Surgical cases in 1867 / by David W. Cheever.

  • David Williams Cheever
Date:
1867?]
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases in 1867 / by David W. Cheever. Source: Wellcome Collection.

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    motes gangrene, by favoring and increasing the passive congestion which exists already ? Such we know to be the action of warm poultices in the congestive stage which precedes senile gangrene. I am inclined to think that the suppuration which followed the acupressure was due to long and rough manipulation in securing the vessel. Could the last manoeuvre adopted have been foreseen and used first, I think laceration and stretching of the sheath and cellu¬ lar tissue might have been avoided. The peril of secondary haemorrhage from the vessel divided by the ligature was avoided by acupressure. It may be noticed in the first case reported, that flexion, for a few hours only, altered the sac so that consolidation took place promptly. In the second case, flexion was pursued over four days and nights constantly, but without effect. The difference in result, I think, is due to the fact that the first tumor was very small, fusiform, and easily compressed; the second was very large, flattened, and tending to become diffused. Flexion so long in the second case may have enlarged the collate¬ ral vessels, and put them into a better state to sustain the circulation after acupressure of the femoral artery. One month after leaving the hospital, the patient continued per¬ fectly well. Case IY.—Excision of the Hip. Recovery.—(Service of Dr. Buck¬ ingham.) Feb. 12th, 1867. F. T., set. 14, of scrofulous parentage, was healthy until last September, when he began to have pain and stiffness in left hip. Soon after, had an attack of fever lasting three weeks; was confined to his bed thirteen weeks, being much reduced, with night sweats and emaciation. During this time an abscess was opened below the trochanter major, and it has ever since discharged pus freely, with, occasionally, small fragments of bone. He has grown feeble, pale and thin. Appetite good. No cough. The thigh is held persistently flexed. The nates are flattened, and there is a good deal of swelling. Great pain on moving the limb. He was put to bed; extension by weight applied, and the syrup of iodide of iron given. # Feb. 15th.—Unable to bear weight. 20th.—Discharge more profuse; patient more feverish and feeble. * 24th.—A painful diarrhoea; treated by astringents and opiates. March 1st.—Diarrhoea better. Less pain, but cannot bear exten¬ sion. Lies with leg drawn up constantly. 5th.—More sallow and emaciated daily. 10th.—Is very weak. 13th.—Return of diarrhoea. 14th.—Extremely pale, thin and exhausted, with diarrhoea, hectic and suppuration. Appetite, however, good. The patient was now so excessively reduced that it seemed an
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