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 the late John Hilton ; edited by W.H.A. Jacobson.

  • Hilton, John, 1804-1878.
Date:
1901
Catalogue details

Licence: In copyright

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 the late John Hilton ; edited by W.H.A. Jacobson. Source: Wellcome Collection.

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    my house suffering from disease of the tarsal hones of his right foot. He had been several months under professional treatment, having abundance of medicine, but allowed to get about at home as well as he could, without giving any decided rest to the foot. The cause of the disease was supposed to be scrofula, brought on by over-exertion, with possibly local injury. When I saw this young gentleman he was eleven years old; not very unhealthy in appearance, but presenting florid cheeks, thick lips, feeble pulse, cold hands and feet, and enlarged tonsils. The whole of the right foot was swollen, especially the outer side corresponding with its tarsal and metatarsal portions. Ulceration, the sequel to an abscess which had opened of itself, existed for about one square inch over the cuboid and its articulations with the os calcis and the two outer metatarsal bones. The surrounding and overlapping skin was dark and congested. Poultices had been continued up to the time of my seeing him. On passing a probe into the wound, bone denuded of periosteum was at once detected, but he would not allow of a close examination of the part; and, as the foot was swollen and inflamed, I thought it better to send him home to Hammersmith, and place him on his bed with his foot and leg elevated, so as to get rid of their congested state. I saw him again at his home on the 21st of April. His foot had become much smaller and less painful; he had more sleep at night, and suffered less pain : he was already improved by “ rest.” 1 might extend my remarks with respect to the elevation of a limb suffering from a state of congestion. It is at least an important point in treat- ment, which appears to be not sufficiently attended to in practice. After giving chloroform (for he would not allow me to touch him otherwise), I explored the wound; and finding the cuboid necrosed and carious, with disease of its arti- culations with the os calcis, I removed the loose pieces of bone, leaving the periosteum and the whole of the surrounding soft vascular structures undisturbed. The whole of the cuboid bone and a portion of the os calcis were removed. The excavation was large and deep. He was kept in bed, with his leg rabed, until May 9th (five weeks), when his knee was placed upon a wooden leg, with