Volume 1

A dictionary of practical surgery / [Samuel Cooper].

  • Samuel Cooper
Date:
1825
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery / [Samuel Cooper]. Source: Wellcome Collection.

    18/1282 (page 6)
    geon and lecturer on anatomy, where the most distressing palpitations of the heart, and loud pulsations below the epigastrium, were awful symptoms. ‘The pulsations could be both seen and heard at a distance on entering the room in which the patient sat. Several physicians were inclined to suspect some organic lesion of the arterial system; but their opinion was given with becoming diffidence:—not so the sur- geon’s; his impression was, that there existed an aneurism of the descending aorta; and such was the firm persuasion he had acquired of the reality of his impression, that he could grasp the aneurismal sac through the abdominal coverings, though nobody else could, and trace its magnitude and position. After death, the heart was found enlarged, and its left ventricle of enormous size. The inner surface of the stomach also exhibited traces of long existing disease; but the aorta was quite sound. (See Med. Intelii- gencer, 1821, p. 71.) Preternatural pulsation about the epigastrium is also stated by Mr. A. Burns, to’ be sometiimes occasioned by encysted tumors, attached either to the lower surface of the diaphragm, or formed between the layers of the pericardium towards the diaphragm, as happened in an instance recorded by Lancisi. Another cause specified by Mr. A. Burns, is enlargement of the vena cava, or of the right auricle of the heart. Senac describes a case, in which the vena cava was as large as the arm, and there had been a violent pulsation in the epigas- trium. The next cause, enumerated by the same gentleman, is increased solidity of the lungs, more especially of their lower acute margins, where they overlap the pericardium. In this case, the pulsation is about the scrobiculus cordis. Mr. A. Burns likewise notices several other causes of epigastric or abdominal pulsations, already illustrated in the foregoing part of this article, indurations of the pancreas, scirrhus of the pylorus, tumors in the mesentery, or any solid increase of substance about the abdominal aorta, or its principal branches; and, lastly, a peculiar affection of the vascular system itself. The following observations, on the criteria be- tween various abdominal pulsations and those of aneurism, appear interesting. According to Dr. Albers, an internal aneurism originates gradually, aud the pulsations increase in strength by degrees. Other abdominal pulsa- tions, on the contrary, begin suddenly, and are most violent in the beginning, abating after they have lasted some time. In an aneurism, the pulsation is synchronous with the stroke of the artery at the wrist; but this is not regularly the case with other pulsations. Should the patient be affected with melan- cholia, hypochondriasis, hysteria, or other neryous complaints, void blood from the stomach, or a black matter from the bowels; should there be any hardness or swelling of any of the abdominal viscera discoverable by the touch, the probability is, that the pulsations are not owing to an in- ternal aneurism. With the exception of cases, in which these pulsations are owing to mechanical impediments to the circulation, Dr. Albers believes, that they are mostly a symptom of some nervous affection. He also thinks, that the surprise, excited by these throbbings, arises only from their strength and situation, other analogous, strong pulsations, as for instance, those of the heart, or of the carotids, being common enough in hypochondriacal and hysterical persons. ‘The same gentleman adverts to the increased action, which, in inflammation and fevers, is often more conspicuous in some parts of the sanguiferous system, than in others. (Uber Pulsationen im Unterleibe, p. 36, &ce Bremen, 8vo. 1803.) Much important additional information on this subject may be found in Observations on some of the most frequent and important Diseases of the Heart ; on Aneurism of the Thoracic Aorta; on Preternatural Pul- sation in the Epigastric Region, &c, By Allan Burns, p. 262, &c. 8vo. Edinb. 1809. ABSCESS. A tumor containing: pus, or a collection of purulent matter. viz. acute and chronic. For information relative to the former, see Sawppuwration ; and, for that concerning the latter, refer to Lumbar Abscess. See also Abdomen, Antrum, Anus Abscesses of, Bubo, Empyema, Hypopium, Mammary <Ab- cess, Whitlow, &c- ACETIC ACID. Vinegar. Distilled Vine- gar. Vinegaris of considerable use in surgery 3 mixed with farinaceous substances, it is frequently applied to sprained joints, and, in conjunction with alcohol and water, it makes an eligible lotion for many cases, in which it is desirable to keep up an evaporation from the surface of inflamed parts. Vinegar was once considered useful in quicken- ing exfoliations, which effect was ascribed to its property of dissolving phosphate of lime. Its application to this purpose, however, seems hardly admissible, for reasons, which will be well under- stood, from a perusal of what is said on the subject of Necrosis. ‘The good effects of vinegar, when immediately applied to burns and scalds, were taken particular notice of by Mr. Cleghorn, a brewer in Edinburgh, whose sentiments were deemed by Mr. Hunter, worthy of publication. (See Med. Facts and Obs. Vol. If. and the Art. Burns-) In chronic inflammations of the eyes, and eye- lids, and in certain instances, in which the eyes are weak and watery, vinegar is sometimes re- commended as an useful ingredient in the colly- rium. After general and topical bleeding, it is said to be an efficacious remedy even in cases of acute ophthalmy. Whenever vinegar is applied to the eye, it is in a diluted state, as may be seen in another part of this work. (See Collyrium Acidt Acetici.) In the form of a collyrium, it is alleged to be the best lotion for clearing the eye of any smail particles of lime which happen to have fallen into, and become adherent to it, or the inside of the eyelids. (See A. T. Thomson’s Dispensatory, p. 8. Ed. 2.) Concentrated vinegar is sometimes employed With this view, it may be used either as an in- jection, or a lotion, in which lint is to be dipped, and introduced up the nostril. Vinegar is sometimes employed for obviating the smell of sick rooms. ‘Ihe strongest acetic acid which can be made, is found also to be one of the most certain and convenient applications for the destruction of warts and corns, care .