A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period ... forming a catalogue of surgical literature arranged according to subjects / by Samuel Cooper.
- Samuel Cooper
- Date:
- 1838
Licence: Public Domain Mark
Credit: A dictionary of practical surgery: comprehending all the most interesting improvements, from the earliest times down to the present period ... forming a catalogue of surgical literature arranged according to subjects / by Samuel Cooper. Source: Wellcome Collection.
18/794 (page 12)
![Of the twenty-three cases examined by Dr. Fran- cis, two only were in male subjects, and oneof them an adult Indian, in Niagara county. lie saw it in an infant but a few months old, and he subscribes to the opinion that it often depends on constitutional causes, and is sometimes hereditary. In Oneida county, Dr. Francis learned that goitre prevailed among sheep, and Fodere gives us a similar fact of its occurrenQe among dogs. The doctrines of Hunter and others, in considering the sexual functions connected with this disease, are sustained by its greater prevalence among women, and also according to Dr. F., by some well-known facts connected with parturition. Dr. Coventry has removed several cases of goitre by the simple expedient of the patient wear- ing the muriate of soda about the neck. The re- cent plan of Mr. Holbrook, of employing steady pressure, has been tried in this country with some success. The efficacy of burnt sponge has often been seen, but instances of its failure are not un- frequent. The iodine has been used of late years with the best effects, and Dr. Congdon, of Buffalo, has reported its entire success in a number of cases. Dr. Francis informs me, that in a subsequent journey through this state, he found a number of interesting cases, and that the disorder in every instance afflicted the female sex, and, in eight or ten cases, it was obviously associated with the func- tion of menstruation and parturition. The left portion of the gland was most frequently the seat of the disease, but in no instance was it connected with idiotcy. He reports one instance of the entire cure of a formidable case which occurred in a young married female, who upon leaving the neigh- bourhood of Catskill, and removing to the southern states, after a residence of three years, was entirely relieved of her goitre. I can add my own testimony to the value of the iodine, having witnessed its success in a number of cases, which had resisted the other remedies ordinarily employed. The operation of removing the gland by the knife has been performed in this country with suc- cess, but is seldom advised, and will not often be repeated.— Reese. ] BRONCHOTOMY. Into the article on this operation, as it stood in the 6th eel.. Dr. Reese in- troduces the annexed remarks :— [There is no inconsiderable diversity of opinion among eminent surgeons as to the propriety of performing bronchotomy in cases of croup ; and those who oppose the operation very plausibly allege, that in the membranous stage of croup no advantage can result from the operation, however favourable the condition of the sufferer may be in other respects. The views of the celebrated Cheyne would seem to put beyond doubt the in- utility of the operation as already noticed by our author, because it is inadequate to the removal of the artificial membrane which is effused in the ad- vanced stage of cynanche trachealis. I am not prepared from my own experience, wholly to de- cide the difficulty. We have evidence sufficient, I think, to justify an occasional recourse to this exercise of surgical skill; but there is still another means of relief, not stated by our author, that may fitly be introduced here, which will often render this operation unnecessary, even in those cases in which it is confidently recommended by some, and certainly ought to be fully tested before we avail ourselves of so doubtful a remedy. In that stage of croup which has been apfly termed the fatal stage, from its so generally prov- ing such, and which is characterised by the exist- ence of the membrane, the vitriolic emetics have been introduced with decided success. This practice w^as first introduced by Professor Francis, of New York, in 1813 ; and since tbe report of his success, has become very generally adopted in this country, and with singular success. I have now in my possession a specimen of an entire membrane lining the trachea, detached and thrown up under the powerful emetic action of the blue vitriol, after venesection, blisters, calomel, polygala, senega, and all the approved remedies, had been tried ineffectually. I regret that the limits assigned me preclude my inserting the interesting detail of the cases reported by Dr. Francis, in his valuable paper published on this subject, and have to content myself with referring to the New York Med. and Phys. Journ., vol. iii. p. 58. el: seq., only remarking, that in the almost hopeless state in which the sequela of in- flammation are so threatening, calomel, in large doses, is among the most efficient auxiliaries to which we can have recourse. “ After the exist- ence of the membrane/’ observes Dr. F., “ and when the powers of life are on the wane, it is a judicious and sometimes an available resource ; ” and he admits, that in the cases in which he found the vitriolic emetics successful, their agency was probably favoured by that potent mercurial. I find a similar practice has been adopted by Dr. Hoffman, of Vienna, who first used the vitriolic emetics in 1820; and so highly does he estimate them, that he declares their action to be a specijic in this stage of croup. This is unques- tionably saying too much in their behalf; yet certainly they are entitled to high consideration, and ought never to be omitted in these almost hopeless cases.— Reese.] CAESAREAN OPERATION. By Mr. Knowles, of Birmingham.—Case of deformity of the pelvis from mollities. Incision made in the linea alba, and ten inches in length. The child and mother both saved. (See Trans, of Prov. Med. and Surgical Association, vol. iv. p. 376.) She was 36 years of age, and had previously been delivered of several children. Professor Gibson, of the University of Pennsyl- vania, has performed this operation, a second time, with success upon the same woman, who re- covered without a single bad symptom, and eight weeks after the operation, the infant was in ex- cellent condition. (See Philadelphia Med. Ex- aminer.) For an account of this woman’s first labour, in which cephalotomy was performed, see North American Med. and Surg. Journ., No. xxiv. Oct. 1831. In the last American edition of this Dictionary, I find some interesting matter, relative to extra- uterine conceptions. The following case is pro- nounced by Dr. Reese to be unique in its kind. It occurred in the practice of Drs. Cotton and Harlow, of Georgia, and was communicated to Professor Francis, of New York. The subject was a negro-woman, aged 30 years. On the night of the 23d of Jan. 1819, she was taken in labour. Her labour pains ceasing, she was at- tended for a few days for dropsical symptoms. On](https://iiif.wellcomecollection.org/image/b29339674_0018.jp2/full/800%2C/0/default.jpg)
