Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases : as practised by prominent American and European surgeons. Together with suggestions concerning the technique of certain operations with a view to securing better postoperative results / by Nathan Clark Morse ... Containing 5 plates and 155 other illustrations.

  • Morse, Nathan Clark, 1856-1919.
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases : as practised by prominent American and European surgeons. Together with suggestions concerning the technique of certain operations with a view to securing better postoperative results / by Nathan Clark Morse ... Containing 5 plates and 155 other illustrations. 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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    and last Ijut a few hours; on the other hand, if the seat of su]>|juration, from improper drainage or after supposedly aseptic operations, necrosis of tissue with suppuration from stitch-pressure makes its appearance as a result of improperly sterilized articles used during the operation, the symptoms may be so pronounced as to endanger the life of the patient. Again, if extensive surfaces capable of rapid absorption are suddenly flooded with infected fluids, toxemia follows rapidly, and death may quickly follow. For example, in operations for appendicular abscess, or upon a gallbladder containing pus, which is accidentally incised or is ruptured into the abdominal cavity, death frequently follows within a few hours. The ordinary symptoms of infection usually appear within from five to six days following operation. The sudden rise of tem- perature to 103°, 104°, or 105° F., preceded by a slight chill, should always be sufiicient notice to the attending surgeon of infection and im- pending danger, and it demands prompt attention. These symptoms, if neglected, become more and more pronounced; the patient feels hot, or there is a condition of alternating heat with chilly sensations. The skin, lips, and mouth are dry; urine becomes scanty and of a high color; the pulse becomes weak and rapid, and there is always more or less gen- eral disturbance. The patient becomes restless, the face has a flushed, anxious look, the temperature is always higher at night with morning ex- acerbations, sleep is troubled and unrestful, and there is usually delirium. The symptoms, unless relieved, assume more and more a typhoid con- dition ; nausea and vomiting, with profuse diarrhea, extreme exhaustion, and depression of the vital forces, are now prominent symptoms. The tongue becomes dry and brown, and even cracked; the breath is often foul; the perspiration from the body of the patient becomes sour, pun- gent, and of a disagreeable odor; delirium is well marked, and the pa- tient passes into coma. Movements from the bowels and kidneys be- come involuntary, the temperature continues to rise, pulse becomes more and more rapid, and death is ushered in by failure of respiration. This slow form of septicemia may continue for several months, as every surgeon of experience can testify. Marasmus may increase to such an extent that the patient is reduced to a pitiful degree of physical debihty, from pent-up pus. Should living pyogenic organisms, by means of the pus, enter the blood, and be thus carried to various parts of the system, we will have the condition known as pyemia, which difi'ers from septicemia only in the formation of metastatic deposits. The t^-pical cases of pyemia are easily distinguished clinically from septicemia by