A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones.

Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of the eye / by William Mackenzie ; to which is prefixed an anatomical introduction explanatory of a horizontal section of the human eyeball by Thomas Wharton Jones. 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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    tude. Larrey washed the wound, removed the foreign substances which adhered to it, cut away the soft parts which were in a state of disorganization, tied several vessels which he had opened in doing so, and brought the flaps together as much as possible by stitches. He also united by stitches the two portions into wliicjl’ the tongue had been divided. He covered the whole excavation with a piece of linen with holes cut in it, and dipped in warm wine, and then aj)plied fine charpie, compresses, and a bandage. Every throe hours, a little soup and some spoonfi^ of wine were given with the gunvelastic tube and funnel. The dressings wen frequently renewed, on account of the flow of saliva and other fluids, Sup])uri^ tion was established, the sloughs separated, the edges of the enormous wounif a|)proached each other, and the jjarts which were brought together adhered; days after the injury, the man was in a state to be moved, and ultimately cica^^ trization w as completed. After having been fed during the first 15 daysthrougMj the tube, he w'as able to take nourishment with a spoon. jir This patient returned to France, and 11 years afterwards, when Larrey 5iublished his work,*® was alive, and in good health, in the Hutel dea Invalidear de could even speak so as to make himself understood, especially when the largf opening into his face was covered with a gilt silver mask. I have thus attempted to classify and illustrate the dilferent in- juries to which the orbit is liable, and the various effects which those injuries are apt to produce. There remain only two topics, on which I wish to say a few words. 1. Prognosis. It is evident, from the cases which have beegf passed in review before us, that although, in general, immediate death is the consequence of an injury extending through the orbit to the brain, yet this is not always the case; but that in some in- stances life has been prolonged for several days, and that in others the patient has completely recovered. Putting aside the important question, whether or not large vessels have been ruptured, and blood extravasated, it is probable, that it is not so much the absolute amount of injury to the brain, as the suddenness with which it is inflicted, which renders wounds of the brain so generally ftital. We have examples of disorganization of very considerable portions of the brain proceeding slowly, and yet life prolonged for years ; while in perforation of the roof of the orbit, the-smallest wound of the brain may prove immediately mortal. Pathologists have generally attempted to explain the sudden and fatal effects of such wounds of the brain, by telling us, that thereby the heart, or the organs of respiration, are instantly deprived of the nervous energy necessary for continuing their functions.®® But how it happens that death takes place instantaneously in some easel of this sort, while in others the person suffers so little from the sudden injury of the brain, but lingers, like Mr Waldons patient with the gun-breech in his brain, or recovers, like Mr Cagua’s and M. Bagieu’s patients, we cannot tell, any more than we can explain how one man shall have a limb carried off, or shattered to pieces by a cannon-ball, without exhibiting the slightest symptom of mental or corporeal agitation, while deadly paleness, violent vomiting, pro* fuse perspiration, and universal tremor, shall seize another on the receipt of a slight flesh wound. To say that all this depends on differences in nervous susceptibility, is only to repeat the fact in other words, not to explain it.