A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    86/878 (page 62)
    wound a small glass tube is placed, from which the air is withdrawn by the spontaneous action of a spring. The single opening on the skin, and the similar amount of blood that might be drawn by a leech, have induced the appellation of “ the artificial leech to this instru- ment, and when living animals cannot be had, such an apparatus might be of service in the surgeon’s hands. . The cutting part of this instrument might be applied as often as might be thought desirable, and with a variety of tubes the action of any reasonable number of leeches might be secured with as much certainty as if the animals themselves had been employed. . There are few instances in which local blood-letting is required where cupping will not be found applicable; but in some the lancet only can be used, or else leeches; and there are certain cases where these seem the most applicable. On the hands or feet, the gums, the cervix uteri, or on hemorrhoidal tumours, leeches are usually deemed more advisable than the lancet. A variety of circumstances may dic- tate the preference of one of these methods over the other, for ab- stracting blood locally; but I need not detain my readers to point out what common sense and observation may render apparent; for the sake of illustration, however, I may state that on the face the lancets might leave unseemly scars, and, in addition, the glasses could not be advantageously applied, owing to the irregularity of the surface. Here, therefore, leeches are to be preferred, as in the case of ophthal- mia, when they are set on the eyelids, or possibly “the artificial leech” above alluded to might be called into service. I know of no objection to leeches on any part of the body under circumstances requiring local depletion, excepting such as reason might dictate; yet the latter seems with some to admit of most unbounded liberties, for I have known a person allow a leech to fasten on the cornea, in an instance where the surgeon had ordered a number to be applied to the eyelids. To those who know that the wound inflicted by the bite of this animal would be certain to occasion opacity of this transparent part (and what tyro in the profession can be ignorant of the likely result of such an injury ?), it may appear supererogatory to advise that the bite of the leech be limited to the skin, or at most, to the mucous membrane of the eyelids, or that covering the sclerotic ; but the mistake above alluded to, must, with them, plead my excuse for offering an advice to others who may be less familiar with such matters. With this exception, and the still more apparent one of not placing these animals on such parts as may enable them to crawl out of sight into any of the cavities, or into recent open wounds, as is said to have happened, I know of no instance where they may^not be applied. In contusions or sprains, where they are put on the healthy skin, a little blush of erythema may supervene; there will be slight swelling and pain, and possibly a little mental alarm, but the threatened mischief will usually pass away in a few days at most. I have used them extensively on the raw surface of ulcers, and also on parts affected with erysipelas, and have never had cause to trace much harm from