Lectures on diseases of the kidney, generally known as 'Bright's disease'; and dropsy / by S.J. Goodfellow.

  • Goodfellow, S. J. (Stephen Jennings)
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of the kidney, generally known as 'Bright's disease'; and dropsy / by S.J. Goodfellow. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    IX. MODE OP PUNCTURING THE LEGS IN EXTREME ANASARCA. In a paper in the seventh volume of “ Guy’s Hospital Re- ports,” part ii. p. 421, Mr. Hilton gives some directions for performing this operation, which seem worthy of trial. With a long, narrow, sharp-pointed lancet, fixed upon a cylindrical steel shoulder, he makes the punctures along the outer side of the leg or thigh, or of both, about two or three inches apart. He thinks that four in the leg, and the same number in the thigh, will be amply sufficient, or even more than necessary, in most cases. The fewer openings made the • better, provided a free escape of the dropsical fluid be ob- tained. Mr. Hilton has frequently found that two punctures in each part of the limb are quite enough for the intended drainage. © “The instrument, after perforating the skin, should be passed very obliquely, from without to within, across the limb or in a direction from below upwards [^upwards and inwards ?]] through the cellular tissue, between the skin and fascia cover- ing the muscles, so as nearly to reach, but not to wound, the fascia; to intersect the meshes of the areolar tissue to the length of an inch or more; it should then be withdrawn through the same track, care being taken to disturb the parts as little as possible by external pressure with the hand. Ex- tensive subcutaneous incisions of the cellular tissue by a lateral movement of the instrument, are, as far as I have seen, to be avoided ; they are not only not required, but are liable to the objection that an injury unnecessarily extensive to a structure little capable of being repaired in a constitution already depressed by the same cause or causes which may have led to the general anasarca, would most probably be followed by the dangerous consequences usual in such cases.” x