A manual of the practice of surgery / by W. Fairlie Clarke.

  • William Fairlie Clarke
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of surgery / by W. Fairlie Clarke. 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.

    23/340 (page 5)
    lliat it is only when some organ of primary importance is in clangor that v.-o are justified in having recourse to this remedy. Happily wc have other means at our disposal, which are very elTectual in reducing inlhiinmation, and which are not open to the same o]:)jections .as bleeding. 'J'liese are 2)((r;/atiae, diaphoretic, and diuretic ine<y\ci\iOii. In almost all cases of inllammation it is right to give a free purge at the outset of treatment. The exceptions to this rule are certain cases of abdominal inflammation, when we desire to keep the bowels quiet rather than to excite them to action. Perhaps for an adult the best purge that can be given is a mercurial, followed by a saline or aloetic draught—e.f/., 5 grains of blue pill at night, followed next morning by 3 j. of the mist, sennas co., or of the decoct, aloes co., or a seidlitz powder. This has the effect of clearing theprimcG vice, promoting the secretions and relieving the circulation. It may be necessary to repeat this remedy from time to time as the case proceeds. If we use diaphoretic or diuretic medicines their action must be kept up by doses given two, three, or four times a day. Antimonials often answer admirably by encouraging perspiration and tranquillizing the cir- culation. At the same time, the skin and the kidneys may be stimulated by salines, such as the acetate of ammonia, or the nitrate of potash. (F. 29, 45, 54.) Jlercio'i/ has a time honored reputation for allaying inflammation, especially in serous and fibrous membranes. Of late years, however, its value in this respect has been called in question; but there can be little doubt that it is a useful remedy in acute inflammations of a sthenic type, particularly when combined with opium. Its action seems to be that of an alterative, promoting secretion and moderating the force of the heart. But besides this, it would appear to exert a special influence over the fibrine of the blood by diminishing its quantit3^ (F. 70.) Opium is of great service in allaying pain, soothing the patient and procuring sleep. In the form of Dover's powder it is invaluable. Its use in combination with mercury has been already mentioned. Loccd treatment of acute inflammation of the stlietdc type:—Local Mood-letting is a practice much in vogue at the present day, and may almost be said to nave superseded venesection. Undoubtedly it gives us many of the good effects of general bleeding, without the disadvantages which belong to that method of depletion. It may be carried out in a variety of ways ; by incisio?is, scarifica- tions, cupping, or leeches. Incisions are specially applicable to the skin when it is stretched in such a way that it is in danger of sloughing. A number of small cuts should be made with a lancet in jDarallel rows, extending only to the depth of the true skin. Scarification is chiefly used when the inflammation attacks the mucous membranes—as, for example, the lining of the mouth or the gums. Cupping is an efficient means of removing blood, and relieving the over-burdened circulation. It is, however, more suited to deep-seated than to superficial inflammation. The cupping-glasses should not be placed upon the inflamed spot ; nor should the scarificator be used in parts which are left uncovered by the dress—as, for example, the neck—be- cause the scars are apt to remain for life. The artificial leech is a modification of cupping, which is well adapted to some deep-seated and localized inflammations, for examjole, of the eye.