1706t. 1708
'ym p tomsandsi gnso( 1707
trea11 ne1u of, l707- 170:r--
Aor1ic,•alvc, 1694/
Aonoc ntericfistula. 1 \ 47-1148
1148/
Aorwfcmoral bypa.,grafting ,
1740- 174 1, 1740/
Aorwil iacdisca>e, 1772- 177 4, 1774/
Aorwil iaccndanerecw1ny, 174L
17'13/
Aonoiliac !esions,Trans.Atlamic
ln1cr-SocictyCon.<m<us
(TASC) da.ssihcatio n of, 1772/.
! 7 721
Aorwil iac ocdu<ive disc~<e .
1738- 174 5
aorricgraftinfoci io n. surgical
trc>tmcntof, 1744-1745
open aortk<urgcry,co m plicad o n•
of.1 74 1- 1744, l 7 44fl 7 45/
opcnrcconstrunion ,i<..:hniqueof.
1740- 174 1
prescntotionandcn luarionof.
--1Z.12:l_llil
Aortop ulm onaryscptal <lcfcct , Ui26,
1626f l 627/
Aortopu lmonarywindow, 1626,
1626fl627/
A!'C gene, 690-692, 1360
Api<ab an , 221
Ap lasiacuti<co ngcnita , 1945- 1946
Aponeurosi•
external oblique muscle and ,
lfil1
internal oblique m uscle an d ,
im
trari<vcrsusah<lominis m uscle and,
rranS\·ersal isfusci aan d ,
1094-1095
Apo ptotic p atbway>, 684J
Ap p<:ndectomy
incid emal,1305 - 1306
laparoscopic, !300, 1302/
App<:ndiccal artcry. 1296
2110
Append iciti s, 1131 - 1132,
1296- JJOO
acutcuncomplicote<l.1300-1302,
130lf 1302/
hactcdologyof,1297 , 129 7t
inch ildrcn , 1297
magneucresonancennagmg,
!299- 1300
ultrasound, 1299, 1300/
in im munocomprom iscd p.>t ien t ,
1308
infcc!ion a«ociatc<lwitli , 1297
laboratory<tudicsof, 1299
pathophysiologyof,1 297
perforate<l , 1302
b acteriacomrnonlv isolatcdin ,
!2971
-
treatment of, 1302
inpregnancy, !306-1307,
l306fl 3 07f. 2048 , 2049f.
p rcscntat ionof. 1297- 1299
liiswry, 1297-1298, 1298/
physicalc<am ina1 io11 ,
129 8- 1299
prevalcnce of, 1296
>huntsand , 193 1
inspccialp<>pulatio ns.
1306- 1308
lrcaunent of, 1300- 1306
uncomplicated , nonoperative
treatment of, 1305
Appen<licoli tli , 1305
AppenJ;x , 1296- 1311
a nawmyof,1296
c1nhryologyof,l 296
lengthof. 1296
rnucinou<lllmorsof, 1308
nrop l..,;msof, 1308, l308f1309/
norm al-ap pea rin g, 1303- 1305
retrieval of,1300
'Apple-core"fillingdcf.,.1 , 1028
Aq11aricanimals. nonvenomous,
injurjesfrorn , 543
Arc of Riolan , 131 0,1320/
Argon beam coagula tor, 236
Arm,superficia l venousuansposit ion
of. ~
Arnold's nerve , l22
Aromataseinliibitors , breast cance r
1rcate<..lwi1h , 858
Arrcst<-<l hydrocephalus, 1927
Arrhythmias, 552-553
Artoria magna synd rome, 17 8 1
Arterial blood su p ply, ofpancrea>,
l21Q
Ancrialcathetet, for l1 cmodynarnic
mo n itori ng ,554
Artcrialduplexulrrasonography,
1760 , 176lfl 7 62/
Arterial rccon>truction, p ro,,hct ic
gr.1ftfor,252,252t
Arterial switch opera tion (ASO).
1637 -1638
Arterial thrombosis, 656, 1809
Aneries,congcn iial ron<li1iom
alfcc1i ng, l78l - 1782
advent it ialcpticdisease, 1782
per<htcntsci atica n cry,
1781 - 1782
Anh rid>.
Arihroplasiy. 778 -78 1
Arthropod biiesa nd>ti ng<, 538-542
1\rt ihcial bu rr. 450t --
A=ndingaorra , 169ij
A;ccndingaon a <l i><ectionrcpair,
1748fl 749/
A<eendingcolon, leng1hof,
1312- 13 13
Ascites , 1076-1078. 1076b
AshkenaziJew>, U61
A<parta!carninotransfcra<e(AST),
1435
Aspergillosi;, 1596 , 1597/
Aspiration , 34 1
Aspir.nion pncnmon ia, 292-293
Aspir.ition pnc11mon itis, 292-293
A.si>tc<lptitnarypatcncy~
A<trocyiictumors, 19!1 -
Atelcctasis, 291-292 . 5 57
diagnosi;of, 292
trcatmcnt o f,292
Athere<:tomy,1 777
Aihcrosderosi<, 17 55 - 17 56
d iahe1es md lit mas ri<k facwrfot,
ill
Atherosderoticcoronary artery
di;ccasc , 1660-1661. \ (>6 1/
1\trial fi hri llation , 553
Airial <eptal defr..:1 (AS D),
1626- 1627, l627f1628/
Atriocava] shunt , 139
Atr io,·cntricularcanal d efoc1,
1629- 1630, 1629f1630/
Atriovcn trirnbr >Cptal dcfe<:t ,
1629- 1630, 1629fl630/
adLih patiemswi th , 1630
Atrophic b lanche , 1832:1832/
Atypical ductal hyperplasia , 824, 832
Auerbach mycntcric plexus, TI90
Augmcn<at ion mammap l>Sty, 1956
Auscultation , 1125
Auwgenous , 1797
Autogenous ~ s,sccondMy
intcn·entionin . 1802- 180J
Auwimmuncpanacatitis , 1532
Autopliagy,.l'l,. 684
AV valves - Bariumenema,forischemiccolitis ,
B
Balloonangioplasty, 1776
lhnnayan-Zonona •)•ndro me, 1.168t
Bariatric rnuhidi scip linaryi can> ,
l lGGb
BariarricOwcomesLongirndinal
Database(llOLD). 1183
Ba ri atric surgery, 1160
bodycon1011ringafrcr, 1970- l971 ,
197 0/
coml'l ica!io ns of, 11 79-1182
contro•·ersiesin. 1183
mechanism o f action of,
1164- 1 16 5
operat i\'c proccdurc> of.
! l68- 1 174 , 1168b
biliopancreai ic d i,•ers io n,11 7 1,
1!75/
duodenalswitch , 11 72 -1173 ,
1 17 5/
investigot ional, 1183- 1184
!aparoscopicadju>1ablcgastric
band iu g,1 168- 1169,
1 169fll71/
!aparoocopicslcc,·egastre<:tomy,
1 173- 11 74. 117 5/
Roux-c n-Yga>trichrp»s.
1 169- ll 71, 117 l b,
1 172f11 7 5/
vertica l ban dcdgastropla<ty,
1 168
pa ticnt <elccdon for, 1165- 1168
cligihili ty,1165 - 1166,l \ 65b
postoperativecareandfollow-up
of,11 7 4- 11 77
prcoperoti veevaluat ionof.
1165- 1\ 68
prcpar.ttio n and ,1 166-1 16 7,
1 1(>6b- 1167 b
spccificcomorbidcond i1ions,
1 167 - 1168
reopcra tives nrgcryof,1182- 1183
resuhs of. 1177- ll79.ll77r
<pc<:iolc<j uiprn ctufot,1!68
cli nic,1168
operati ngroom , 1168
\3 57
Bariumcsophogram, \ 028, 1028/
Barreuesophagus, 1050
Bardiolinglan dq-~abscc«,
treatment of, 1Q1L 204 1/
Basal cell carcinoma, 14 14 , l 4 11f.
Ba>al-likchrca>tcanccr, 840-841
Ba,cdcfici1 , 52-B
Basemem membrane wne, l l i
Basi !icvcin ,1 7 98
B..,iliximab,623r,719r
Basslersign .1 1261

Bd-2, 683-684
&cklin-1. §M
Bcdsidesmgicalproxcdurc•, S77-585
~::::;:::~::;;;· vt.¥i to mcc::-
578/
ind ica1ionsfor.1Z2.::2§1
laparotomy, -5l!l
pat icntse!enionfor. 579-581
percutaneous dil.t>ti;;-;;;;r--
1rachcos10my, jlil
percut~nwustndoscopic
ga.m mtomy. 582-583
prot0<ol for, 579b- -
r:llionalefor. 577-578. 578(
safetypraetices fo r, 578-579,
S79b,58(if - -
tracheo>tomy. S8 1-582
lk.,,sting, 541 - -
Bch~<"di~. 178 1
Beb<>cept. 62Jt. 627-628
BEUE l'instrurne111 , 1.£
Bdimumab, 7191
l3dow-knceamptuation , l77l.
177\f
Belt lipc<;tomy. 197 1
Benign an aldisonkrs
eomnion , 1400 -1 409
analfi;sure>,1 402-1406
anorectalsuppurat ion ,
l.1flli.:.ilQZ
h"uh in ann , 1407 -1408,
l 407b. 1407/
l1ernorrho ids ,1 4 00 - l4 02
piloni<laldiscasc, 1408-1409
less common , 1409-1~12
ac<juiredimmunodeficicncy
•yndmmc , 1410
Cmhn',di.sc•:;c ;;f;;orcctum ,
141 1- 1412
Benign b;! iarydi<ease (Continued)
postcholecystectomysyndromcs,
1501 - 1508
acutcchobn giti., 1507
bile duct injury, 150 1- 1505,
1502[
biliaryleak , 150 5- 1506, 1506[
gall stoncileus. 1506-1507
lostsrnnes ,1505
p<Htcholccystc<:tomypain, 150 5
rccurrcntpyogcniccholangitis ,
1507- 1508
retainedbil iarystones , 1505,
1506[
sphincterof O dd i d)'Sfionction ,
1497
lknign h;l iarym><<cs , 1512
Benignextemal hrdrocephalus ,
!930
Benign hcm>tologiccondi tions,of
spleen , 1559- 1562
hcmogloh inopat hics ,1561-1562
hcmolyticancrni>.CAusc<l h y
er)"throcycoenzyme
deliciency, 1561
hcrcd ita ry,phcrocyto,is , 1561
immunethrombocytope nic
purpura, 1559-1561 , 1560b
llcnignmucosal 1u111orS, 1032
Benign pleural effusions. ~
Benignpro>tat ichyperplasia ,699 ,
2077-2078, 2078f2080f
BenignsubmucoS>ltumors, 1032
Benignirachroewpl1agcalfiswra:-
1026 -1027
Benigntumors,ofesophagus, 1032
Benzodiazepines,<edationu<e -;r,-
.5..tl=5.5..!1
lktahlockcr thcr:i py
benefitsof. 5521
C".>rd iacriskfactorind icatorsfor,
552b
Beta-adronergicre.oeptors,556
lkthc«lacritc ria,fo r rcporling
thyroidcyto pot hology, 898t
Be\'acizumab, ~ 7 1 9 1, 12.l
Bia nchi proced u re, forshott bowel
syndrome , 1874-1875 , 1874[
Bicarbonate. 1195
Bicuspid ,-akcdi<easc, 1698
Rijidob,ute,ium , 1320 -"1""32\
Bilateralhernias,1 10 4- 1105
Bilaicralimernalmammaryanery,
1672-1673. 1672/
Bilateralneckcxploration . 93 1-932,
932b --
l\ilaycr<ubsti1utcs,forwound
healing, !56
Bile due< - nonopera<i\•o, 1Q2!_, 20 92f
bloodsupplyo( 1428/
common . sr~ Co m mon bil e d "ct
cymof, 1469
llilcduncanar, 1~14-1~18
cl inical presentat ionof, 1515-
1516, 15 16/
diagnosisandas:;cssmentof
rcscctability, 1516-15 \ 7,
1516/
:~~;:~:: 1:;n;;~~1Cll1 of, _!1!Z
palliation of, J1!Z
riskfacto<5of, 1514-1515
stagini;anddassifica tiono( 1515,
1515r- 15 161
trcat mc1uof, l2!Z::_!_2_li!
mcdical, -1il2:lilll_
Bil~d ue! inj u ries , 3 19 -320,
1501-1505, l50lf
causesof, -1!2_
diagn<»i<and management o(
l 503- 1504,1503b. 150'if
outcomes of, 1504 - 1505
pr<csc1ua1io11anddiaguosisof,
=
presentationo( \ 50 2
radiologicandcndo.<eopic
techniques in , 1504, \ 505/
1re~1memof, .J1Q., 1502- 1504
idemifiedaf1ercholccysicctomy,
1503-1504
recognizedatthetimeof
chole<:ystcctorny,
1502-1503
Bile formation , liver and , 1432,
14 321
Bilcvd posit ive airway pressu re
{Bil'AI'}. 558
lli lhcmi>. 1473-1474
llil iaryatrcsia, 639
Bil iarrcrsu .15TO-l5 l 1,
l5 10f15llf
Biliaryd i:;casc,345-J47,346/
calculous, 149 1-1492,
149 1fl492/
<urgcry for. 1498-1501
malignant , 1512-1518
Biliarrdrskinesia, 1496- 1497.
1882-188.J
Biliary leak, 1505- 1506, 1506/
Bi!iaryobstruc1ion, pall ia1i\•e1herapy
for, 1552
Bi!iarymictures, 1509-1510,15 10/,
1536, 1536/
llil iary>ystcm , 1425-1428,
1482-1519
anatomy of, 1482- 1486. 1483/
vascular, 1482- 1484
1484f l 485/
mai;nctic rcSQnancc imagrni;,
1489
INDEX
Biliary1r<ct d i<ease (Continued)
symptoms of, 1486- 1487
fever. Ji[Z
jaund icc , 1487
pain , 1486-1487
Biliopancrcaticdiversion ,ll71,
1175/
complicat ionsof, 1182
resultsof,11771,1 178-1 179
l\ilirubin ,1 433
mcta ho lim1o( in livcr,
1432- 1433
Billro tli,lhcodor, 8-9, 9[
Bio.wailab ility, 25 1
Biochemicalstud ies . forcoronar)'
a rtcrydisc"-'C, 1662
l\iochcmotbcr>py. 710-711
Bioengineercdskinsubstitutes, 154
furnreof, JSZ -
Biologic mesh ,453-454 , 45-if
Biologics.forul.oerativecol it is,1 344
Biornatcrials
biom imctic , 168, 168/
a ll ddi,·ery u,;;(,f, 168- 169
dircc1edd ifferemia1ionuseof.
l&ill
Biomimcticmaterials, 168, 168/
Biopsy -
bone tumor<, 774-777 . 776f777j
breast d isease .~
coreneed le,I!f!::JJL lli
cutanrn"' melanoma , 7 27-7 28
cxcisional , lli
fine-uttdl c aspiration, 776-777
ofbrca>t , 826-82 7 - -
sentinel lymph node , 736-73 8 .
736/
111 -RADS , .!!12.,_ 83 11
l\i,phospbonatcs , LM
Bi1es, 532 -546. 1ua&0Stings
animal, lli.::21§:
arthropod , 538-542
human , 2l!2_-
mammalian . ~
marinc , 542-544
snakcbites.u£Snak<hites
tick, ~
Bivalving t hccast . 479
Blackwidowspide-;:;:538-539, 538/
llladdcr,1070/ --
anawmyof, 2069-2070
cancer,2099 -2100,2099r
musclcinvasi\•e, 2 100
non-muscleinvasi\'e,
20 99-2100
injury,2090-2091
im"gingl<>r,2090-2091,20 9 1/
managementof,opera1iwvows
Bladdcrstor.1i;c, problems with ,
2076,2077/
Blalock,Alfte<l, 15, 15/
lllalock-T3ussig (B'i"}shunt, \ 619,
16.34[ -
Blastlunginjury. 221:
l\lasttrauma, 594-595. 594<
Blotchford scorc , lH1_. 1142b
1202, 12021
lllccd--;,g,s o.52 , 64.65
ofam1s, 1395 -
associatcdwit h gener.lizcdpelvic
pain , 2035
associatcdwit h latcrali,cdpc;l"ic
pain , 2035
a.ssociatcd ~tn idl i ne
su pra p ubicpain , 20.35
2111
INDEX
Blec<ling(Continued)
rolonic,1153-l\55
controlof. .1..:2
fbnk pain , 2035
gcncr.ili,.cdah.!ominalpain
wi1hou1 , 1Qi2
lateralizeJpdvic pain wid oou! ,
= causesof, JQ:§ - -
in Crohn'scolitis , l..121,
inulccnth·ccolith, 1345
mi<llinepdvic pain without , 2035
nonvariceat l l43 -l 148 - Bowen disease, 748, 1413, 2012
o bstipation , 2035
related to portal hypertension ,
1!48-1 151 , 1149/
<mall howd,spcdfic cau;c;of, 1157
with.om pain , 2034
Blepharon,1952
Bkp horopla'1y, 1952
Bl ind loopsyndromc. 1290
lllood, lost ford"'' Ill shock , 51/
lllood cuhurc<,255
Blood flow, liver and , l43l
Bloodglucoseconcemration, control
0( 243-244
Blood pressurcnionitoring,367
Blood<uh>tilutc< , 77-78
llloo<l<ul'ply,tothyroid gl. nd, 8S4
Blooduansfosions, B_. 49-50 -
dcscriptionof, 243
Blow-hole proccx!urc, 1345
lllumbcrg,ign , 11261
Blu1ner\sl1df, 1313- 131 4
lllun! ahdorn inal trauma, evaluat ion
of, 432-434, 433/
lllumcercbrovascularinjurics
(RCVls). 423, 1817 , 18171
Blun! injury, in intraihorackgrca!
\'esse!s, JJ!.!.§_
Blu111 1horacicaot1icinjury,1738
BMS-936559 , 7191
llochdalckhcrnia, l2Z2.:li8.J)
Bod~· contouring , 1970- 1971
aftcrbuiatric •urgcry, 1970- 197 \ ,
1970/
suction-a<>imxf lip"<:!Om y, 197 1
Bodymassindcx(BMl). 107-1 08
assessment o( _llL 126 -, -
in1crprc<a!ionof,l08b
ll<x!~· w>tcr, 81-82
Bodyweigh;:-107
Bornl>esin,1 192
Homb;nabombina. 1192
Bollen1acroenvironmcnt . IB::Ilf>_
lloncmicrocnvironmcn! , 77 3-774 ,
775/
Bonernrnors,1Zl:.Z!!L 20!3
ancurysmalbonecyst , 2013
bcn ign , 781-784
biopsyof, 774-777 , 776f777f
incheS! wall , 1601- 1Gu2, 1602/
cndwnd rorna, 78 1, 2013 , 2014/
evaluatioll of, Tfll/ -
giam cell rnmor, 782-784 , 783/
:~::~!~:c,::~,i ~f, 1ZB.
oS! cod10n J rorna, 78 1, 782/
0<1 coiJo>tcorna, 78f:"782 , 783/.
2013, 2013 ~
overviewof, ZZJ
prim>rybonc>arcoma• , 2013
,.;condary (mctastat id , 201)
skelernl reconstruction ;;r:--
778-78 1, 779/
stagingof. 777-778
2112
Bony t liorax , 1573
liordcrlinephyllodesrnmors . .B..12
Hom.fittb,.rgdorfir;, 540-541
llorrmannclassihcation •r><cm ,
12 16, 1216/
Bouwnnihedeformity, 1994/
Bowdobsm1ction, 306-307
afrcrpallcrcas transpbntatio n, 662
prcscn!at ionof, 306-307 - heal map , 841, 841/
srnall ,347-348 - -
Bowdsounds, 1125
Boyd'sperfowor. 1829/
Brachioplasty,1 97\
Bradyardia,dehn ition of,553
Brain,injudcsto, 41 7-420, 4 18/
evaluation of, fjg::::rpy-
managemcntof, 41?-420 ,4 19/
immediate, fil - - lobular:N
Brain •hsce", \ 934- 1935, 1934/
Bra i11<1irnul>1ion,l?24
Bra in Tr>uma Foundation , fil
Branchvaricosities, t reatmentof,
1839-1 840, 1839/
Br.inched-chain amino acid,
(BCAAs) , 10 1
Brand1ial clcf1 ~, 809
Branchial clcf1rcmna~ l 861- 1 862
1862/
Brawny edema, 1832/
8RCAl , fil 832
HRCA2, fil.1 832
11...,...,
abnotmal dewloprncruof,
n1:B.2(i
abscess of, i l l
ahscnccof, 824
accc"ory, 824
anawmyoT.820-821
axillary nodesof, 820
cysts, 835-836 -
devel~f, 822-826
ductal sy>tcmo ~ l/.823/
fatnccrosi s of, 1!1Z
- i nol dcrad ul~
fibrocys1icchanges , ..ll1A
infenionsof, fil
lobularunitsof, 821-822, 823/
microscopicana1~Ji2.l.:.li2.2_
palpalionof, 826
papilloma<o ~
papillomatosiso L 8.lG
physiologyof, 822 -826
radialscarsof,_§JZ
sclcrosingadenosisof. 836-837
tissucof, m --
Brc.s< augmentation , 1956·195 7
Brea>tcancer
ageofpatient , 830-83 1
arcob involvemen t , Bl&
aromataseiohibirors, 858
a<>c><rnentofpo1cn1ialbcnefit ,
855-856
basal-lih, 840-84 1
bilateral mast"<:tomy, 869/
BRCAl , .@J,_ 832
BRCA2, fill. 832
d 1crnopreven1 iu11 for, 834 -835
ch crnud1erapyfor,85~
dassificationof, 837b
con t ralateralbreast , lli.:l!ZZ
d uctal carcinomain•i tu, 837, 838/
hrcost-conscrving rhe .;pyfor,
~ 84 7/
lurnpecwmyfor,8521
mastectomy for. ~
Breastcancet (Conli>wed) Breasi d isease , 343-344,819·864
.<C ntind nodesurgeryfor, B.i.3_ adenorna, ..aJ.Ji
tamoxifenfor,8521 ben ign , 831 , 835-837
:~~;:;,,~~.:~~-;!~
trcatmcntof,1!.2.l.:1!21
cndocrinct hcrapyfor,857-858
epidemiologyof, 837-842 corcnttdlebiopsyof. 827
fami lyhiswryuf,~ diaguosisof, 826-827
genctioof,832
goalsoftherapy,855·856
epidem iologi 3 4 ' J
fibroadenomas . ~
r.hrn<ystk , 824
hcrcdi!ary,]542 finc-nccdlc -;;;pl rationb iop•yof,
high -riskpat ients ,829b,830 -835 fil6=82Z
hiswlogicriskfactorsfor, hamorwmas, lli
831 -832,832< image· localiledsurgical excision
historicalperspective, 849 829
hormoncu>ca11d , 83 3
inflammatory, 860
i 1wasive , ~
dunal, 8.~8 , 839/
839/
lobular cJrcinonu in,itu,8J I ,
833-834, 837, 838/
loc,.llyad,·ancc:J;8GO
magnet ic resonance imaging of.
829b
mammogr.ip h ic,.;rcenini;, ~
828•
neuadju\'antsysie1nic1hcrapyfor,
858-860
nipplcinvolverncnt , .a.2Ji
noninvasivc , 837-838, 838/
O\'atianablation ,858
pathologyof. 837-842
personalhisto;:y;;r.83 1
prophylactic mastectomy for. 835
radiat ionthcrapyfn r, 844 , 85.f-854
raloxifcncf< >r,Jl.11 _ __
reeurrenceof, 865
rcproduct iveriskfacwrsfor,833
risk assessnlCOt,83J. lU5.
risk factorsfor.829b. 830-8J3.
83lb,8321
sentinel lym ph node dissection ,
B..12:..82Q
sexand ,830·831
stagingo( 842-84J, 84Jr-844r
subtypesof, 840-841
surgical1rcaun cruof,843-851
brc.st-cnnserving thcr•py,
844-845 , 845r tran>'·ersercctusabdominis
historicalperspeeti,·eson , myocuianeousHapfor,870b,
843-844 870/.871
transvcrse11ppi;rgracil isHap for,
872,875f876/
Breastsurgery,1955-1958
llreasttumors, 841-842
angiosarcoma, lli
phyllodc,ttimor" 841-842
llrcaS! ·conservini;><iri;ery,846-848 ,
cosrneticchallenges, 84 7-848
technicalaspectsof,846·847
 INDEX

Btta>t-conserving therapy, 844-845 , Burn(s){Ctmtinued) Cancer(Continucd) Cud iaccot11plia>1ions,296-301

84 51. 852·8B. J!li,_ 2060 inflammat ion in , 2Q2 epigenccioof, Ji'.M Cudiacevaluat ion , 207, 208f209/
foctorsinHuencingel igibilityfor. injury, and me1abolicstress esophagcaLufEsophagealcancer Cardiacinjuries,429-430
MJi rcsponsc , lll:.ll:I g:utric.secGa<triccanccr Cardiac output, in pregnancy, 2054
hi"olob'Y· 846 in,ulinfor, 5B-52S gcnct ic•ol, 689-690 Cardiac Ri, k Index (C R!) •yS1cm ,
margios, fil"" mctformin for, ill globalburd~7 552. 552b
pa1 icm age, 846 nuiriiionalsupponfor, 123 ltcadand c"..:k.;e;;:-Heada11dneck Cud iacvalvcs,emb ryologyof, 1693/
tumorsile, _lli inoldcradu h s, 355 - Cardiogcnicshock . 300, 554
Breasi/ovariansyndrome,6911 oxandro!onefor. 522-521 incidenceof, .6J2 causes of, J OO
Brcntu<imahv<..lotin , 7191 pathophysiolog~· of, 505-512 lip ,794 , 795/ management of, 556-557
Bri'1lcworm>. i l l local ~~~?cs , 505-507. 506b, lung.suLungcanccr prcscn tat ionandmanagcrncntof,
Broad -spenrum p rcoptrntive med u lla rychyroid .690 300
amibiotics, ~ system icchanges, 507 -512, oksityand, 678-67? c.rdioplegia infusion , 167 1
Bronchi, congenital abnormalities of, 508/ -- pancrcatic.iul'ancrcaticcancer "Corcliopulmonarr•xis". 1578-1579
1.5..fil_ propranolol, 523 rectol. ucH.ectal canccr Cardiopt1lmonarybypass
Bronchial >trcsi~ . 12fil ren al sy><cm,-;:ir.:. .:tson, 211 S!cmccllsand, 168 C-&nnuhtion for, 1674
Bmnd1ic-cusis , _!222 mlcofn incsfor, -121 supcrhcial , 1033-1036 with hrJK>thcrmichhrillatory
!Jronchogenicqsts, 1580- 1581, scron<l-d egrce, 506-507 , 507/ cescicu lar, 2102-2104 arrest ,1679- 1680
J_f!Q,1§_§2 -- size, 507, 507/SOs'i:Sl l/ neurologic proteccionduring,
Bronchol it hias is , J.22.i 'pccih"Ztreatmento( 515-52 1 1672
Bronchopulmonarydisorders, 1595 i nhabtioninjury. 5~ sep.1 r>tionfrom . 1676
Bronchopulrnonary111alforma ~ 5161 -- Card iopulrnonarycxercisc1c>1 i11 g
186~-1866 wound c-~rc , 5 16-519. 517t (Cl'ET) , 1578- 1579
broochogeniccyst, 1865 t hird-dcgree, 507, 507/ c.rdiopulmonaryresusciiation , in
congenital lobar emphysema, Burnun it.orga;;-;::;-;ionand
1866 peT50nncL 506b
congenital pulmonary airway l\ urn wound
1nalfonna1 ion, 1865, 1866/ co,•etagcof, 518 -519, 5 18/
pulrnonary<niuc><r~ cxds io n of, f i l f i l
!86~-1866 Bum fracture , .12J_
!Jronchoscopicspecimentcchniques, Buschke-LOwensceincumor.1u
249 Vcrrucmi>carcinoma
Bronchoscopy B11tterflyfragment, .1frl... 466/
bc<lside, ~ID Bu11crfly hemaroma, 2092/
<l iagno>tic , 583 Bu11resspla1es, A.6.li
Brown reduse-:pTders, 539-510, 539/ Butyracc. \J23
l3uccalmucosacancer, ~
Buckle fracture, 462-463
Budcwn idc, forCroh n\di;cca;cc ,
c
CA ll.2, 699-700 , 2046
1261 Caffeine, in evaluat ing li\•er function ,
Buerger disease, 1780 1436
Bullousemphyscma, 15? 8 , 15? 8/ Cakincurin inh ibitors . 624-625
Bundle of His, 16?1/ cydosporine ,624
Bun ncll'snoman'shnd , 1987-1988 immunompprcssion uscof, ii12_
Bu ricdghnd>, 1034 ncphro10xicityaSS<>eiatcdwith ,
Burn(s) , 505 -5::rr- fil.:fil!l
aminoicrobialsfor, ~ C akiphylaxis . 928-929, 929/
basic treatment of. fil:2!2 Cakiton in . !l]L 1007
cscharotomics, _5.lj_ inthyroidhoncriontests, 889
initial as<c<<mcnt in , l!l Calciwn i n-producingCccll~81
prchospital managcmcnt , jj.1. Calcium , 8?-92 - ductal carcin omain situ.su
resuscitat ionin . 2.!l..:.2..!2, 514t homrosusisof, ?24, 926/ Ductalcarcinoma insicu
transportin , 513 h )'pocak<mia, 9o::<.Ji hepatocellular. rcel-!epatocdlula r
wonndcJre iO.- .i!]_ regubt ionof. ~25 t
co loricrcqu ircmcmsof. 123, 123 1 Calcium stones , 2o8J
~"ardiovascular syste m, dlcei< on , Calculousbili;u ydi<ca<c , 1491-1492.
-2Q2:.ill_ l49 lf l 492/ lobul>rcardnornain situ , 831
chemical, 525 -528 surgeryfor, 14?8- 1501 medulla rychyroid . suMe<lullary
classification of, _lli, 506b Caloric rrquiremc nts, fil~ 1hyroidcarcinoma
d epth of. 506-507. 50 7/ 185?< papill>rythyroid . su !'apill ary
cderm in . 2Q2 Calot node , 148J, 1481/ thvroi d carcinoma
df1cacyofdiffcrcn1anabolic Camperfa<cia , 1066, 1067/ riskfor, 1342-1343
agcn«toirnl'rovcmu<clc Campto<lactyly, 2015 Mjuamouscdl. su5..juamousccll
proteinsynthesisin.52?/ ca,,,pylobacurjcjuni,ascau"'of
electrical. 525-'~28 infcc1iouscolicis,1 355- l356 in ukerat ivecol iiis , 1345
ctiologyo( 505 Canakinumab , 7 1? t Ca rci nomacxplcomorphic
fim -dcgrcc .~ 507/ Canalicula r mcmbrane , 1130 adcnoma, 80 7-808
Auidrcsuscitat ionfor, -113. Canccr.1ulllwCarci11on1a; Cardia, 1188
fourth -dcgrce , 507 , 50 7/ lv!ctasia.s.cs;Ncoplasrn>; Cardiacarrcst an dmp>eardial
gasirointestina ~em , effccfson , Tumor(s} protection .1671/1674-1675,
_ill agingand , 677-678 1675/
hypcrmcubolkrcspon;ccin , brca''-'uBrca.st canccr Ca rdiacarrhythmi>»po'1opcrat ivc ,
508-509, 510f511/ colorectaL iuColo rectalcanccr
atte11uationof, 221.:22S_ inCrohn'scolitis, l.li2
immune sysiem,effectson , cpidcmiologyof, 677-67?,
211:.ill 678/680/ - -

2113
INDEX
Carnwnia, 548
Cmx;hol an~ . 21_ 556
biosynchesisandphpiologyof.
968-970. 970/
Ca~:~:;;r":~;~g~~:i;~,7 ;;,y;or
Ca1hc1ercare,244-245
Cat hcter·associacedurinaryt ract
infoc1ion (C1\UTI), in intensive
carcuni1 , -2ZQ
C>thc1cr-ba,cdthcr.i pi cs, J..'.IB
Ca1he1ers
arcerial, 554
bhdder, 244
cc ntra lvcnous.ufCemral venous
atl1ctcrS
Cancll -R ra.sch maneuver, 1546
Cauda cquina syndrome , ill
Caudak lobe, of liver, !422.1423/
Caust ic ingestion , 1026, 1026<
Cavall igameni , 1422
Ca,•criu>niatoustran>forrnation,of
portal vdn , 1437
Ca,·ernommalformati on s, 1904
CD4'Tcells,604, 705,706/
CDS' T cells. 6 \ 2. 705
CD25,626-627
CD27,61lt
cozs,610,6 111
CD30,6\lt
C040,6\0-6 1J,6111
CD40/CD154 p>thway, 610-6 11
CD+l, .@±{fil_
CD80,6!0
CD86,610
CD95,606-607.6111
CD13'1 .6l11
CD1J7 ,611l, .Ili
CD152 ,611t
CDIS4,610-611
CD l7 8 ,606-607
CD265 .61lt
C D 278 ,611·612,61 11
C0279 ,611t
Cccal volvul u>. 1335, 1336/
Ce<:ocolicvol,·ulus, __!]1§
C d iacaxi san curysms , 1789
Cel ia c ly mphadcnopa d:;y.1031/
Cell adhesion molecules (CAMs) ,
-6.l!.l:!ilU
Cell cydc , 681-683, 683/
Celldcad, - -
nonapopwtictypes of. 684
resiSling , 683-684 - Chcmodectomas.lllh
Cell su rfucerccepco", 61'1
Cell wall-aclivcagcncs , 258-261
Cdlubrtransplaniacion~
replacemcm , .616.
Cen ccrsfor Med icare a nd Medi cai<l
Scrvice•(CMS) , 1165
CenrcrsofExccllcno: (COE) , 1165
Ccrural h ypmhyroi<li>in , li.8.2
Ccn tml linc-a<><>Ciatc...!bloo<lstrcam
infcc1ions, 194. 195/249-250 ,
249r, 256-8 7
a nt ibiot icsfor,251-256
trcat nlentof. 256-257
Ccrural ncrvous>y« tm
infcrtionsof,1933- 1936
acquired immunodeficiency
syndrome, 1935-1936
intr>eranialinfe<:tiom ,
2114
Cen1ral nct\'Ou>sptct11 (Conlinued)
tumorsof.1909-19 10
intracranialtumors, 1909
Ccntr~I ncurc>eywma , 1912
Ccntr:il,l ipin scrtio n, 1978/
C emralvenousca cheters, 1798- 1799
hemo<lynamicmoni toring, 554
inincensivccarcllnit, 2ZQ_
Ccntr~l ,·cnous p rcss urc (CVP) , 554
Ccphalicvdn , 1797- 1798
C ephalosporin ,252, 2531, 259. 2591
Cerebral perfus ionpressurelCJ'P).
ill
Cerebrospinalfluidshu1m ,
1')28-1929
Ccrcbrcwa.<cuhr<li.<or<lcr<,
1')03- l909.!903b
aneurysms ,1904 - 1908
artcriovcnous malformations ,
1903- 1904 . 1903/ 1904r
eapillarytcbngie<:1asia, 1904
cavcrnousmalfo rrn at ion s, !904
duralarcerio,·enousmalformation ,
1909
Moyamoyadix;ax; , 1908-1909
tr,1umaticfistub , 1904
"c11om angiom a, 1904
Ccrcbnw..scuhr,•..scubrinjuric<,
endovascubr managcmontof.
18 12 , 1813/
Ccrtolimmah,hirulccrativccoliti>,
1344
Cerwlizumabpcgol. 7191
Cervical adcnit i<, lill2
Cet\·ical lymph nodes , 1849/
Cet\·ical spine, inj uriesof, 493
Cc rvical tcr:uomas. .!!!!2 -
Cervical t hyroidcctomy,"an<lanl,
912-9 17, 913/917/
Cervical u hrasou11d , 930, 930/
Cet\·ical•·ertcbr.,l boJ}l'iactu res , 122r
Ccf\·ix, -2!!ll::2!lll
Cctux imah(Erhitux) , 22.!J_
CCI mcthylation , 694
Chance fracture , 4221
Cl1an<ldicrsign . 1 ! 26r
Charcot•ign , ll26t
Charges, 176
Cl1cmicarl;;:;-rns , 526-528
adds, 527-528, 527/
alkali , 527, 527/
hydroc-;;i;:;;ns , 528
Chemokines. in wo und healing,
=
Chcmor~<lbdon , fo r esophageal
cancer. ~
wr<u•surgery. 1038- 1039, 10381
Chemotherapy
forbrustun<0er,856-857
forcrophagcalcanccr, 1037, 10371
l aryngc~ l anccrtrc.icd with , _Bill)_
lungcancercreaced w;th ,344
formctasiaticpancreacic
ad cnocarci no ma , 155 1-1552
fororopharyngcal0<11 iamousccll
carcinoma, l2Z
forpanctcaticcanccr,1 550- 1551,
15501
Chesi w•ll . 160 1- 1603
deformi tics. 1881-1885, 1885/
surgicalmanagemencof, 1885
infe<:tion<of. 1603
i njurics, ~ 428/
rc«>m<ruct io nof,1953 - 1954
traum aof,1 603
tumo,.of, 160 \ -1603.16021
bone, !60 1-1602,1602/
mcta!l!atic, ! (,OJ
re<:onstrnct ion ,1603
rofr1isrnc, ! 602- 1603, 1602/
Chest x-roy. before 1horacic
oper:it ion• ,..!1ZZ_,_ 1577/
Chiari J malformatio n, 1932- 1933
1933/
Chia ri l lmall<>rma1ion , 1933
Chiari malformation , 1932- 1933
Chil<l-l'ughdassification, 1436,
1436r
Child-Pugh sco ring •)'Slenl, 2161
Children . Ju Pediatri cs
Chimcric mo noclonalan tibo<ly, 718/
Chlorhexidincgluconate, 244
Chloride, 1324
Chloroform ,360
Cholangiocarcinoma , 1514
Cholccysiccwrny - p>!hophys iulogiccha;;gescousc<l
bilcductinjuryi<lcntific<laftcr,
1503-1504
b ileductinjuryrecognizedat the
time of, 1502-1503
galtb laddcr unccraftcr, 15 14
laparoscop ic ,1 132 - cdl u lar ditferetuiO!ion in•·ol..cd in,
Cholccyswkinin (CCK), 1485
Choledochal cyst ,1 881- ~
1882/
Cholcdocho<l uodcno stomy, 1497/
Cholcdocholi thi asi, , \ 494- 1496,
1495/
Choleliihi..sis, 2060-2062
nonoperat ivccrcatmentof, 1492
obesityan<l ,1168
inprcgnancy,2048-2049
Cholcrcticdia rrhn , 1323
Cho ndrosarcoma, ~ 1602
Choroi<lplexuspapillon1a,an<l
ca rci nom>. 1912
Chrisropher.Fre<lcrick , 12-lJ
Chrorn ogra nin A (CgA) , 1273
Chron ican<latypica linfe<:tion>,
2001
Chronicappendic ic is,ascauseof
abdom in alpa;n , \J05
Chronic arterial insuffi ciency.
1756-1758,17571
Chron icchok-cy<ti ti<. 1492-1493
Chronicfraccures, __1fil
Chroni cgamiiis , 37-38
Chroni chcp>tic infla mm at ion ,
J2::iQ
Chronjchepa1i1isCvirusinfcc1 io11<,
fJ.!l_
Chronic hydrocep halus , 1927
Chronj c inflammaiion , 2i::11. 697
byorgan•yste m , 35-36
pancrc.>S,.Jll -
pulnionary. 35-36
Chroniclivcr<liscasc,assc;srncntof,
1137
Chroniclym phocyc;cle.,kemia
(CLL), 156j
Chronicmycloge nous lcukc m ia
(CML) . 1563
Chronjcobsiruc1 ivcpuln1o nary
disease(COJ'D) . 35-36
C h ro nic painsy11dromc, inguinal
hernia repair and, 1105
Chron ic pan creac itis, 1531- 1537
d inical manifcs<at i~
1532-1533
d iagnosisof,1533
funci ionaltesis,1 533
imagingsrnd ies , 1533, 1533/
1534b
riskfac<orSfor, 15'! 1-1512
alrnho lahusc , 1531-1532
genemmations, 1532
smoking, 1532
treatmen t of, l533-l5J7
cndosco pi c, !534
rnc<lical,1533-1534
su rgical ,1534-1537
iypesof. 1532
autonnm une p ancream 1S,
C h ron icprc<Surc sorc,squarnou sccll
c.rcinomai n, _!1&, 146/
Chron icrcnal infla mmacion , 40-41
ad apt ive immu nity in , All
immunethuapyfor, 41
by, 40-41
roleofinnate immunilyin
d evelopmentof, .1!1
C hron ic vascu lar in flam m at ion ,
J1l.:l2
"'
ind irect mcchanismof ac1ivacion ,
..IB:l2
1hcrapcuticoptionsfor. _l2
C hron ic,·enou,in suflldcncy, 1840
C h yle, ! 606
Chylopetitoneum , 1854 -1855
Ch)'l othorax, ~ 1606b,
1851
Chylousascitcs, 1078
Cigarcttc•m ok ing ,asrhk fac<o rin
lung ca nc~r. 1583
Circu1 n ferem ial cas1 i11g, 479
Circumfle>;artet)',169~
Cirrhosis. .l2o:iQ. 565-566.1436
cl inical manifcs!at ions o f, 39-40
immunc-m<~liatcd hepatic
<legradation , 39
ovcrview of, _22
•yste m ic immun e system cffe<:1'
of. _12
Cisatracu rium ,3651, 550
Ci!l!crnachyli , 1849/-
c- kitreceptor, 768
"Clamshell" incision , JiZ2
Clark .. lcvclofinvasion , llQ:Zl!__
731/
Class l rn>jotl1iswcom pati bili1y
C.:mip l<:x , (,()2-603,603/
Classll majorhiscocompat ibili cy
complcx , 603 , 603/
Clavipe<:toral fascia. 820
Clay brooksign ,1126 '
C !can surgical procc<lu tcs ,in >utgica l
sii c infcci ion , l l i
C lean·conca minaiedprocedures. in
surgicalsiceiofecc io n, 215_
1168

Cli11 ic.o.l l11sii <u1eWi1lidrawal
Asses.smcm (CJ WA). 55 1
Cl inicalpulmonary infection srore
(CPIS).149
Cli n0<hctyly, 2015
Close<! franure,soft <i<>ue
de><ructionin , A.83
Closed(Ferguson)
hemorrhoidcctomy. 1401-1402,
1403/ --
Clmcd mi<ral commiS>urotomy,
1692/
Cfo.r1ridiumd;_{firiltcolitis, 311 -3 13
causeso( .l!._l_:l_l_1, 312r- -
prcsentationandd iagn osi sof,
.lL2=3.U
trc.imcrllof, 313
CUmridium diffi~infect ion ,
1353-1355,1 354/
Cf,,,rridiumdijjicdt->5'<Ki >tcd
<lisc.sc.12.Z
Clo1ri111a1-0k 27 0t
Clottingmcdi>nis ms,566-567
Cluscorgrnfi, _GZI)_
Cmetp roto-oncogone,l2l5
Cmgub rion , 57/
changcs,inpregnancy,2048
inliver, 1434
wncof, 506, SOG/
Coagulopat!i)\53-54, 56-58
Cocc idioidomycosis, 1~159 7[
Coccygcu' mu>elc , 1093/
Cockcn l pcrfor:itor, 1829/
Cockeu 111f>"tforawr,1829/
Co<lcufProfcssionalCunduct,20
Codman stripper, 1836
Coclenterates , _i1}
Cogan s~·ndmmc , 1781
.
eo.,:~:~:~ ,;rm•, ~
cogni ti \'e decline and de1nentia,
.ll5..:.1lli
deliriu m, 337
d cpre><ion , 336-337
g:!::~::::~ ~:~:·r,J;g~~;~l
Cog11 i1i \•eim pairinent, 206, 206b,
2071 - Composi te tissue transpTm!ation,
Cohort study, J22
Cob:torny
opcn.349
right , 1336
C-Oli1is, il54'.'. 1155, 1155/
Crohn's , l349- Ll53
forms of, !324
infectious , 1353-1356
i<chcm ic . ~
ukerative , 1339- 1349
C-Olbgen
struct11 reo( IJ8
synih esisof. IJS-1.19
iypesof, 138
Collagcnous;:;:;l i1i; , 1342
Colloid tumors, 838-840, 839/
Coloanalanastomosis,sphinc1er-
spari ng ahdomi nal r<rincal
rcscc1ionwith , 1J.ll..!!:..Ll1
Colon , 1312 -1 393, 2064. !eet1fso
spceificsegrncruofcolon
aboorptionin ,1323
adenocarcinomao( l.J.22
anatomy of. IJ12- IJ18 , 13 l 'if
artcrial>tipplya ndvmou,and
lympha 1ic dr• inage ,
1314-131 7, 131 7fl322/
cross-sect io nal, 1320/
using , 1151 - 1152
fo r pseudo-obstr11 cr;on , 1338
Colo recio l cancer, J..Illi. l 'Vi'l _,u
a&0 Rec1alcanccr
American Joint Commi ttee o n
cancerTN M stagingsystem
for,1 3741- 137 51
fam il ial. concept of. 1359
gene mutations t hat promote,
13601
Colo>torny
descriptiono f. 1326- 1327
en d dccscen d ing . 1327-1328,
1328/ --
loop , 1328-1329, IJ28/
physiologicconsi<lern <io n sand
prac1icalin1plicatio nsof,
J.JlI
Comm ittee on Traum a (COT) , --1.l:IB
Common bile duct
laparoscopicc•plorationof,1496 ,
1500.1500/
openexploraiion of, 1496 ,
1497fl498f 1501, 150 1/
Commun icat ingand obsmoct ive
h)·droeepld us ,192 7
Co morhidity, 337-338
cardio,·asculardiseasc,337
pulmona ry complications,
3J7-JJ8 , J37t
Compa rtm ent')'nd ro me, 2004 .
2005/
alxlomiml, 555 -556
acute . u~Acutecomparcmem
syndrome
Compensato ry h ydrocephalus/
hydroccph al ns e~ vacuo. 1927
CornpleinctH >y«cm , 33. 708
aei ivationof,34/ - -
Complementarity-determining
regions , 717-718
Complcm en t·dcpcndcnt cytotoxid ty
{CDC) , 718
Comple1 ion1~idec10my, _2lIB
Complex access, 1803-!804
vascu!aracces.sromplicatiomof,
1803-1804 . 1803/
Complex dccongcsti,·ephyskal
th erapy, 1852
Complexsd erosinglesions , JilI
Complica1c<ldivef!iculi1is,
managemcntof,133J - JB4
Complicate<lskin andooft tissue
infcctions{cSSTls), lli_,_ 258b
Complicatio n>. ieeSurgical
com p lica1 ions.
Composite end poirus, 177
vascubrized , 633. 6 34/
Compression l'lati--;;g;-AZll
Co m pressio n 1mmpthcrapy, 1852
Compulsive poswperntive
surveillance , 281
Computed tomography (CT )
forappendici ti, , 1299 . 1300/
fo r biliarytrcc d ise..se,1488-1489,
1489/
forcolonic icschcmia, 1357
forcongenirnlhean <lisease ,
1622-16B
gastriccanccrstagingand , J11_!_
in nutri1io nal assessmcn1 , _lilll
Cornputc.Jtomogr•phyangiography,
diagnosing lower GI
h emorrhage using, 1152- 1153
Co m putcri,,ed phys ida nordcr en try
{C POE)systcm , _!2Z
Concordaru xcuografo , 631 -632
Co nd it iona llyesscruial am inoaeids,
=
Conduit choice and harvesting ,
16n-16n
Co nd,•lomaacum inatum , 14 12-
14 13, 1413/
Cone procedure, 2041 -2042
Co nfoun<ling, __!_!Ll:
- malformation , 1865, 1866/
INDEX
Confusion , defin ition of, 547-548
C-Onfusion .soessmentmethodfor
the JCU (CA M-JCU) , 547-548
Congenital ahnormal ities,of
abdom inal wall , 107 1- 1072
Congenital andacquir..d
h}d roccph al us, 1927
C-Ongenital and developmenta l
deformit ies, bre»t, 1958
Congeniial anomalies, 20 13-2015,
2016(-2017/ --
C-Ongenitalbronchop ulmonary
malfonnations, __!2§__!_
C-Ongenitalcysticadenomatoid
malformat ions, nfil_
Congeniialcystic lesions , 1580-
1581, 1580(
Congffiiial <liap hragma1ic hern ia,
1863- 1865, 1864/
C-Ongeni ta lc.u d eform ities , 1946
C-Ongenital hea rrdisuse . 1619-1657
a natomyand! crm i nol~
1620- 1624. 162 1/
considerat ion s for, l§l2
cyano1ic, 1634- 1637
d iagnosisof, 162 1-1624
d iagno"ictes1', 1622-1624
physical cxarnin~
--1.G.2hlJ:i22.
historyof. 1619
hypoplastickfl"heartsyndrome
1uHypoplai;t iclcft hcart
synd rome(HLHS)
bionovcf\•iewof, 1625- 1645
ao rticarch ono rna lies,
lfi1.HMj_
auioventricularseptaldefect ,
\ 629- 1630, 1629fl630/
conotru ncal anoma lies ,
1637 - 1640
dcfectsas;ocia1 ct!wi1h increasc<l
p ulmo nary b lood How,
1 6~~-1627
lcf1 vcntricular ou1Aowtract
ob"mction , 1640-1641
venous drainage abnormal ities ,
1632 - 1634
ventricuhrseptal defect,
1627-1629
miscellaneous anomalies,
1650- 1654
mi<ral,·.h-canomalics ,
\ 653 - 1654
vascu lar rings and pulmonary
aneryslings, 1650-1 652
periope r'1t ivccarco( l 624- 1625
.>n esth .,iap irfalls .1624
singl e,·cutricle. 1645-1650
hypopl asd e !ehheartsyndro mc ,
164 7-1650 , 1647/
tricuspida iresia, __!__§12,
l 64(f1647/
su rgery, pa th ways for practicing
16 19 - 1620, 1620/
!r•nSposi!ionol thegrea!artcrics
su.li-ansposit ionofthegreat
arteries (TGA)
g:~::~:::: ~:~;pca:'~~~::~:~'.";·8~
Congenirnlnevus , 7 25/
Congeniial pulmon ary airway
2115
INDEX
Co11gcnital vasculardirotde..s,
J..iS.ld.5..81
Conotruncal anomalies, of
congcnii.lhcartdi;ccasc ,
1637- 1640
double-oucleirighcverurick !MO
irar»po<itionofgrea1 arteric-.;---
16J7-1640, 1638/1639/
congcnicallrrorrccted, 1640
Consdous«-.Jad on ,360 -39 ~
Con"ipat ion , 1381-139 1, 1389/
irar»itmidicsof,l390- 13') 1
Comam ina1Mprocedur<·s, insurgical
•itc infection , 1i2_
Continuousaspirationofwbglou ic
secretions , 244
Con t inuousvcnovenous
hemo<lialy.is, 565
Co111 inuurnofcare(CoCJ. 121:..!.2i
Con traccption , 2036
Contractures , 2018 -2020
C:>ntrollMscudyofLanre-01idc
An t iprolifcrot ive Re'l"Jn"' In
NcuroEnd0<;rincT11mors
(CLARINET) 1ri~I. 1275
Conventional imaging, inohscurc
G I hcmorrhagc.1156
C:>1wencionalon-p ump
c.rd iopulmonaryhypa" ,
1669-1677
Cooper'sliga1nems , 821, 825/
Cor 1ria1tiatmn . 16j""2:]6 33
Cor>I snake,, i l l
Cordotomy, 1924
Core net:dlel>iop•y, 776-777,827
Cori cycle , 101. 143-3 - -
Corona phl~mica, 1832
Coronaryartcriove11ow; fistula,
aneurysm•and , 1653
anatomicconsideraiionsin ,
1658- 1659, 16 59/ 16591
phpiologyandrcguhtiond
coronarybloodAow,
1659-1660, 1659b
a norn alicsof,1652- 1653
Coronaryarterybypassgr>fong
(CABG)
odjunctsto, 167 7
inotropes -;-;;dph >rrn acotherap)"
ifilZ
intra -aortic l>allcKrn l"""I"
-1.GZZ
uansewphageal
echocanliogr;iphy, 1677
wr>Usb;il loono ngioplosty/-
l_,arc-mc1alste11«. ~
ver<u1contcm1x>r.>11eousmc<lical
therapy, 1665-1667
w"'"<lrug-elut ingstems, 1667
ver;usmcdical thcrapy.forlcrt
main CAD, l8iZ_
rol c of,1669
an<l spcdalpopulation sof
patiencs. 1686
inobesepatiems, 16 86
inoldcrpaticnl>, 16 86
inpaticn"withdiab<:tc•. 1686
i11patiemswithrcnaldisease,
1686
in women , 1686
2116
Coronaryanerybypas.surgpy,
historyo( 1660. 1660r
Coronaryartcrydisease,353-354
cardbccat hcteri,,.:uionand
intcrvcntionf<ir,1664-1665,
1664/
d inical man ifestations and
diagnosisof, 1661-1665
clinical presentation of, 166 1
<liagnos!ic tcstingfor. 1662-1664
mechanical complications of,
-1!i8..U6..85_
physical cxam ina<ionof,
166l- 1662 . 166 2b
Coronaryarceryrn·..,cularizat ion
complc1rncssof, 1668
convcnlionalon- l'um p
cardiopulmonary bypass,
1669- 1677 . 1670b
cannulat ion.for
card iopulmon>rybypass
1674 . 1675/
c>rdiacarresta n<lmyocar<lia l
protcction , 1674-1675.
1675/ --
cardiopulmona rybypass,
1670-1 672, 1671/1672/
con d uit cho icea11dlian•csting,
1672-167"
hemostasis , 1676- 1677
mediansternotomy, 1672
ncurologioprotcctio ~r ing
card iopulmo na rybyp><s.
ill2
posi1ion inga11d <lrapi ngin ,
1669-1670
separation from
card iopulmonaryl>ypa.ss.
1676/
101>lartcrialrcva>eulari>,ation ,
lfil3:lGZ1
coronory a nerybypassgraf1ing . 1N
Corona ry arrcryb)'P""'
grafting
in<licat ionsf<>r, 1665-1677, 16661
left main coron>ry a rt ery disease,
!667- 1668
lcftvemricularsptolic
dysfunction . 1668
mechanical com p lic• tions,of
coronary artery <lisc~se ,
168~- 1 685
left ventricular aneurysm ,
!6H- 1684
mitr:il regurgitation . 1685,
1685f l 6 86f -
vcn1ticular>cptaldefc..:1 ,
1684-1685
lll)'OCar<lialrevascularizat ion,
ahernat ivemetho<lsfor.
1679- 168'1
cardiopnlnlonary bypasswith
hypotl1crmicfibrillawry
arrc<1 , l 679-1680
hybrid procedures, 1682~!683
min imallyinva>ive d ircct
rnronaryancry hypass ,
168 1-1 682. 1682/
off-pucnp coro11aryariery
bypa>sgrafti ng, 16 80
168 1. 1681/
l"'rcu1aneouscoronary
intcrvenrion . sul'ercur aneou•
coronaryintcf'·ent ion{l'C I)
pmtoperativcc"3rc , 1677-1679
discharge from intcn<i,·ccarc
unic, 1678
med icala<ljuncis,for
postopera tive management ,
1679
OUlCOn>es, 1678-167<J 1679b
pulmonaryC'Arc in , 1678
preoperat iveevaluatioil,1669,
1670/
pro>imallcft antcriordcsccndi ng
artcry <lisease . 1668
ST-scgmen1 elevation myocardial
infarction-acu1cmyocardial
infarction , 1669
unstable • ngina/non-51--segment
elevation myocardial
infa rction.1668
Coronary insuflicie11cy, 1658- 1690
Corpus, 1188
Corpusullowmmy, 1925
Corpuslutellm cyst , 2029
(',orrc-cte<I transposition , -1Jtl!l
Corrclarcdd.>ta , _lfil
foracu1erespirarorydis1tess
•yndrome, 560
forCrohn's<li>ea>e , 126!
im munosupprcssiveuscor,622
fm ulccrat ivccol iti" 1343
Cosiimula1ion blockade . 630-631
Cosiimulawrymoleculcs ,6 111
C'-0stoclavicu hlf tcst , 1604
Com, l l i
Counseling, patient , 340
Courvoi<icr<ign , 11261
Cow<lendisease ,6911, 13681
CpGisla nds{CGls) , .!i'.!A
Cranialdy,,aphisnl. 19J2
Cr:rnial epidur;i l abscess, 1 933-19J ~
Ctaniofacial mkro><>rni~ . 1946
Craniofadalsurgcry, 1945-1947,1945/
Craniopharyngiomas , 1915
Cran iosynoswsis, ! 933, 1933/ 1945.
1948/
"Creeping fat" . 130 3-1304
Cnowrcsourrcrnanagernent , 193
Cricoi<l , J2b - prognosis of, 1265-1266, 1266/
Cricoidstenosis, 1595
Crico1hyroidotomy. f i l 415f 1948
~;:~·;~~;;~fore,. ,.;, 1189-1 190
Cri1ically illpa1ie1us
cnteralfce<lingin , 562-563
pat hogensof. 263-265
Crocodil es , _i1J_ - -
CroFah , 5_H-5J5
Crohn'scol iti, , 1349-1353.1350/
ca ncerin, 1..22
c"3uscof, 1349-1 3 50
clinical presentation of, _!_lli_
Crohn'scol itis (Continued)
diagno•isof. 1350-1351 , 135 1/
elective operations for, 1352/
cpi<lem iologyof, 1349-1350
c>tracolonicmanircstation, in ,
fisiulasin , 1352
fulminantcolitis in . _ll_21
growth retardation in , 1352
indication< for <urgery;J351-
1352. 1351b
iruestinalobstruction in ,1351
inita-alxlom inalab<ecss in ,
135 1-1352
intractab ility in .1351
mass ive blee<ling in , 1352
l'athologicfc>turc<o~50
grossappearance , 1350:1' 350/
hiswlogicap peara-;;;:zJ 350,
1350/ -
po<1opcr. t iverecurrenceo( 1353
<urgicalmanagcnientof,
m in imallyinvasi,·c
approachesto,1353
surgical proceduresfor,1352-
1353.1352/
toxicmcgacolonin , 1352
ttea11nen1 of, 1351 - 1353
i ndiC'~tion s for surgery,
1351 - 1352
medical <heral'Y· 1351
Crohn',disca<e, 1154, 1254-1266
ofanorcct um , 1411-1412
dici ical pre<ema<ionof, 14 11,
14 11/
ev•luat ionandtrcatmentof,
1411 - 1412,1 4121
a•cau:;cof>mall l>.1wcl
ol>strnction ,1248
causesof, 1255- 1256
geneiicfactor<, 1255- 1256,
1256 r --
immunologicfoc1ors. 1255
infcctio us agents , 125S -
d i n icalmanife>tat io ~ 1257.
l25 8t, 1259/
d iaguosisof, 1257 - 1260, 12 59/
1260r
historyof. 1255
incidrnce a--;;-J--;:]>idcmiologyof,
1255
managemeruof, 1260- 1263
medical the rapy, 1260- 1262
nutritionalther.p)', 1262
smokingcessat ion , llQ2
surgicaltreatrncnt , 1262-1263
1»thologyof,1256-12- 57- -
grosspa<hologicfeatures.1256,
1256/1257/
microscopic feature•,
1256-1257. 1258/
inl'rcg11an9 , 2Ufui
small bowel bleeding and , 1157
spccilicproblemsof, 1263-1265
acu te i lei t is , ~
c•nccr, _!l!i5_
colorecrnl J i..,a.se, 1265
duodenaldisca.sc, 1265
gastroimestinalbleed ing, 1265
penetrat ingdisease ,1264-
perfor.>tion , 1265
periana ldiscasc , 1265
strictu ring d isea.se, !263- 1264,
1 263/1264/ ~
urologiccomplications . ~
 INDEX

Cro<>-prcsc!HO!ioo ,707-7 08 Cysi(s)(Conlinued) Dccpi n fec1 io11s ,2000-2001 Dermal sub>ti!utcs, for wound
Cross-sect ional srndy, _!12 Rarhkc'spollch , 803-804 palmarspa.oeinfeccions, healing. ill:_l_§Q
Cruvoilhiorsign , 11261 simple , 1469 2000-2001. 2002/ Dermatofibroma,2012
Cryo ahladon ,237 splcnic,l56J-15(,.4 pyogcnicflcxortcnmynm·i1is, Dcrma1ofibro<arcomaprotnhcran>,
Cryothcro py, \ 034 t hyroglossal d nct , ll09 , 1861, 2001 , 200 2/ 750 . 766
CryptococrnsiS":'l5 96-l S97 1861/ -- Deepinferiorepigascricanery Dermoidcyscs , 1860
Cryptord1idism , 1885-1 8 86 , 1886/ Cysiadenocarcicio1 na, 1469 perforatorflap.forbrcast Descendingcol;;;;-:-kng1ltof, 13 13
Cubit>I tunnel syndro me, 2007 Cystadcnom.>, _!_1&2 reconstruction , J!ZQ, 87 1/ Des.oendi ng mediasrina l inte rcosta l
Cu llen, 'lhomas. 2 Cyscicarrery.ana tomy o f. variations Deepinferiorcpigamic•·e,,.,ls, lym ph trunk , 1849/
Cu llen sign , 11261 in , 1427/ 1093/ Dc.cc ndingd10radcaor1ic
Cu ltural competence , 21-22 Cystic ha.sal cell ca rc in om a>, Deep pcronca l nc"·c , 1828/ a ncnrprn,da<>ifica1ionof,
Cu hura! sensi1 ivity, 2!~ 748-7 <19 Deep veins, 1735/
Curlinguker, 121 1- Cysiicduct , 1427, 1428/ Descriptives!a!iS!i<:<, 180, 1801
Cush ing•)'ndrome, 976-979 Cystich b rosis , 1542, 1581 Descript ive stud i es . ~
biochcmic~I diagnosis >nd Cystichygrom ~ped iacr ics, Deepvcnoussystcm , 1827- 1828 Desfluranc.36 11-3621.J62
locali>.:uion ,977-978,978/ ~ Dccp•·cnousdirornbosis , 184 1-1 845 Dcs mo idturnor, 765-766 ,
c pi dcmiology an<ld in ical features , Cystic medial necrosis, 17 81 can<csof, 184 1- 1842 1072- 1074. 10 73/
Cyscicnwp lasms . ~
~:::~~~~.~'.~~·~'~1,";'~~:~o~
976-977, 977/ dinica l diagnosisof. 1842, 1842/
su bd inicat 979 ofpancreas,1537 -1 54 1 d iagnoS1 icronsidcra1 ionsin , 1842
surgica l management and Cystic pl.re, 1423/ 1425- 1427 imag ingstudic, andlaboraror y Destructive bions, 1924- 1925
outromes,979 Cystosarcoma p hyllode" 841 testsfor. 11142-184.1 De>;mederomid ine, 550-5';1
Cush ingub:r,12 11 Cysw.copy,207 1 - inddcnccof, 1842
Cuiancousa ngiosarco ma , 750 Cyswurctliro><:opy,2071 aftcrki dn cy tra nsplacuat ion ,656 Diabetes md lit us
Cutaneous lichenamyloidosis Cytochrome111,,, _§b 62/ lowerexcremity.1841 - 1844 acherosclernsis risk , fil
(Cl.A) , 100) Cytokines , 21_ obcsiiyand , 126 immuneiherapyfor. 960
Cu taneous malignant nco pbsms , cdlularsourccsandbiologiccffects prophyla>is r,;;;-184,l- 1844 ;, kfallor"1 nspla n tati.;;:;lo r,.22Q.
Z1H.ill of. 28< trcatmen t o( .!11.i pa ncrcat icrra nsp lantat ionfor . .9£0.
u11conuuon , ? SO de«:rip1io11of, 61 4 upper cxtrcn1i1 y, 1844- 184 5 surgico.I 1rcauntrl! of, 959 -960
C1uancous rndanorna, lli.:ZQ proin namrnaw ry, 145 rctricvablcvcnaca">fihcrs, <y1ic 2, olx:si1yasriskfac10 rfor,
biopsyof, 727-728 summaryof. 6051::()061 1845.1845b ill
ca u>eso( 12.1.:lli 1herapy.forCrohn'sdisease, ueat mencof, ~ wound heal ing affected by,
epidemiology of. 724-725, 725( 1261 - 126 2 vcnacavafiltcr,l845, 1845b 14 6 - 147
invasive , ~ tum o r imnrnnothcrapyuseof. Defecation. 1324 Diabcticfoot . 1767- 1769, 1768/
pathogcnesisof, 726 , 726[ 7 10 -7 1 1,7 11/ Dcfceography.1382 Diabetic retinopaihy. fil
pathology of, 72ffiO in wound heal ing, 1341 for rec1occlc,1 400 Diagno<1 icbrond10«:opy, 58 3
precursor lesiOrlSOl,725-726, Cyromegalovirns (CMV) , 668 Degenerative disorders, of spine, Diagnost ic imaging
715/ -- ascauseofcolicis, l..liG_- 19 18 - 1922 acerabulum , 475,476/
punchbi<>p>yof. 728 Cytotoxican1ihiotico , 262 ccrvicaldi.cprolap,c,ccrvical ank lc ,4 76 -477
nhravio lctrad i>ti;;;;-;:xpo,urcand , CytotoxicTcells, 6 12-:70 5 spondylosis,and ccrvical elbow, 47 5
22A:l2i Cyto10xic T lymphocyt<·-associa1ed S!enosis , 1920, 1920/ foot,477
Cu!tingballoon , 1777 oruigcn 4(CIT A-4). 610, 7 06, d iagnosisof, 1920-1921 hip,475-4 76
Cp not iccon gen ital hea rt disease, 707/ - - - lumbardiscprnla psean d lu mbar knce,476.476/
1.fil1:lill c....,rny, Vin.oent ,865 degenerat ivecondiciom . pelvis,475.476/
pulrnon.ry>trcsia \ 921 - 1922 sh ou ld cr,4 74-47 5,475/
andinuctventrirnl.u.scptum , D locafo,:nionandd iagnosisof. spinc , 477 -478
1636 - 1637 Dabigauan ,220 -221 19191, 1922 Dialysis access, 1796- 1804
wi1h ''entricu larseptal d<·fcet , Dadizumab ,6231, 7 191 lun1 barca 11 al stenosis , autogonousfisiulas,s<:eondary
\ 637 DJ k in, Henry, 7 inte rventionsin . 180 2-1803
rccra logyoffalloc , 16J4-16J6, DamagecontrnT lllmbardiscprolapse.1921 cenrralven ouscacheter.
1634{-Ui37/ - - dc><:riptionof, 581 management of, 1922 1798 - 1799
valvub rpulmonic>tcnosi< . 1637 rcm>cit ation , .t![7'0b managcmcntoption sfot, 19 2 1. complcxaccc<>, 1803- 1804
Cyd ic lipopepc idcs, 260 Danforch sign .1 1261 1921fl922/ dia lysisouccomes qu •lityinic iative
Cydin-dependemk~s, fS.3. Danger-associa ted mok..:ularpauerns paihophysiologyof, 1919- 1920 guidelines, 17 96-1797
Cyclosporine, 356. 6 23<,624 ,iiliZ (DAMP,),25. spinal anatomyin . 1918- 1919, failed/fuilingaccess,paticntswith
for ukcracivecol it i,, 1344 DJpsonc , 539-540 191 91 180 1- 1802, 1802/
Cylin dricalcdl papillomas ,lilll Daptomy~ Dclii«:cncc,283- 284 , 283b in itial evaluation , forncwaccc;s,
Cyli ndrom a, \ 592 Dataam lysis , 180-182 Dcla)'cdun ion , A..6.2 1791!
CY!'JAl , ii!M rorrcl aied data, J.§1 Dclirium. BQ.::illfil 337 , 3371, nommdacure, 179 7.1 7971
Cyst (s) h ypochesis ieS!ing ,l§l 340-341 superficialvenoussystem,of u pper
ancurysmal OOne , 2013 instr11m enralvariab lcanalysis , J..B.1 cau«:of. 11Q, 320b e>: trcm ity, 1797- 1798
B>rthol in glan d, t reotm enrof, missing data. _!!g_ dehnitionof. .5..1Z:21.!! ven o11strJnsposi1ion
2041. 204 1/ mu l<ivariableanalysis, -1.8.l poS!opctati,•c, 206-207, 207 b 1cdmiqucsof, 1800- 180 1
biliary:l51 0-1511, l 5 10fl5 11/ pro1x:11'ity><:orc an alysi; , Jl!l.,lll1 presentation and diagnosis of, tyix:sof,1799-1800
br.mchialdefr. JiQ2 variabletypesand descripcive .lllLl.21 Diaphragm.cruraof, 1043
breast . ~ stae isc ics , llill.,_ 1801 cre>1memof, .Jll Diaphragmac ic injuries, 432,432/
hronchogcnic, 1580-158 1,1610, D.wis,U.pl. 12- 13 . 13/ Ddormcproccdurc , 1397- 1398, Diasta5isrccti , 1072
lB.!i2 --- dcQuervaindi«:a«: . 2004 1.l99/ Diastc matomydia. 1932
d1ole<lod1al. 188 1-1 8 82, 1882/ Dea1hreccptor .S.. ..6l:!.3. - Dcrnen tia, 1Q§,_ 206b,2071, 335-336 Diazcpant , 550
epi de rm al indusion , 20 10-2011, DcBakcy, Mkhad , J..6., !6/ Dcndriticalls, 600-60 1 Diel, majo ;:-;:;:;nponcn!Sof, 98
20 10/ -- Debridemenr,sofcc is.sue,bcdside, descripiionof,705 Dierarysta rch,1241 -
ganglion , ~ 2009/ 2Z2:2fil_ myeloid , 707-708 O iethylec her, 3611
hydot id , 1452- 1454 , 1453fl454f Decision making tu mor antigen ac<1 u isition by, 712/ O iculafoybion , \ 146. 1146/
mcdia,.i na l. primary, _!i_l_Q patient participa tion in , 11_ Dcnonvillicrsfuscia. 1399 123 1- 1232
n1cserueric,1 082 sltare<l , 22 Dcnosu1 nab,7191, fil Differecnial 1nisdassi fica1io n , 174
O!HCtllal. 1081 - 1082 Derondiiioning,34 1-34 2 Deprcssion , 206, 207 b, 336·337 Diffuse esophageal spas m (DES),
peric:ud i al. ~ Deepfrmoral •·cin , 1829/ Dermal sinuZl932 -- 1015-1016

2117
INDEX
Diffu>e lu11gdisease , 1598- 1599.
! 599b
DiGoorge•yndrome, 1630·163 1
Dig i1allyaugmcn1cdsurgcry,
394-396.395}396/
Diiodocyrosinc, 1!..8.U
Dirc..:1allor"'ognit ion ,620/
"' olecubrbasisfor, 621/
Dirccteddilfcrcntiacion, 168-169
Dirty procedure<, in surgical site
infec1ion , li5_
Disasiers
dassi licat ionoLand implica1ions
fortraumacare, 586-587
-5.l:ili.:S.Bl
:::~~:i~~;:~:~:i'c';ii~::~·~,~_ifili
hos pital p lans for
inciden t rommand , _i2Q_
rccci ,·ingcasuahics, 22!)_
t r~urna a.spec!< of, 590·591
triage, 590-591, 59- ,,-
ho;[~~i;i:~::~:~ ;~~~92-593
gcd of. 587
initiolpr,-;:;:,591,59 1},
othc raspec«of. 592
major medical. 586-587
natural --
in jurypattcms in , 32}
m ed ical relief effort in , 5..'11
surgeon'srolcin , 593
trau 1nacarcin , 22J-
traumaservice li ne in, 588, 588/
Disei tis, 1935,1935/ - ><entinclnodcsurgeryfor, Jiil
Di>eorda~nografo , 632
Di>cax:-spccificconsidcWions,
256-262
Dio!oca1 io11s , 1997, 19971, 1999,
1999/
dex:rip1ion of. ill
evaluatio n of, 493-494, 496/
h; p, 493-494 - -
kntt~4
Disstt!ion,aonic, 17 46- 1750,
174(fl747/
Dista l cholangiocarcinoma. !rcatment
of. l2!2
Di>tal phahngcalfr.cturc, 1997- 1998
DiS<al subdavianartcrialoontrol.
181 7
Distribu ted type. ofsplcnic artery.
J.ii(i
Di,·c rticulardiscasc, 1019.102 1,
1153, n~o-n~4
backgroundof. LBO
epiphrenicdivert icula. J.Q1!.,
1022/
eval uat ion of. 1331 - 1332, \3 32/
H incheydassificat ion of, 1333
managemmtof, 1332- 1334
complicated d iverticuli t is,
1333- 1334
uncomplicated di,·crt iculitis ,
1332
midcsophageal divcriicula,
1020-1021, 1021/
paihophysiologyof. 1330-1331,
133!/ --
pha ryngoc"'phagcald ivcrt iculum ,
1019-1020, 1020/
ofsmall ime>ii ne, 1280-1 286
d uodcnaldivenicula,
2118
D ivcf!iculi1is
management of
compl icated , 1333-!334
uncomplicated , 1332
spccialconsidcrat ion , f<ir
right-sided,1334
inyou11gpa1iems,1334
DNA mcth)'htion , 701
DNA microarra)'. 242-243
DNA tumorviruscs , ii2!!_
ONA-hasc<l marker>, 701
Dodd'sperforator, 1829/
Domain hernias, loss of, 11 15
Dorsalrootcn tr)'rone lesion . 1924
Dorsal venous arch , 1829/
Do rs:.lis pc....lisvcin , 1829/
DOTATATE , 1274- 1275
Double ruprnre , 1788 -1 789
Double switch , 1640
Double-outlet rightvcntridc. 1640
Doxorubicin , _l_i§_
D ressi ngs
rnaintcnancc ,244
wound , .11!:.J.12, 149b.
l 50t- 15 1r,152b
Drew, Charles , _!!_, 8/
Dro p finger, 1994/
D rugfevcr,254
DrugwithdrAwal syn d rome, 254
Drugs, metabolism of. in liver, 1"34
Dual-encrgyx-rayabsorpt iometry
(DEXA) , 108
Ducrcctasia, ~
D uctalcarcinotna insi1u, 837.838/
lu1n ptttorny for, 8521 -
mastectomyfor, ~
tamoxjfenfor,8521
trcatmcntof, B.i.l.:1!21
D u1nbbdl1 umors, 16 12
D u1npi ngsyn d romc, 1212
Duodenal at resia, 1870
Duodenal di><ease,Crohn'sdiscasc
and , 1265
Duodenal divcrtirnb , 1281 - 1282
cl inical 1nanifes1a1ionsof,
128 1- 1282, 1282/
incidenceandoauscof. \ 28 1
treatment of, 1282, 1283/
Duodenal injurics ,439-440
Duodenal >tcnosis , 1536
Duodenal switch (DS) , 1172- 11 73,
11 75/
resulrsof. 11771,1 178 - 1179
Duodenal ukcr, .l.!.22:.l1QZ
d inicAl rnanifestat ionsof, J.!22
ahdorninal 1>ain , ll99
diagnosisof, 11??- 1100
flexibleupp<rendoscop)'.
1\ 99-1200
H~/icobart~'PJ/o,; test ing, 1200
upp<:tgdsttoitucst inal
radiography, \ 199. ll99/
invasivetestsfor,12~
cuhure ,1200
hi,,ology.1200
antacids , 1200
_tl, m:epwr amagoni>ts ,120 1
medical management , 1200
Duodcn>I ulcer (Co,,linu~d)
protonpllmpinhibi tors . 1201
sunalfate,1200- 1201
Duodcn<>jejuno>1 o my,antccolic
"~""' rctrocol ic, 1550
Duodenum , 964f965J !086/
neuroen docrine 1u111orsof, ?98
polypsof, ..!1.ZQ - forcongcniralhcartdisc.>sc . ..!&ll
vascular compression of,
1292- 1293. 1292/
Duplcxartcrialu hrasound ,
l282dZ&1
Duplex survei llance , 1786
Du plexulrr.>sound . 1843
Dupuyt rencontracturc. 2019, 2020/
Duralarn:riMenousmal~tions,
Dynamicrc1enc ionsmures ,4501
Dy><embryoplas1icncuroepithelial
tumor, 1912
Dysfu nctionalutcrincblccd ing,2039
Dyskcratosis , 789
Dysrnenorrhc;:--1036
Dysphagia , 345, 1019
inesophagealcanc<ers, 1028
Dyspla,ia
high -gradc , 1033-1036, 1033/
in uker:uivccolit is, 1345
Dysplasticncvus, 725
Dysrhythmias, in --;;;t,:mivecareuni1 ,
E
"'
Ear,no><e, and1 hroa1complications,
ill.:Til
Lr deformities, congenital, l946
Lr tumors , 80~-807
Eardrumpc rf<ir:u ion , 594
Earlyprcgnanc)'. 2034-
EasternAssocia1ion for 1heSurgery
ofTraurna(EAST) , 408-4 0?
Ebsteinanoma!y,oftricuspid,., lve,
1653. 1654/
Ehurnat ion ,JQ!2
E-cad herin, 686 , 686/
Ediinacea , 230/
Ech inocandi ns. 2Zll
Echinococcalcyst , 1447-1448
Echinococcosis, 14_52_ _
Echinodermata, 2'.!1
Echocmliography,555
~:~ ~::!~';~a~::~~td~:::~· 1 ~~2
fo, !1bromusculars11baortic
stcnosis, ~
Eckfim.da ,1440
Ectopicpancrcas ,1522
Ectopicpregnancy, 2039
surgeryfor.2042-2043
potent ial co mp lications of.
204 '\
techniquc in , 2042-2043
Ecul i>.urnah. ~ 7 191
Edema, 1842/
in burn injury, 2Q2
Efuliwmah. 7191
Effectivcncss ,.lZS_
Effercmloopol-"'tuct ion , 1213
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Another random document with
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those who had a hankering after the Covenant to turn to the loyal
side, which allowed them greater latitude in their games and plays. It
was therefore announced that, in the ensuing week, the pastime of
Robin Hood and Little John (which had not been celebrated in the
beginning of May, the usual time, on account of the disturbances)
should be practised on the playfield, along with the usual helps to
merriment.
Of all the crowds that poured out from the town on that day to see
the spectacle, it is our business only to take notice of a young man
and maiden that tripped along just as it was commencing. They
appeared to be of the first order of the citizens. The maiden was a
lively, interesting little girl, with blue eyes and a fine complexion; her
limbs moulded into the most exact symmetry, and her whole
appearance in the utmost degree fascinating. Her dress was white,
with a sort of scarf or plaid wound round her person, and fastened by
a loop and silver button on the left shoulder. Her flaxen hair, except
a few ringlets which strayed down her neck, was confined by a silken
snood, which, even at that period, was the badge of Scottish maidens.
Her companion was above the middle size, of rather a slender make
and ruddy complexion, with expressive dark eyes, and coal black hair
flowing down, according to the fashion of the royalists, in large and
glossy curls. He was about twenty years of age, and though his figure
was somewhat boyish,—or feminine if you will,—yet the fire of his
eye, the intelligence of his countenance, and the activity of his frame,
confirmed his claims to manhood. Although the young man intended
only to be a spectator of the revels, he was dressed in green, with bow
and arrows, which was the dress of the actors of the play.
As they approached the playfield, now called Gilcomston, the
shouts of the delighted populace were heard, mingled with the
sounds of the pipe, fiddle, and trumpet, the songs of the minstrels,
and the cries of the jugglers. The Abbot and Prior of Bon-Accord (or,
as they were called after the Reformation, Robin Hood and Little
John) had just arrived; and having been greeted by the populace,
were forming a ring for the celebration of the sports, which was
guarded by a body of their archers. We have no need to detail the
performance; suffice it to say, that the piece was intended for a satire
on the Covenanters, they being shown to the lieges under the
semblance of evil spirits, and the royalists of angels of light. Towards
the close of it, the young man whom we have mentioned felt his
sleeve pulled by a person behind him.
“Thou art he whom I seek,” said the person who thus forced
himself on his notice; “and thy name is Basil Rolland.”
“It is,” returned he; “declare your business.”
“Not here. Thou seest we are surrounded by the multitude.
Remove with me to a little distance, for I would hold some secret
converse with thee.”
“That may not be. I came to squire this maiden to the revels, and
may not leave her alone.”
“Suffer the damsel to tarry here for a short space, and follow me to
a little distance.”
“Go with the stranger, Basil,” said she, “and I will remain in the
same spot till you return.”
“Do so then, Mary,” said Basil; “I’ll return anon.”
As they retired to some distance from the crowd, Basil had leisure
to note the appearance of the stranger. From his dress little could be
learned; it was in the extremity of plainness. He had been a man of
uncommon muscular strength, but it seemed much decayed, perhaps
from the struggles of an active life. His eyes were sunk, but retained
their lustre; and premature furrows were on his brow. When he
halted, Basil addressed him:
“Will it please you then, sir, to communicate your tidings?”
“Then I ask thee, Basil Rolland, what dost thou here?”
“Why, grave sir, I’ll answer thy question with another,” said Basil,
laughing at this solemn opening of the conference: “what dost thou
here?”
“My gray hairs, young man, are a testimony unto thee that I come
not here on any light matter.”
“Why then, my foolish face may be a testimony to thee of the
lightness of the cause that brought me hither. Marry! we have at last
got rid of Montrose and his prickeared gang, wherefore we may be
allowed to enjoy ourselves on the prospect of peace.”
“Enjoy thyself!” said he. “And what enjoyment canst thou gain
from these absurd and impious mummeries? They are a sacrifice to
the evil one; a bloody engine of Prelacy to betray the unthinking soul.
Peace! What have ye to do with peace? Have not thy friends been
treacherous as a snare, and unstable as water? Hath not the finger of
Heaven written bitter things against them for their guile and deceit?
Have not their enemies trampled them under foot, and they in whom
they trusted been as a scourge and as a snare unto them? Have they
not been lukewarm in the good cause, regarding the favour of men
more than the will of God? Are they not even now triumphing at the
hurt of Israel, and rejoicing that the pure evangel has been
withdrawn from them? Let them lean on those whom they have
chosen, and well shall it be for them if they can protect them against
the just wrath of the godly.”
“Your words are dark and threatening, old man, but to me they
appear as the ravings of a feverish dreamer. You seem to tell me of
some danger hanging over us; but our enemy’s forces are disbanded,
and in my judgment there is nothing to fear. The town is fortified:
Aboyne, with a strong army, possesses it. So away with these fancies;
and if you have aught to say that concerns me particularly, say on, for
I must return to my sister.”
“Thy sister? Well, Mary Leslie may deserve the name. I am thy
friend, wherefore I am so thou shalt quickly know. Ponder well what
I have said. Remember that the calm often precedes the storm, and
that it is better to take part with the faithful, even in adversity, than
to be the friend of covenant-breaking, soul-seducing prelatists. I will
see thee to-morrow at the booth of Samuel Fairtext at eventide. Meet
me there, and it shall be for thy good. Farewell, mayst thou be
partaker of all covenant blessings.”
So saying, he walked off, and in a short time was lost among the
crowd, leaving Basil at a loss what to make of his insinuations. When
he came up with Mary Leslie, the Skinners, who represented the
royalists, had succeeded in driving the Litsters, who represented the
Covenanters, into a smoky den or booth, which, in a moment after,
took fire, while the whole angelic train joined in a song to the praise
of the Viscount of Aboyne.
He remarked, however, that the spectators were now very
inattentive to the sports. They were drawn together into small knots,
all over the field, in earnest conversation, which, as it became more
general, entirely drowned the iron voices of the performing cherubs.
The spectators began to leave the field in great numbers. Robin
Hood’s body-guard even followed their example, and Little John, by
the same inexplicable spirit of discontent, deserted his friend and
leader. The whisper (as it was at first) was not long in extending to
the spot where Basil and Mary were standing. The cause of the
disturbance may be gathered from the following conversation:—
“Now, the like o’ this I never saw,” said Thomas Chalmers, deacon
of the fleshers. “That deil’s buckie Montrose is to the road again, an’
comin’ wi’ thousands upon thousands to the town. Fient a hoof mair
will I get killed till we be clear o’ him.”
“Weel, weel,” said Jamie Jingle, the bellman, “it’s a gude thing it’s
nae waur. Come wha like, they’ll aye need a bellman.”
“Nae waur, ye clappertongue!” said another. “I wad like to ken
what waur could come? Willna a’ thing we hae be spulzied by thae
rascals,—black be their cast!—an’ wunna there be anither speel at the
Covenant, whilk we hae a’ ta’en an’ unta’en about half-a-dozen o’
times already?”
“Ye’re vera right, Saunders,” said the chief of the tanners; “but for
a’ that, Aboyne may gie him his kail through the reek; and, if the
news be true, there will be a great demand for shoon and belts, whilk
sud be a source o’ comfort, ye ken.”
“What hae I to do wi’ your belts an’ your brogues, Benjie Barkhide?
What hae I to do wi’ them, I say? A murrain on the Covenanters, say
I, and a’ that pertains to them.”
“A curse on the Covenanters an’ prelatemongers baith, conjunctly
and severally!” said another citizen. “I wish the deil would snite his
nose with the hale clanjamphry, though he sud get me to the bet o’
the bargain, for wishing them sae.”
“Wha would hae thought o’ this in the morning?” said Barkhide.
“Weel, lads, I think we sud a gae hame, an’ put as mony o’ our bits o’
things out o’ the way as we can.”
They departed, and this sentiment becoming general, in a short
time the play field was emptied of the revellers.
As Mary and Basil moved homewards with the rest, the latter
evaded the questions put to him concerning the stranger. He saw,
however, a coincidence between his darkly expressed hints and the
events of the day; and while he resolved for the present to keep this
secret, he anxiously wished for the promised interview.
 Chapter II.
The red cross glares on Frazer’s towers,
My love, I dare not stay;
The bugle peals through Lovat’s bowers,
My love, I must away.—Old Ballad.

We shall now conduct the reader to a shop in the Broadgate, over

which appeared in ancient characters,—
Patrick Leslie & Samuel Fairtext.

It is not to be supposed that the street had the same appearance

which it now exhibits; neither are the unsophisticated to imagine
that the shops resembled those of our own times, with lofty roofs,
gigantic windows, mahogany counters, splendid chandeliers, and
elegant gas burners. The windows were not much larger than the
loop-holes of a modern prison; the roof was low and covered with
cobwebs, and the goods exposed for sale were all lying at sixes and
sevens. The forepart of the shop extended about ten feet forward into
the street, and was decorated on the outside with swatches of the
various commodities that were to be sold within. In the back shop,
which was nearly as dark as midnight, were deposited the whole of
the goods, except the specimens just mentioned. In the inmost recess
of these penetralia, was Provost Leslie, with three or four stout
fellows, removing, under his command, the goods in the back shop
or warehouse.
“Saunders,” said the provost, “ye’ll tak awa yon silks an’ velvets,
and put them into the vault i’ the dryest—ay, that’s anither flask
broken, ye careless gowk! I’ll set ye about your business gin ye wunna
tak mair tent. As soon’s you get that barrel awa, ye’ll tak down the
Prayer-Books from that shelf, and put up twa or three dozen o’
Confessions o’ Faith. An’, my little man, ye’ll run up to my lasses, and
tell them to leave a’ their wark an’ come down to grease the sword
blades, for fear that they rust in the cellar, an’ syne tell the same to
Sammy Fairtext’s maidens, an’ bring them a’ wi’ you as fast’s ye can.
—Ay, Basil, are ye there? Troth, gentle or semple, ye maun help’s the
day. You are a canny lad, sae try if ye can collect a’ the trinkets and
the siller cups and spoons, and take them up by to my chamber.—Ye
ne’er-do-weel! ye haverel, Sandie Hackit, what garred you spill the
wine on that web? Ye needna mind it now, ye sorrow; it’s nae worth
puttin’ out o’ Montrose’s way.”
When Basil Rolland returned from executing his commission, the
stranger whom he had seen on the former day was in the shop,
engaged in conversation with Fairtext. The latter bade Basil conduct
him to his house, whether he himself would follow when he had
dispatched some necessary business. When they were seated, the
stranger began—
“Thou hast seen, youth, that the things which I hinted to thee are
in part come to pass. The city is in confusion, the men of war are
discouraged, so that they will assuredly be a prey, and a spoil, and a
derision to their adversaries. What dost thou now intend?”
“What but to join the army of Aboyne, and do battle with my best
blood against these murdering rebels.”
“And what would be thy reward, young man? Thy good sense tells
thee that it is wrong to deprive free-born men of liberty of
conscience. You would fight for your own slavery. Charles is one who
regardeth not covenants. He will reward jugglers and lewd ones,
rather than those who have shed their blood for his wicked house.
But he already totters on his throne, and the day may not be distant
when he himself shall cry for mercy from those whose fathers,
mothers, and children he hath slain. If you are vanquished in the
approaching contest, all with you is lost; if successful, you are
nothing the better, except for upholding a Papistical hierarchy, the
raw project of a godless debauchee. Thy grandfather did battle on the
wrong side, and, after his fall at the battle of Pinkie, the family fell
from its former power, which it has never been able to regain.”
“Let me ask what comfort or reward could I expect by deserting my
friends? The Covenanters have renounced their oath of allegiance,
and have imbrued their hands in their countrymen’s blood. Good can
never follow an enterprise begun by perjury, and continued with
carnage.”
“And did not Charles first deliberately break his oath and the
covenant made with the people? The paction was therefore nullified
by him, and could not bind the other party. If they have shed blood,
their blood has been shed; and it was not till every attempt at
pacification failed that they took up the carnal weapon. And, for
comfort, I have long supported this cause, and I can look back with
greater pleasure to my conduct in this respect than thou canst on the
picture of thy lady love which even now is peeping from thy bosom.”
“It is my mother’s picture,” said Basil, blushing to the eyes.
“Thy mother’s!” said the stranger, while, with an emotion which he
had not yet exhibited, he caught at the picture with such violence as
to break the silken riband with which it was suspended, and,
unconscious of Basil’s presence, riveted his eyes upon it, scanning
the features with the greatest eagerness.
“The same, the same,” said he to himself; “the arched brow and the
feeling eye, the smiling lips and the rosy cheek. But where is the
principle that gave these their value? Where is the life, the soul?”
continued he, kissing the senseless painting. “How inferior was this
once to thy beauty, and how superior now to thy mouldering ashes!
Didst thou appear as the ideal charmer of a flitting dream, or wert
thou indeed the pride of my youth, the light of my eyes, and the
mistress of my heart? Thou wert! thou wert! my sorrows tell it.—
Preserve this picture, young man. Thou never, alas! knewest a
mother’s love—or a father’s affection: the former flame was rudely
quenched, the latter burned unknown to thee.”
“Then you knew my mother?”
“Ay, Basil, I knew her. We ran together in infancy, we danced
together on the braes of Don, and wove each other garlands of the
wild-flowers that grew on its banks. Then we thought this world was
as heaven, while we were as innocent as angels. As we grew up, the
sun, the wood, the rock, was our temple, where we admired the
beauteous novelty of this earth. All was love, and peace, and joy; but
sorrow came, and those sweet dreams have vanished.”
During these unexpected communications, Basil felt himself
strangely agitated. The old man seemed to know his history, and with
a mixture of doubt and anxiety he inquired if he knew his father.
“I am thy father,” said the stranger, weeping, and throwing himself
into his arms; “I am thy parent, thy joyous, sorrowing parent. How
often have I wished for this day! It is now come, and thou art all that
I could wish—except in one thing, and that is not thy fault. I have
claimed thee at a time when the boy must act the man, and take part
boldly in the great struggle. We must depart from this place to-night.
The citizens, thou knowest, are summoned to join the royalists under
pain of death, so that we may be delayed if we tarry longer.”
“But whither, my father, shall we go?” said Basil.
“Where but to the persecuted remnant that are even now
struggling for freedom. We will fight under the banner of the
Covenant.”
“I have now found a father,” said Basil, “and his commands I must
and will obey; but you will not bid me lift the sword when every
stroke must fall upon an acquaintance or a schoolmate?”
Isaac Rolland then began to mention to his son the reasons which
induced him to join this party. He had no more of enthusiasm than it
becomes one to have who knows he is embarked in a good cause. He
mentioned his own early history, which we shall blend with that of
his son. He had been one of the mission, headed by Sir Thomas
Menzies, that visited King James in 1620 on civil business. About
eighteen months before, he had lost a loving and beloved wife, with
whom he had been acquainted from early infancy. She died on the
birth of Basil. After this affliction, Isaac Rolland could find no
pleasure in the place of his nativity, where everything reminded him
of some dear departed joy; wherefore, having interest to obtain a
situation at court, he left his only son Basil under the guardianship of
his friend Fairtext, and contented himself by hearing often about
him, without ever visiting him till the time at which this story
commences. Rolland was acquainted partially with the
circumstances of his birth. He knew that his mother died when she
gave him life; he knew also that his father existed, but nothing
farther. Isaac laid before his son, in a clear and methodic manner,
the reasons for which the Covenanters took up arms, the
reasonableness of their demands, and the tyranny of their enemies.
He neither palliated nor denied the excesses of either party, but
contended that these should teach all to use their superiority
mercifully. The forcible point of view in which he set his arguments
wrought instant conviction in Basil’s mind, which his father
observing,—
 “Come, then,” said he, “and let us prepare for this struggle. If we
be successful (and shall we not be so in such a cause?), we shall have
the consolation of having given peace and freedom to the land. I have
a sufficiency of world’s goods, and thou and thy Mary—nay, start not,
I know all—thou and thy Mary will be the support and comfort of my
old age, and the subject of my last prayer, as ye have been of many,
many in the days bygone. Bid your friends farewell, and an hour
hence we meet to part no more. Be cautious, however, my son, for
these men of Belial have set a guard on the city, and death is the lot
of all who seem about to leave it. Farewell! God bless thee, my dear
son;” and he again folded him in his arms.
When Basil was left to himself, it would have been difficult to say
whether he was more sorrowful or joyful. He had found his father, a
fond and doting father; but his heart revolted at turning his back on
the scenes of his youth and the smiling face of his Mary. The latter
was the more distressing. She had listened to his suit, and the good-
natured provost, when acquainted with it, had sworn that no other
should marry his Mary. His own father seemed to approve his
passion; wherefore he resolved to bid her farewell, and moved
accordingly to the provost’s house.
She was alone, and received him with her usual smile of joy, but
was startled at the unusual expression of sorrow on his countenance.
“Mary,” said he; but his lips could articulate nothing farther.
She became alarmed. “Basil, you are ill!” said she.
He seized her hand. “Mary, I am come to bid you farewell—
perhaps a long farewell.”
She became pale in her turn, and asked him to explain himself. He
resumed,—
“When we were young, Mary, you were my only companion, and I
yours. You were unhappy when away from Basil Rolland, and I when
absent from Mary Leslie. When, in the folly of play, I had girded
myself with your father’s sword, you complained to him, while the
tears ran down your cheeks, that brother Basil was leaving you to
become a soldier. Such things at the time are trifling; but how often
are they the types of blessed love in riper years. I am now to leave
you to mingle in scenes of strife: let me carry with me the
consciousness of your continued love; confirm to me the troth that
you have plighted, and, come life or death, I shall be happy.”
“But why, O Basil, why are you leaving us? Have we not more need
of thy presence than ever?”
“I have found my father, and by his command I leave you this very
night.”
“This night!” said she, while the tears coursed in torrents down her
pale cheek. Basil caught her in his arms, and they wept together who
had never known sorrow before.
“Be comforted, Mary,” said Basil at length; “we shall meet again,
and the present sorrow will enhance the gladness of the meeting. My
happiness depends entirely on you, and my father looks fondly to our
union.”
“Oh! when you are gone far from this, you will soon forget the
vows that you have made. I have no mother to guide me; oh, do not
then deceive me, Basil.”
“I swear that my heart never owned the influence of another, and
that its last beat shall be true to you.”
“Then,” said she, throwing herself into his arms, “I am happy!”
Basil hastily explained to her what he knew of his destination, and,
with a chaste kiss of mutual transport, they separated.
He acquainted no other person with his intention of departing, but
returned to make some preparations for his journey. These were
soon completed; he was joined by his father, and leaving the town at
sunset, they walked leisurely to Stonehaven, where Montrose’s army
was encamped.
 Chapter III.
See how he clears the points o’ faith.—Burns.

Hamlet. Hold you the watch to-night?

Horatio. We do, my lord.—Shakspeare.

Day was dawning as our travellers reached the camp of the

Covenanters. They rested for some time to partake of victuals, which
their journey rendered necessary. Isaac Rolland then judged it
proper to present his son to Montrose, and accordingly conducted
him to Dunottar, where the general then was. They were admitted to
his presence.
“I expected you sooner, Rolland,” said Montrose. “What
intelligence have you gathered?”
“The enemy are preparing to take the field with a numerous and
well-appointed force, and I have gathered, from a sure source, that it
is their intention to attack our forces as soon as some needful
supplies are received from the north.”
“How do the citizens stand affected?”
“Almost to a man they have joined Aboyne. They have fortified the
city and the bridge, and are determined to hold out to the last.”
“The ungrateful truce-breaking slaves!” said Montrose. “But
vengeance is at hand. Who is this young man whom thou hast
brought with thee?”
“My son,” said Isaac, “whom grace hath inclined to take part with
us.”
“A youth of gallant bearing! Young man, thy father’s faithfulness is
a warrant for thine. Let thy fidelity equal thy reputed spirit, and thou
shalt not lack the encouragement due to thy deserts. You may both
retire to rest, and I will apprise you of the duties required of you.”
They saluted the general, and retired.
A foraging party returned with a report that Aboyne was already
on his march. This was found to be incorrect by some scouts who had
been dispatched that evening to gather what information they could
about the enemy’s motions. They brought the intelligence, however,
that Aboyne’s equipments were completed, and that it was the
popular belief that he would march immediately to meet the
Covenanters. Preparations were accordingly made for immediate
marching. Numerous foraging parties scoured the adjacent country
for provisions, and horses for transporting the baggage and
ammunition. According to the custom of the Congregation, when
about to engage in warfare, the next day was appointed for a general
fast throughout the host.
There perhaps never was assembled any body for the purposes of
religious worship that exhibited such an appearance of romantic
sublimity as the Covenanters did on such occasions. At the present
time they were assembled under the blue canopy of heaven, in a
hollow valley betwixt two mountains, the summits of which were
planted with sentinels, to give notice to the main body of any
interruption. Upon the declivity of one of the mountains was erected
a wooden pulpit, before which was assembled the army, to the
number of about 2000 men. A dead stillness prevailed among them,
while the preacher, a man richly endowed with that nervous and fiery
eloquence which was the most effectual with men in their situation,
explained to them a passage from the fifteenth chapter of Second
Samuel:—“Thus saith the Lord of hosts, I remember that which
Amalek did to Israel, how he laid wait for him in the way, when he
came up from Egypt. Now go and smite Amalek, and utterly destroy
all that they have, and spare them not; but slay both man and
woman, infant and suckling, ox and sheep, camel and ass.” This
passage he applied to the condition of the Covenanters. He described
the sufferings and grievances of the persecuted kirk, and showed that
the Almighty did not disregard these, but, in His own time, would
avenge the blood of His saints. He told them that God was now
calling on all who were on His side to fight for the good of the land,
and that His soul could have no pleasure in those who drew back
from the approaching contest. “And now,” said he, while the fire
flashed from his eyes, as with prophetic ardour, which was answered
by a corresponding enthusiasm in his hearers; “and now the men of
Babylon have set up an image of gold, even a molten image, and they
say, ‘Fall down and worship the image that we have set up;’ and they
have fenced themselves with trenched cities, and they have
encompassed themselves with spears, and a multitude of horsemen
and slingers, and archers, and they say unto this help from Egypt,
‘This shall be for a deliverance unto us.’ But fear not ye the multitude
of their strong ones, neither be dismayed at the neighing of their
horses; for the Lord of hosts is on our side, and His right hand shall
work valiantly for us. He breaketh the iron weapon, and burneth the
chariot in the fire. He laugheth at the bow of steel and the rattling of
the quiver. Walled cities are no defence against His hand, nor the
place of strength, when His thunder muttereth in the sky. Wherefore,
gird up your loins to fight the battles of the Lord. Smite the
Amalekites from Dan even unto Beersheba. Destroy the lines of their
tents, and their choice young men, that the reproach may be
removed from the camp of Israel. Turn not aside from the sacrifice
like the faint-hearted Saul, but smite them till they be utterly
consumed, and their name become a hissing, and an abomination,
and a by-word upon the earth. Think on your children, and your
children’s children, from age to age, who shall hold your name in
everlasting remembrance, and look to the reward of Him who sitteth
between the cherubim, who hath said, that whosoever layeth down
his life for My sake shall find it.
“The days are now come when the father shall deliver up the son to
death, and the son the father; when the brother shall be divided
against the sister, and the sister against the mother. But the days of
Zion’s peace shall also come, when all the princes of the earth shall
bow down before her, and call her the fairest among women.
(Canticles, sixth and first.) The house of the Lord shall be established
on the tops of the mountains. The New Jerusalem shall appear as a
bride adorned for her husband. (Revelations, twenty-first and
second.) The tabernacle of God shall be with men, and He will dwell
with them, and they shall be His people, and God himself shall be
with them, and be their God; and God shall wipe away all tears from
their eyes, and there shall be no more death, neither sorrow nor
sighing, neither shall there be any more pain, for the former things
shall have passed away. Go forth, then, to the battle. Quit yourselves
like men. Be strong. Look to those ancient worthies who, through
faith, subdued kingdoms, stopped the mouths of lions, waxed valiant
in fight, turned to flight the armies of the alien. Fear not their
multitude nor their fury, for he that is with you is greater than your
enemies. Think on the persecuted state of Zion, and may the God of
battles be for a buckler and a defence unto you!”
 A hum of approbation ran along the lines of the Covenanters at the
conclusion of this discourse, while the preacher called upon them to
join with him in praising the Almighty. The part chosen was that
eloquent passage of the eightieth psalm, where the Israelites are
spoken of under the similitude of a vine.
As the last note of this hymn ascended in solemn strains to the
lofty heaven, several of the scouts made their appearance, with jaded
horses, bringing the news that Aboyne was already on his march, and
approaching rapidly to Stonehaven. Orders were immediately given
to the army of the Covenanters to set out on their journey. These
were promptly obeyed, and, in a few hours, the armies met at Megray
Hill. This was announced to the Covenanters by their advanced
guard being driven back by the royalists. It was not, however,
Aboyne’s intention to hazard a general engagement, as his soldiers
were wearied by the march. But Montrose, dispatching a strong band
of infantry, supported by a detachment of cavalry, broke upon them
suddenly both in flank and rear, involved them in the greatest
confusion, and forced them to seek Aberdeen by a rapid flight, after
leaving a considerable number dead on the field. Montrose pursued
them, with the greatest possible dispatch, to Aberdeen, where they
made a stand. The Bridge of Dee was fortified in a very strong
manner, and protected by four field-pieces and a strong guard of the
citizens. Montrose made several attempts at forcing it, but was
vigorously repulsed by the defenders, who poured in a shower of
missiles with effect on the assailants, while they themselves were so
sheltered by their breastworks that they received little injury.
Montrose was obliged, therefore, to draw off his forces, and, as it was
evening, gave up the thought of any farther attack. Having found a
convenient place, he pitched his camp about a mile from the bridge,
and stationed his sentinels on the little eminences in its
neighbourhood, while those of Aboyne were planted on both sides of
the river for a considerable distance above and below the bridge.
Both armies, fatigued with the exertions of the day, availed
themselves of the repose offered by their situation, and in a short
time the busy hum of both camps was changed into stillness.
Our hero had accompanied the army during the march, with that
wonder and admiration which youthful minds feel in such spirit-
stirring scenes. The strictness of the military duty, the contempt of
danger, the degree of subordination and regularity that prevailed (for
the abilities of Montrose prevented that ruinous confusion which the
camp of the Covenanters too often exhibited), and the promptness
and patience with which the necessary commands were executed
made an impression on the mind of Basil strongly in favour of his
military life. The general, at the commencement of the march,
ordered him to be near his person, and by means, as the Covenanters
would have said, of a “soul-searching” conversation, contrived to get
a clear view of his character and worth. The opinion that he made up
was in favour of Basil, and he scrupled not to give him more direct
assurances of his favour than he had hitherto done. The honours that
had been paid him by this distinguished statesman and general gave
rise to a new train of ideas in his mind; and, as the army was
preparing for the night’s repose, he was charging the enemy at the
head of his own troops, succouring the distressed damsel, and
hurling unheard-of destruction on his foes. But the mightiest
conquerors have often found themselves conquered when they least
expected it; and, as the valiant Don Quixote felt his very soul
withering when thinking on the absence of his Dulcinea, so our hero
regarded the short time that he had been separated from his Mary to
be an age. An ugly river and a hostile army lay between him and his
love. If Leander swam across the Hellespont, surely he might cross
the Dee, and trust the rest to his prudence and good fortune.
His father was engaged with the general; so out he wandered, and,
by his correct local knowledge, succeeded in passing the various
sentinels, and getting to the banks of the river, a little below the
rocks called the Craig-lug, where he had the fortune to find a small
fishing-boat (for, so far back as the year 1290, Aberdeen is celebrated
in history for its salmon-fishings). He easily rowed himself across the
river, and, fastening the boat on the northern bank, stole along the
water’s edge, and entered that part of the town which, as fronting the
harbour, was not walled. He directed his course to the Broadgate,
and, as there were still several stragglers in the street, ensconced
himself behind a projecting shop till all should be quiet.
When he left the camp, the night was calm and serene. The breeze
that floated by was unable to curl the surface of the river, and the
moonbeams were dancing in silvery circles on the placid waters as
they gurgled by. But this was not of long continuance. The
atmosphere became quickly loaded with clouds, the moon was
obscured, the rain fell in torrents, and the sullen howling of the east
wind, with the hollow muttering of the thunder, indicated one of
those storms which not unfrequently disturb the beauty of summer.
Basil wrapped his cloak the closer around him, and hastened to the
provost’s house. All in it was dark and still. He knocked; but no one
returned an answer. Astonished at this, he endeavoured to open the
door, but it resisted his efforts. Being acquainted with all the
intricacies of the provost’s domicile, he gained admission by a
window, but found the house deserted of its inhabitants and stripped
of its furniture. Mary Leslie’s apartment was then the object of his
search. It was also desolate. Her lute, her books, and her landscapes
were all removed. In groping through the room, his hand fell on a
small picture, which the next flash of lightning discovered to be her
miniature. He pressed it to his lips and hid it in his bosom, regarding
it, as the holy man did the prophetic mantle, as the last unexpected
memorial of a lost friend. It would be vain to attempt to describe his
amazement at these appearances. He trembled for his friends, when
he knew the deeds of violence that were daily practised in these
perilous times. He determined to arouse the neighbourhood—to
search for, pursue, and destroy in one breath, all who had been any
way concerned in this outrage. Reason, however, came to his aid, and
he saw the utter uselessness of his attempting such a thing, except by
the assistance that he could obtain from the Covenanters. He
therefore turned sorrowfully to retrace his steps, which, from the
darkness of the night and the violence of the storm, was not an easy
matter. Having rowed himself across the river by the little boat, he
was making a circuit to reach the camp, when he saw a light at a
small distance from the landing-place. It proceeded from a hut that
was built at the foot of the rock for the accommodation of the
fishermen. Curious to know who were in it at this untimely hour, he
pressed forward, and listened to the following dialogue:—
“Ay! an’ will ye tell me that the possession of Joash, the Abiezrite,
wasna in Ophrah? But it’s just like a’ your fouk; ye ken naething
about the Scriptures, but daze yourselves wi’ that ill-mumbled mass,
the prayer-beuk. But your yill’s very gude, and far better than what
we have.”
 “I doubtna, my lad,” said another voice; “your fouk are sae stocked,
I daresay Montrose is gaun to mak you a’ Nazarenes, for he gies you
neither wine nor strong drink.”
“Dinna speak lightly o’ the Scriptures, Sawnie Hackit; ye’re just a
blaspheming Shemei, or a time-serving Balaam.”
“Hout,” said Hackit, “gie’s nane o’ your foul-mou’d misca’ings. I
wunner what the deil garred you turn a Covenanter, Tammas
Granehard, for ye usedna to be that fond o’ covenants, unless it was
ane for a fou pint stoup at Jamie Jinks’ hostelry.”
“I wasna aye i’ the right way, Sandie, muckle to my shame; but
better late mend than never do weel; an’ I’m thinking it would be
better for you if ye would come wi’ us, for your fouk can never stand
ours, and, instead o’ getting share o’ the spuilzie, ye’ll maybe get but
a weel-clawed crown.”
“I doubtna but ye’re very right, Tammas; but what would come o’
my ten achisons ilka day, forby the jibble o’ drink, an’ my place at
Provost Leslie’s?”
“I’m doubtin’ your place there’ll no’ be worth muckle, if we tak the
town. The provost isna a man to be passed over, wha can sae weel
afford to pay for’s idolatry.”
“Did ye ever hear,” said Hackit, “o him ever losing ony thing when
the whigs had the town one day and the royalists the next?”
“Weel, Sandie,” said the other, “I canna just charge my memory wi’
ony thing o’ the kind; and gif it wasna, it was that God-fearing man,
Samuel Fairtext, that saved him.”
“Ay,” said Hackit; “and, when the royalists were here, it was the
jolly old cavalier that saved Fairtext. Troth, it’s the only wiselike
partnership that I ken o’ at present; for, if they had been baith whigs
or baith royalists, they would have been ruined out o’ house and ha’
ere this time. But, ye see, when the royalists were in the town,
Fairtext kept himself quiet, and they wadna meddle wi’ him on
Provost Leslie’s account. And now a’ the gudes are removed, an’ put
under Fairtext’s care; sae that the Covenanters wudna tak the value
of a shoe-tie frae him, for he can pray and grane as weel as ony o’
them. The provost and his dochter have left their ain house, and are
to dwell wi’ Fairtext till the danger be ower.”
 By the latter part of this conversation, Basil felt as if the imaginary
weight of sorrow were removed from his bosom; but, instead of it, his
arms were pinioned on a sudden, by a strong physical force, so
firmly, that he was unable to move himself round to discover the
occasion of this unceremonious embrace.
“Come here, ye dotterels!” said a strong voice; “ye sit there, gabbin’
an’ drinkin’ awa, nae caring wha may be hearing you. An’ you, my
birkie, will better be as quiet ’s you can, or, deil tak me,—an’ I’m no
used to swear,—but I’ll scour my durk atween the ribs o’ ye.”
A couple of men now came out of the hut and assisted in dragging
Basil into it. As soon as they had forced him in, the person who had
first seized him quitted his hold, exclaiming, “Eh, sirs! is that you?”
Hackit also let him go, and Basil was able to look around him. There
was neither chair nor table in the booth, but turf seats around the
walls, plentifully littered with straw. A candle, fixed in the neck of an
empty bottle, illuminated the place, and revealed a goodly quantity of
bottles, with two or three horn drinking-cups on the floor, by which
it appeared that the party had been engaged in a debauch.
Thomas Granehard still kept his hold, and, in a stern voice,
demanded what he was?
“What the deil’s your business wi’ that?” said Hackit. “I ken him,
an’ that’s eneuch.”
“But I am strong in spirit,” muttered the Covenanter.
“The toom bottles testify that, to a certainty, Tammas,” said the
other. “But, never mind; get anither stoup, Geordie, an’ sit down,
Master Basil.”
“Blithely,” said Geordie; “and troth, Master Rolland, I didna ken it
was you, or I wudna hae handled you sae roughly. But sit down, for
it’s a coarse night.”
“I may not,” said Basil. “I must to the camp. But why do I find you
here?”
“Ou,” said Hackit, “ye see Geordie and me belangs to Aboyne, for
the provost sent a’ his servants to him. We’re upon the watch the
night, ye maun ken. But wha, i’ the name of the seventy disciples,
could stand thereout in a night like this? Sae we made up to the
Covenanters’ warders, and met in wi’ Tammas there, an auld
acquaintance; and we thought it best to come here and keep
ourselves warm wi’ sic liquor as we could get, and let the camps
watch themselves.”
“Do you know that you all expose yourselves to death for this
frolic?”
“There gang twa words to that bargain. We’ve done a’ that could be
reasonably expected,—we watched till the storm came.”
“Well, you are not accountable to me; I must depart.”
“Weel, a gude evening to you. But stop!—now that I mind—ye
maun gie me the pass-word.”
“The pass-word!” said Basil, in a tone of surprise.
“Ay, the pass-word! Ye see, Sergeant Clinker says to me, ‘Now,
Saunders, if ony ane comes to you that canna say Balgownie, ye’re to
keep him and bring him to me.’ Sae, for as weel’s I like you, Master
Basil, ye canna pass without it.”
“Balgownie, then,” said Basil laughing.
Hackit turned on his heel, saying it was “vera satisfactory,” when
Granehard remembered that he had got a similar injunction;
wherefore, making shift to steady himself a little by leaning on his
arquebuss, he delivered himself thus:—
“Beloved brethren,—I mean young man,—I, even I, have also
received a commandment from ancient Snuffgrace, saying, ‘Thou
shalt abstain from wine and strong drink; and whosoever cometh
unto thee that cannot give the pass, Tiglathpeleser, thou shalt by no
means allow him to escape, otherwise thou shalt be hanged on a tree,
as was the bloody Haman, the son of Hammedatha, the Agagite.’
Wherefore, now, repeat unto me the word—the light of the moon is
darkened—another cup, Sandie—woe to the Man of Sin—a fearsome
barking—dumb dogs—Malachi——” And he sank down in a state of
complete and helpless intoxication.
Basil earnestly advised Hackit and his companions to return
immediately to their posts, and retraced his steps to the camp, as the
reader may judge, not excessively gratified with the issue of the
night’s adventure.
 Chapter IV.
With forkis and flales they lait grit flappis,
And flang togedder lyk freggis,
With bougars of barnis they best blew kappis,
Quhyle they of bernis made briggis;
The reird rais rudelie with the rappis,
Quhen rungis were layd on riggis,
The wyffis cam furth with cryis and clappis,
‘Lo! quhair my lyking liggis,’
Quo they;
At Christis Kirk on the Grene that day.—King James I.

Basil was dreaming about Mary Leslie when he was awakened by

the dreadful note of preparation. The bugles were sounding, men and
horses hurrying to and fro, and a body of Cameronians—or “hill-
fouk”—had formed themselves into a conventicle beside his tent, and
were listening with the greatest attention to a favourite preacher.
When he came out, the scene was beyond measure animating. There
was no trace of the late storm, and the little birds sang their
accustomed songs. All was bustle, both in the camp of the
Covenanters and that of the royalists. The latter were repairing the
fortifications of the bridge, which had suffered in the last night’s
attack. The royalists were already under arms, but Montrose had no
design of attacking them, till the ebbing of the tide should render the
lower fords passable in case he should be unable to force the bridge.
The Covenanters remained idle during the forenoon, while the
royalists stood in order of battle, uncertain as to the time of attack.
About two in the afternoon, the shrill sound of a bugle collected
the Covenanters to their standards; and Aboyne’s sentinels, who till
now had kept on the south bank of the river, fell back to the main
body. Our hero was ordered by Montrose to lead a body of horsemen
to the lower ford, to remain there till informed of the bridge’s being
taken, when he was to push to the town and guard Aboyne’s house
from being plundered, and seize on all papers that might be found in
it. He departed accordingly.