The surgeon's vade mecum : a manual of modern surgery / by Robert Druitt.

  • Druitt, Robert, 1814-1883.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: The surgeon's vade mecum : a manual of modern surgery / by Robert Druitt. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    28/816 (page 8)
    Treatment.—The indications are, 1st, To mnove, so far as we are able, all conditions, known or believed to have the power of ei-eatincr the tetanic state ; and, ind, To give the patient every chance of sponta- neous i-ecovery, by husbanding his strengtli till the disease shall cease of itself. In the local treatment, the first points to be accomplished are, to remove all extraneous bodies from the wound, if there be one- to make incisions, if necessary, for the free disciiarge of pus, or lor the relief of inflammatory swelling and tension ; and if any isolated poi- tion of nerve or tendon happens to be on the stretch, to divide it. Then the part may be fomented with warm decoction of poppies; after which, warm opiate or belladonna lotion may be applied on lint, and the whole part be enveloped in large soft poultices. Sundry other measures have been proposed in order more etfii-ctually to lemove local irritation; such as the division of the principal nen-e leading from the wound; or, as Mr. Listen has proposed, the making a \ incision above, so as to isolate it and cut of}' as much nervous communication as possible; or the destruction of a ragged, contused, ill-conditioned wound by aciiuil cautenj, as Lari ey and othei-s have practised with great benefit: or the excismi of the wound if cicatrized or nearly so. fr'ometimesj when the wound is nearly cicatrized, or has ceased to suppm-ate, the application of a blister or of strong stimulating ointments has been of service; but, as Mr. Curling* observes, it happens, unfoituuately, that the tetanic condition of the spinal cord, when fully establisheil, is mostly independent of its local excitiiig cause, and does not cease on its removal. Hence amputation of the injured .part has very rarely been successful, and has even aggravated the mischief; so tliat as a general rule it ought not to be pertbrmed, unless desirable for some other reason besides the tetanus. We must next review the constitutional remedies that have been employed in tetanus, suiting their relative utility, and the cases in which they are most likely to be benelicial. 1. Antiphlotiisiic measures.-—Bleeding cauuot be used unless there IS satisfactory evidence that the disease is dependent on, or accompanied by, inflammation of the spinal cord. Mercuri/, given so as to induce ptyalism, was thought to do good in tetanus thnty years ago, when it was called the sheet anchor, and believed to do good in all cases. But there is no satislhctorv evidence tliat It IS of use. Funjatices are indicated, beamse a loaded st^ite of bowels IS known to be a c^use of very morbid conditions of the nervou.s system, and because, possibly, they may eliminate some unnatural ele- ment ui the blood. bus, a powder of calomel and jalap mi.xed with bu ter maybe puta the back of the tongue, for the patient to swallow, and may be followed ni an hoiu- with a large dose of castor oil, or by a drop or two of cr„t,..i od ; and enemata of tinpentine may be admini- stei'ed until the bowels are conijiletely uidoaded. -r *i!;'^ '' T;'''T- '''K Hie .Jucksoniun Prize Kssny for 1834, by r. lilizanl Ciu-hng, ].ondon, 183G, p. 122. ooi, uy