Manual of the principles and practice of operative surgery / by Stephen Smith.

  • Stephen Smith
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Manual of the principles and practice of operative surgery / by Stephen Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    affections of the heart are not serious hindrances to recovery from operations; shock and loss of blood are attended with more than ordinary risk in persons whose hearts are feeble or embarrassed by valvular obstruction, but a rapid or irrejfular pulse, witliout organic disease of the heart, and with respiration not exceeding twenty or twenty-five, does not contra-indicate an operation; degeneracies of the arteries are only serious when general in the extremities, espe- cially the lower, rendering primary hemorrhage diflicidt of control, and secondary hemorrhage more fre(pient and dangerous after ampu- tation, and so interfering with nutrition that destructive supj)uration is liable'to occur, with slow and imperfect healing of the wound; diseased veins complicate operations only when varicose, and cut through, as in amputations, thus exciting inflammation; of the dis- eases of the respiratory organs, chronic bronchitis and emphysema, especially in old people, render operations extremely hazardous, owing to imperfect respiration, cough, and loss of sleep; phthisis, when progressive, adds greatly to the dangers of operations, from the consequent fever, loss of food, and pain, but, when chronic, operations are advisable, which relieve the system of painful and wasting local cliseases; persons suffering from long-standing strumous affections, with the appearance only of tubercular disease, may be greatly benefited by the removal of the diseased part ; menstruation and prciinancy are conditions rendering operations undesirable. 7. Various other affections ^ modify the prognosis as follows: se- vere operations during the sta<xe of shock after injuries, and during the period of acute inflammation, with high temperature, are danger- ous; spreading erysipelas, cellulitis, and gangrene add so much to the dansers of severe operations, that the'chances of life are best when only the ordinary treatment is followed ; avoid operations in acute pya;mia, when there are rigors once or more in a few days, and pro- fuse sweatiuLis. with very rapid pulse and breathing, and with delir- ium and rapid wasting, or with dry tongue and yellowness of skin, or any considerable numl)er of these symptoms; but an operation is justifiable in chronic pyaemia when there is wasting and sweating, with the formation of abscesses here and there, and the injured ])art is manifestly useless and a source of irritation or of exhaustion; croup does not contra-indicate tracheotomy, nor peritonitis herniot- omy, which are operations of necessity, and are not materially af- fected by the general acuteness of the existing affections ; of the diseases of the kidney, those associated with the constant jwesenee of albumen in the urine predispose operated patients to erysipelas and pya^nia; pyelitis renders operations, as lithotomy, lithotrity, and even catheterism dangerous, owing to the liability to urinary 1 Silt J Pagkt.