The cure of the more difficult as well as the simpler inguinal ruptures.

  • Halsted, William, 1852-1922.
Date:
1903
Catalogue details

Licence: Public Domain Mark

Credit: The cure of the more difficult as well as the simpler inguinal ruptures. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    instituted, the swelling of the epididymis immediately sub- [2i0] sided and the urethral discharge promptly ceased. Four years ago the author used, for the first time, a part of the aponeurosis covering the right rectus muscle to close the lower part of the right inguinal canal. I felt compelled in this case to resort to some such measure, for the internal ob- lique was fatty and attenuated to a degree not very often seen by us, and the rectus muscle did not seem to promise so much as its fascia did. This patient was a college-mate of mine and for this reason I wished, perhaps, more than ever, to be very sure of the result. One year ago I examined this patient very carefully and was gratified to find as solid a closure as one could desire. I considered the result as perfect as any that I had seen. Dr. Harvey Gushing, house surgeon at the time, made a sketch of this act of the operation, which Brodel has kindly elaborated (vide Fig. VII). This procedure may have a wider application than I have proposed for it. The able a surgeon as Dr. Orville Horwitz, apropos of Janet's work on the abortive treatment of gonorrhoea by permanganate of potash, should write : In spite of the claim of quick cures and prevention of complica- tions a length of time elapsed before it began to be generally adopted in this country. The profession was skeptical as to the claims made for its brilliant results. This was probably due to the disappointment which had followed the employment of retroinjections of hot water sug- gested by H. Holbrook Curtis, and of the continuous irrigation with a hot solution of mercury bichloride, recommended by Dr. W. S. Halsted, which at the outset seemed to offer more benefit to the patient than the conservative methods then in vogue, but resulting after a fair trial by a large number of observers in being found valueless and often danger- ous ; the employment of these remedies having been found to be attended with great discomfort to the patient and being frequently ac- companied by severe complications, such as acute posterior urethritis, seminal vesiculitis, prostatitis, and cystitis. This is not the proper time to tell how one must use the bichloride solutions in order to obtain the best results which have been claimed for it, but to judge from my own experience with this method twenty years ago in private practice, too much has hardly been said in its favor. The bad and indifferent results probably come from mismanagement or misconception. I should be glad at some future time to publish the treatment in detail, for it happens that I have not heretofore described or, in print, claimed any- thing for the method which rightly bears my name. I agree with Dr. Horwitz that irrigation with hot water is not only useless but dangerous.