A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart.

Caird, Francis Mitchell, 1853-1926

Date:: 1889

Credit: A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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$and furllicr doses introduced. In this way aboul a grain lo a grain and a half may l)e injecteil. Over 2 grains may give rise lo inconvenience, and, indeed, it is to prevent an over-dose that the weaker solution is preferred for hypodermic use. Anx'sthesia, as in the case of mucous membranes, is complete in about five minutes, and lasts for about five minutes longer. We are thus enabled without pain to open abscesses and hydroceles, shell out cysts and (iUty tumours, excise epithelium of the lip, amputate fingers and t(3es, and practise circumcision. Tlie great value of the drug in anal surgery is marked. The jiatient can strain and aid, while operations are being jierformed for piles, fissure, fistula in ano, or polypus. A solution (lo per cent.) injected into the urethra, or the intro- duction of a bougie of cocaine and cacao-butter, five minutes prior to instrumentation, often largely obviates pain. Caution.—It would appear that some peojile are highly susceptible even to moderate doses of cocaine. In such, it gives rise to dis- agreeable, if not dangerous symptoms. The patient becomes pale, and syncope threatens; or, again, he may turn dusky or livid. Giddiness, cardiac irregularity, retching, delirium, unconsciousness, and collapse, have been noted. Tre;ilment consists in laying the patient at full length, giving stimulants and heat; good has also been obtained by inhalation of nitrite of aniyl. (4) Local Insensibiliiy by the Bloodless Method.—Local anresthesia may also be ]3roduced by rendering the part bloodless after Esmarch's method, and freezing with the ether-spray. The subsequent thawing is, however, very painful, and cocaine has now entirely superseded this method. CHAPTER IV. ANTISEPTICS AND WOUND-TREATMENT, Contents.—Antisc|5tic Treatment and the Germ Theory—A. General Antiseptic Principles and Practice—Antiseptic Materials- Isolation—Cautions necessary in the use of Antiseptics—Various Antiseptics and their Relative Advantages: Carbolic Acid, Corrosive Sublimate, Iodoform, Boracic Acid, Chlorate of Zinc, &c., &c. —Use of Antiseptics during Operation—Antiseptic Ligatures, Dressings, and Strapping. A. General Antiseptic Principles and Practice. The whole question of the treatment of wounds turns upon the differences which obtain between a compound and a simple fracture, an injury with skin broken and one in which it remains intact. All surgeons endeavour to bring wounds into a condition comparable$