Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel.

  • Hermann Senator
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel. 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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    1 : 1000 solution of bichlorid, and the part wrapped in salicylated cotton or ordinary absorbent cotton to take up the serum; the dressing is renewed as fast as it becomes soaked. After capillary drainage it is well to cover the puncture with a little salicylated cotton and seal the wound with iodoform collodion. The latter procedure is less painful and cleaner than simple incisions; the patient is spared the discomfort of being soaked through ; and the quantity of fluid abstracted can be accurately determined. Depending on the degree of tension, the latter amounts to several liters (quarts) in twenty-four hours. During capil- lary drainage the patient must be under constant supervision, to guard against the needle becoming displaced and thereby enlarging the punc- tured wound, as such an accident increases the risk of infection and might lead to hemorrhage. It is therefore necessary in some cases to withdraw the needle at night; and in any case it is wiser not to leave the apparatus in place day after day; the puncture should be carefully sealed with collodion, and if the procedure has to be repeated after a time a new puncture should be made. The former practice of effecting evacuation by puncturing the skin in a number of places with a fine needle is not to be recommended and should be resorted to only in cases of emergency, as the risk of infection is even more difficult to guard against than in the other methods, and, owing to the ease with which the punctures heal over, the evacuation of fluid is much smaller. On the other hand, the writer has seen some good results follow the method of applying vesicants to the edematous areas, which is a popular remedy in some regions. [In private practice among people where the services of a skilled nurse are not obtainable and where economy in the matter of surgical dressings has to be considered, multiple simple puncture wounds on the legs can be dressed with liberal amounts of cotton or linen cloth that has been recently boiled, and that is frequently changed when soaked with discharge and rebelled. In this way a sterile dressing that is absorbent can be kept on the leg and infection will rarely occur.—Ed.] Whenever the accumulation of fluid in serous cavities attains an alarming degree, the affected cavity (pleura, peritoneum) must be evacu- ated by puncture according to recognized rules of practice. Edema of the vocal cords, which is often an alarming condition, must be treated by intralaryngeal scarification, and if that method fails, tracheotomy must be performed. Lastly, pulmonary edema is to be treated after the usual well-known methods. UREMIA. By the term uremia we designate a symptom-complex which makes its appearance when the function of the kidney is deficient, and which consists chiefly in disturbances of the nervous system and of the digestive organs. The renal insufficiency is caused either by disease of the organ itself or by some affection situated in the urinary passages, somewhere between
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