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
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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.)

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    a spasmodic closure of the glottis, has recommended the operation of tracheo- tomy. Vid. Medical Repository of New-York.] Happily, there is, in surgery, one me.ins of preventing- hydrophobia, when it is practised in time, and in a complete manner. Every reader will know, that the excision of the bitten parts is the operation to which I allude. Indeed, as hydrophobia is often several months before it begins, the wounded parts should, perhaps, lways be cut out, even though they are healed, and some weeks have elapsed since the ac- cident, provided no incipient symptoms of hydrophobia have already commenc- ed. The operation should be done com- pletely; for a timorous surgeon, who should fear to cut deeply enough, or to cut a sufficient quantity of the surround- ing flesh away, would be a most danger- ous one for the patient. All hopes of life depend on the prevention of the dis- order; for, in the present state of medi- cal knowledge, none can rest upon the efficacy of any plan, except the extirpa- tion of the part. This some have done 'with caustics. However, as their action can never be regulated with the same precision as that of the knife, and, con- sequently, they will not always destroy the flesh to a sufficient depth, excision should always be preferred. The latter method is also the safest, for another important reason, viz the part, and poi- son lodged in it, are removed from the body at once; but, when caustic is used, the slough will not be thrown off for some days afterwards. Some surgeons of the present day are not content with cutting out the part; they recommend, after the operation, filling the wound with the aqua am- monise purse, so as to produce a general sloughing of its surface, by way of grc iter security. I shall conclude this article with re- ferring my readers to the following works, for farther information on hy- drophobia: Sauvages sur la Rage,- James on Canine Madness; Mead on the Bite of a Mad dog; Seleg, Nugent, and Hamilton on Hydrophobia; Medical Mu- seam, vol. 2; London Medical Transac- tions,^. 2;^Hed. Obs. and Inq. vol. 3; Edinb. Med*Comment, vol. 5, p. 42; Vaughan's Two Cases of Hydrophobia; Dr. Powell's Case of Hydrophobia; Lat- ta's System of Surgery, vol. 3; Cullen's First Lines, vol. 4; Memoirs of the Med. Society of London, vol. 1, p. 243; Medical Communications, vol. 1; Mem. of the Royal Society of .Medicine in Paris; Sup- plement to vol. 4. Fcrriar's Med. Facts and Observations. HYDROPHTHALMIA, (from viug, water; and opQcc\ftoc, the Dropsy of the eye. In all the cavities of the animal body (says Scarpa) which are continually moistened by a serous vapour, as well as in those destined to contain a determinate quantity of an aqueous, limpid fluid, there is such a reciprocalness of action, between the secerning extremities of the arteries, and the minute mouths of the absorbent vessels, that the fluid effused in these cavities is always in circulation, being incessantly renovated, but never accu- mulating beyond a certain degree and determinate measure. When this mutu- al action, existing between these two vascular systems, is interrupted, in con- sequence of a general or local indispo- sition, the above cavities, being no longer moistened by a serous vapour, shrivel and become obliterated; or, on the contrary, being unusually distended by the excessive quantity of fluid, they acquire an enormous magnitude, much beyond what a person, unacquainted with these things, would suppose. As Scarpa continues, the eye, consi- dered simply as a cavity destined to contain a certain quantity of limpid fluid, is occasionally subject to both these infirmities. The first is termed at- rophy; the second, dropsy of the eye, or hydrophthalmia. In the first case, the globe of the eye gradually becomes smaller; and, as the absorbent system does not cease acting, when ther more fluid to be absorbed, it gradually consumes the solid parts of this organ, which it insensibly diminishes, and in time destroys. In the second case, the eye assumes a greater bulk than is na- tural to it; sometimes acquiring such an extraordinary magnitude, that it pro- jects out of the eye-lids, at first with great weakness, and afterwards with total loss of sight. Surgeons generally state, that the immediate cause of the dropsy of the eye, is sometimes an increase of the vitreous humour, sometimes of the aqueous. In every case of this kind, on which Scarpa has performed the opera- tion, and in other examinations of the different stages of the disease, made on the dead subject, he has constantly found the vitreous humour, more or less, altered in its organization, liquifi- ed, and converted into water, according as the disease was ancient, or recent.