Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by John Hilton ; edited by W.H.A. Jacobson.

Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / by John Hilton ; edited by W.H.A. Jacobson. Source: Wellcome Collection.

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

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    anterior cornua of the lateral ventricles—this persistence of a condition normal to about the fourth month of intra- uterine life suggested that the hydrocephalus, with its pathological cause, had commenced during the period of intra-uterine life.* * Dr. West (Med. Gazette, Vol. xxx. p. 127) tabulates fifty-six cases of hydrocephalus treated by paracentesis, in sixteen of which recovery was said to have taken place; he points out with regard to most of these recoveries that the evidence as to the time that had elapsed since the operation, and as to the patient’s health before and after, is insufficient and unsatisfactory. Dr. West then, in proceeding to discuss the reported success (ten out of nineteen) of Dr. Conquest in this operation, shows that in fifteen out of the above nineteen cases, “ no data are given beyond the mere number of punctures and the quantity of fluid removed. The age of the patient, the duration of the disease, the size of the head, the condition of the intellectual faculties before and after the operation are not noticed. We are left in perfect ignorance as to the time which elapsed before each patient was reported cured. “ If the symptoms observed during life yield little encouragement to resort to the operation, the appearances disclosed after death afford a powerful argument against it. An account is given of the post-mortem examination of twenty-six cases. In every instance, fluid, sometimes in considerable quantity, was contained within the ventricles, or in the cavity of the cranium, and the substance of the brain was softened and attenuated. But in addition, there existed in sixteen cases serious organic disease or malformation of the brain itself, though no symptom during life had betrayed the existence of a condition which mechanical interference could only aggravate.” Dr. Wilks (Dis. of the Nervous System, p. 145) expresses an equally unfavourable opinion. “ I have myself tried it in two cases, but should never propose it again—not on account of the severity of the operation, but from the want of possible success—when the fluid is drawn oft' it will again form, and in order to prevent this, if a bandage be applied symptoms of compression follow. Our difficulty was so to regulate an elastic bandage as to exert pressure sufficient to prevent expansion, and yet not to cause undue compression.”—[Ed.]
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