A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 1).
- Samuel Cooper
- Date:
- 1816
Licence: Public Domain Mark
Credit: A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![of a simple wound; and whether the wound is deep, or superficial, the anti- phlogistic treatment is equally indicated. The edges of a wound penetrating the abdomen, but, unattended with any obvi- ous injury of the viscera, are to be brought together with a sticking-plaster, just in the same way as common wounds. In this situation, sutures are more frequently proper, than in most others. Particular care is also to be taken to keep the bowels from protruding, by the application of a compress, and bandage. All the means of preventing inflammation are to be adopted, (see Inflammation) and quietude is, above all things, to be enjoined. Our good old surgeon Wiseman (ob- serves Mr. John Bell) has said with great simplicity, as a great many have said after him, Thus it frequently happeneth, that a sword passeth through the body, with- out wounding any considerable part. He means, that a rapier, or ball often passes quite across the belly, in at the navel, and out at the back, and that with- out one bad sign, the patient recovers, and as has very often happened, walks abroad in good health, in eight days; which speedy cure has been supposed to imply a sim- ple wound, in which all the bowels have escaped. But, we see now, hoiv this is to be explained; for, we know, that in a thrust across the abdomen, six turns of in- testine may be wounded,—each wound may adhere ; adhesion, we know, is begun in a few hours, and is perfected in a few days; and, when it is perfect, all danger of inflammation is over; and, when the danger of inflammation is over, the patient may walk abroad ; so that we may do, just as old Wiseman did in this case, here alluded to,* Bleed him, and advise him to keep his bed, and be quiet. In short, a man, thus wounded, if he be kept low, has his chance of escaping bv an adhesion of the interna] wounds. (Discourses on the Nature and Cure of Wounds, p. 329, 530, edit. 3.) When a man is stabbed, or shot in the bell}', the surgeon can seldom do any good by being vary officious; and the wisest conduct, that he can in general adopt, is to keep his patient as quiet as possible, have recourse to bleeding, piv scribe ano- dynes, and the lowest fluid diet, and con- tent himself with applying superficial dressings. In the event of severe pain awd swelling of the belly coming on, leeches, fomentations, and emollient poul- tices will be necessary, and nothing will * P. 98. Thi ca e of a man, who was wounded across the belly, und well and abroad, in seven days. now avail, except the most rigorous anti- phlogistic means. INFLAMMATORY CONSEQUENCES OF WOUNDS OF THE ABDOMEN. Sometimes, notwithstanding the best treatment, alarming symptoms cannot be prevented. At first, these are commonly of the inflammatory kind ; consequently, repeated bleeding, and redoubled attention to every part of the antiphlogistic treat- ment, are indicated. If the inflammation should not be subdued by such measures, internal mortification and death may fol- low, or abscesses form in the abdomen. SUPPUIIATION in the abdomen, ln CONSEQUENCE OF WOUNDS. Abscesses within the bag of the perito- neum are far from being common occur- rences. As a late writer well observes, the containing and contained parts of the abdomen present to each other a uni- form and continuous surface of membrane. This membrane is of the serous class, and the species of inflammation, to which it is especially subject, is that, which has been denominated the adhesive. The mem- brane lining the intestinal canal, is of the mucous class, and the ulcerative in- flammation is the species, to which this class is liable. This beneficent provision is an irresistible evidence of the operation of a salutary principle in disease. If the inflamed peritoneum had run directly into suppuration, ulceration of the surrounding parts would have been required for an out- let; and if the internal surface of the irri- tated bowel had tended to form adhesions, the canal would have been in constant danger of obliteration. (Travers on Inju- ries of the Intestines, &c. p. 10.) That collections of matter, however, do sometimes take place in the cavity of the abdomen, in consequence of wounds, is a fact of which there are too many proofs on record, for the possibility of the case to be doubted. At this moment, be it suffi- cient*^ our purpose to refer to two ex amples of the occurrence, as related by Mr. Benjamin Bell, in his System of Sur- gery, vol. v. p. 256. If the abscess were in any other part of the body, and did not readily point, the wisest practice would undoubtedly be to make an opening sufficient for the evacua- tion of the matter. But suppuration in the abdomen can seldom be ascertained with certainty, before the collection of matter has existed a good while; for, the situation of the abscess is so deep,that no fluctuation, nor swelling, becomes perceptible, until a considerable quantity of pus has accumu-](https://iiif.wellcomecollection.org/image/b21110669_0013.jp2/full/800%2C/0/default.jpg)
