Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by the late John Hilton ; edited by W.H.A. Jacobson.

  • John Hilton
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by the late John Hilton ; edited by W.H.A. Jacobson. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tendency to sleep; sleep supplj'ing the great desideratum previously required. Take, for example, the case of a child suffering greatly from the irritation of stone in the bladder, which prevents sleep, induces sometimes extreme emaciation, and urges the child even to the verge of death. How marked, how almost immediate is the change on the removal of the stone I On giving rest to the bladder, and consequent constitutional rest to the general system, the child falls into a profound and prolonged sleep.* In principle, the same remarks and the same reasons would apply to cases of extreme dyspnoea relieved by the operation of tracheotomy, of strangulated hernia after the reduction by taxis or the knife, or to the removal of an extraneous body from the auditory canal. In these and in many other instances which might be adduced, the relief afforded by the surgeon is often followed in children by long and highly restorative sleep. The interruption of rest by local disease, occurring to persons i^ the middle period of life, does not cause the same degree of exhaustion and wasting as in the young. They bear the loss of sleep better, because their constitu- tion has to sustain the stress of repair only—not of both development and repair, as in the child. Their recoveiy is slower; their subsequent sleep is not so profound nor so prolonged, nor their rest so complete. The defective sleep * In calculating the risks of an operation, especially one entailing niueli shock or prolonged repair, tlie capacity for long refreshing sleep 18 of the utmost importance. Sir J. Paget, Clin. Lect. and Essays, p. 44, writes:— If a patient can always sleep long at a spin, that is a good patient. In one of the most perilous operations for hernia with which I have had to do, a case in which the hernia had been reduced en hloc, and in which its return was effected with considerable force and disturbanr^e of parts, I believe the patient owed his recovery more to hU capacity for sleep than to anything else. H3 was a young bargeman, duil-witted and over-worked; and in his ordinary life sleeping whenever he was neither working nor feeding. Shortly after the operation he went to sleep; and he slept sixteen hours out of the fir.-t twenty-four, and in a scarcely less proportion of his time for two or three days afterwards,- and he recovered, although he had acute peritonitis, for which I thought it necessary to put on nearly a hundred leecliea. -{Ed.].