A treatise on lesser surgery, or, The minor surgical operations / Tr. from the French with notes and an appendix, by William C. Roberts & James B. Kissam.

  • Jean-Baptiste Marc Bourgery
Date:
1834
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on lesser surgery, or, The minor surgical operations / Tr. from the French with notes and an appendix, by William C. Roberts & James B. Kissam. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    persons, who. during the attack even, upon being interrogated, denied the receipt of a bite, in whom it had however actually occurred, there is reason to believe that fear has, of itself, kindled up the malady, and must greatly predispose to its occur- rence. Everyone, therefore, to whom the accident happens, should instantly re- sort to the prophylactic measures laid down by the author, on page 3-24 ; and also upon the subject of cauterization, at page 148; after which, the condition of the animal by which he has been bitten should be inquired into. If, which will often happen, the dog. or whatever it be, prove afterwards not to have been rabid, the mind will be set at ease. On the Other hand, although the worst is known, that knowledge cannot be more painful than the previous suspense ; and the patient will then have the satisfaction of reflecting that, at least, those measures have been adopted, which will, in most, if not in every instance, ensure protection. The distress upon swallowing, or upon the sight of liquids, is unquestionably the most remarkable symptom of the disorder, and, to a degree more or less exten- sive it is believed nn-cr to be wanting In many, like effects are produced by blasts of air, however slight; by strong lights, or the glitter of any shining sub- stance, and a looking-glass in particular. The buzzing, or passing of a fly; the sound, nay, the mere mention of fluids; the touching of the hair, &c, are suffi- cient, in some cases, to create paroxysms of a convulsive kind. But, in different individuals, some or other characteristics are wanting, or less prominent. The mind is generally rational to the last; the physical strength is unimpaired ; and thus far, the nature of the poison and of its effects, as well as the immediate cause of death from this complication of terrors, lies hid in obscurity. Upon the prophylactic measure of cauterizing, either actually or potentially, the author has been sufficiently minute. The patient should forthwith wash and suck the wound, if accessible to the mouth ; and then resort either to the red hot iron, or to excision by the knife. The part should be completely cut out, even after a lapse of weeks from the accident; and, by English surgeons, this is preferred to caustics. It removes, say they, at once the part and the poison. Amputation, even, is advised, when the nature or depth of the wound precludes the chance of excising it by the one, or of destroying it by the other method. To the wound made in the excision, cups may be applied, as Dr. Barry has advised us, on page 167. These means, as preventives, with the injection into the veins during the disease, and bleeding ad deliquium as was practised by 3Ir. Tymon, constitute all that art can do, in warding off, or in combating this fearful malady. To enable the reader to judge of its nature for him following case is subjoined, as one of the most striking illustrations of the disease, that has lately been made public: Dr. Elliotson's case. A boy named W. Charles, astat. 16, was brought into St. Thomas' Hospital, in May. Upon the Doctor attempting to uncover his face as he lay in bed, he suddenly fetched a deep breath, then seemed half choked, and half a dozen such sobs occurred in rapid succession, his countenance expressing extreme distress. Dr. E. then took hold of his hand beneath the bed clothes, to feel his pulse, and in so doing, as a wave of air was necessarily induced upon his face by the motion, the same occurrence took place. Again, upon Dr. E. holding his hand, with the fingers down, over his face, and bending them towards the palm of his hand, the arm and rest of the hand being kept perfectly still, sufficient agitation of air was produced to make him open his eyes, take a sudden inspiration, feel choked, and experience such a succession of convulsive sobs as induced him piteously to intreat that the wind might not be drawn on him in that way The agitation of the air produced by Dr. Root's pulling out his snuff-box, was attended by a similar effect, and as it occurred soon a.ter his entrance into the hospital, led to a suspicion of the nature of the case. A lo king-glass was now sent for, and the reflection of the light cast from it produced the catching of his breath. He gaz d at it intently for a few seconds, hid his face with his hands, and desired that it might be withdrawn. Milk produced a like result. The boy himself denied having been bitten by any thing whatever ; though the probable cause was traced, afterwards, to an injury from a dog in the December previous. Dr. Root having decided on treating the case with the super acetate qflsad, which had been favour- ably spoken of, and not repeatedly tried, some of u was dissolved in water, and offered him in a tea spoon ; he absolutely refused to swallow it, declaring that he could not; and became so much agitated as to have a return of the sobs and forced inspirations. The guaco juice was now, however, substituted for the lead, in the further treatment of the case. When let alone, the boy lay quiet, occasionally catching his breath; pupils dilated; pulse SO to 96 ; heat natural; face flushed. At half past four, two ounces of guaco juice were injected per anum. It seemed to tranquillize him, and he slumbered unsoundly for some time. He was disturbed by the slightest noise, and each return to consciousness was followed by sobbing, pain in the throat, &c. He started from the n eumbent posture, wrapped bis blanket round him to exclude the air, and with the most agonizing expression of coun- tenance, struggled convulsively for breath. At half past eight, a lighted candle was brought into the room, and excited him in a frightful degree. The instant the first ray reached him, he sprang convulsively from his bed, and exhibited his usual fit. The secretion of saliva now became abundant, and he spat about without reserve. When it became necessary to give him Ins medicine, and this was told hnn, he was supported by an assistant behind, and another held the liquid in a small bottle before him. The anticipation produced a 6pasm: after an ellort he would dart with
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