A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 2).

  • Samuel Cooper
Date:
1810
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    18/464
    and sal-ammoniac. To one pint of wa- ter, in a bladder, ten ounces of the mix- ed salts are to be added. If, after four hours, (says this distinguished sur- geon) the symptoms become mitigated, and the tumour lessens, this remedy may be persevered in, for some time longer; but, if they continue with una- bated violence, and the tumour resist every attempt at reduction, no farther * rial should be made of the application. (On Inguinal and Congenital Hernia.) When ice has not been at hand, aether has occasionally been found a good substitute, when allowed to evaporate from the surface of the swelling. Care must be taken, that the cold be not so applied as to freeze the scrotum, and bring on sloughing. (A. Cooper, p. 15.) Opiates.—Mr. Hey has seen several cases, in which opiates, given freely, (in athletic persons after bleeding) have procured a reduction of strangu- lated hernia. He cannot say, however, that this remedy is generally success- ful; but, it has the advantage of remo- ving, for a time, the pain and vomiting usually attendant on strangulation, even though it prove ultimately inefficacious. Opiates should be given in large doses, when it is wished to try their effect in procuring reduction; and whenever the symptoms of strangulation return, after having been removed by opiates, the operation should be performed without delay. (P. 134,135.) Tobacco Glysters.—For this purpose, some surgeons prefer a decoction of tobacco, made by infusing, or boiling, one drachm of the plant, for ten minutes, in a pint of water; others employ the smoke, which is prepared, andintrodu- ced into the rectum, by means of a well-known apparatus for the purpose. Perhaps, both methods are equally effi- cacious; but, as one requires an appa- ratus, while the other does not, and is equally proper, the decoction may be entitled to most recommendation. The machine for the smoke is also frequent- ly found out of order. Tobacco glysters are, next to the operation, the most certain means of bringing about the re- duction of the strangulated parts. They not only excite the action of the intes- tines, they also exert a peculiar de- pressing influence on the whole sys- tem, reducing the pulse, and causing1 nausea and sickness, cold sweats and fainting, under which circumstances the parts recede spontaneously, or may- be easily reduced. Mr. A. Cooper pru- dently advises injecting half the above quantity at first; for, he has seen two drachms, and even one, when used as an infusion, and introduced at once, prove fatal. (P. 24.) The rest should present- ly be injected, when it appears, that the tobacco does not operate with the ex- traordinary violence, with which it does in a few particular constitutions. Poultices and Fomentations.—We only make mention of these, to say, they have not the least confidence of any ex- perienced, or intelligent surgeon. Who- ever wastes time, in these urgent ca- ces, in trying the effects of such appli- cations, merits censure for his creduli- ty, ignorance, and unfitness to under- take the treatment of a rapid disease, in which, as Pott remarks, if we do not get forward, we generally go back- ward; and whatever does no good, if it be at all depended upon, certainly does harm, by occasioning an irretrievable loss of time. \_Placing the patient on an inclined plane, with his feet highest.—Winslow and Cooper recommend this position of the body during the efforts to reduce the hernia by taxis. I would recommend it however, to be continued longer; from having seen two cases in which thin simple measure succeeded after seve- ral of those, already recited, had been tried in vain. The patient should lie upon his back, and the foot of the bed be elevated about twenty inches higher than the head. This posture need not interrupt the administration of other remedies, and in some cases will be found powerfully to aid them.] OF THE ORDER, IN WHICH THE PRE- CEDING METHODS AND REMEDIES SHOULD BE TRIED, AND OF THE TIME, WHEN THE OPERATION SHOULD NOT BE DELAYED. In the treatment of a strangulated hernia, a surgeon cannot be too deeply impressed with the danger of spending time in the trial of methods of inferior efficacy, or of such, as are evinced to be ineffectual in the rases before them. The taxis is of course the first thing to be tried, and Mr. A. Cooper thinks the attempts should be continued for a quarter, or half an hour. When these have been ineffectual, the patient, if the circumstances do not forbid, should be immediately bled, and have a large opening made in the vein, so that the suddenness of the evacuation may be