The principles and practice of surgery / by John Ashhurst ; illustrated with five hundred and thirty-three engravings on wood.
- John Ashhurst
- Date:
- 1871
Licence: Public Domain Mark
Credit: The principles and practice of surgery / by John Ashhurst ; illustrated with five hundred and thirty-three engravings on wood. 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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![importance. Lentil within a compai'atively recent period, surgeons united in recommending wliat was called absolute clieV in cases of inflamma- tion, and this was usually pretty much equivalent to no diet at all. As regards this matter, I cannot but think that medicine is more advanced than surgery; very few physicians at the present day, I imagine, try to starve out pneumonias, and I cannot see why the principles which are now almost universally adopted in the management of internal inflam- mations should not be equality applicable in the case of the external, or of the internal when produced hy traumatic causes. Up to a certain point, the inclinations of the patient may be looked upon as a pretty safe guide; no man suffering from a violent inflammation, whether exter- nal or internal, has an appetite for heavy meat meals or for stimulating- sauces, and it may reasonably be concluded that this is a prompting of nature to avoid such condiments. But we must be cautious not to run into the other extreme. It has been, I think, clearly shown by the researches of modern investigators, that in addition to the waste of tis- sue which accompanies the inflammatory process, there is a large expendi- ture of force (as evidenced by the great elevation of temperature),^ and it is but rational to suppose that this waste and expenditure ought to be compensated for by a supply of easily assimilable food. As to the results met with in practice, it of course becomes any one surgeon to speak with great modesty and hesitation; I can, however, honest]}^ aver that I have met with better success in the treatment of inflammation upon this plan, than I did when I habitually directed low diet, according to the rules still laid down in many surgical works. I do not doubt but that a patient suddenlj' attacked with inflammation may subsist for a short time—pei'haps a day or two—upon barley-water or water-arrowroot, and probably this meagre diet may be more suitable than the heavy meals which he has been in the habit of consuming; but I believe that he will do better still l\y taking in small quantities and at frequent intervals some light and easily digestible but nutritious ai'ticle of food. The diet which I myself am in the habit of ordering for patients suffering from severe inflammation, is milk in quantities varying accord- ing to the age of the individual, and at longer or shorter intervals accord- ing to the facility with which the process of digestion is accomplished. I have supported adult men for weeks at a time upon milk given by the teacupful (fjiv) every hour, and I know of no single article of food which is adapted to so great a variety of cases as is this. In the more advanced stages of inflammation, beef-essence and different forms of strong broth may be appropriately made to alternate with milk in the patient's diet. As a general rule, once in two or three hours is often enough to give food in cases of inflammation, though when only small quantities can be taken at a time, the interval of course must be shorter. With regard to the administration of alcoholic stimulants no positive rule can be given. In the early stages of inflammation they are usually not required, and should not be given unless the state of the pulse or other circumstances indicate that they are needed. The onset of delirium (unless the brain itself be involved in the inflammation) is almost always an indication for stimulation. The quantity to be given should not commonly exceed four to six fluidounces of brandy or whiskey, or half a pint of wine, in the course of twenty-fourhours ; I have, however, in tiie later stages of inflam- mation (as in some cases of severe burn), occasionally increased the ' See in relation to this point, Rev. Dr. ITaugbton's Address on the Relation of Food to Work done by the Body, etc. {Brit. Med. Journ., Aug. 1868.)](https://iiif.wellcomecollection.org/image/b21039094_0056.jp2/full/800%2C/0/default.jpg)
