Abbildungen der Seite
PDF
EPUB

ADVERTISEMENTS.

GREAT TRUSS MANUFACTORY.

JOHN BEATH'S PATENT IMPROVED J. WHITWELL, Druggist, corner

TRUSSES.

R. BEATH invites those who de

dangerous and distressing disease of Rup ture, to call at his office, 672, Washington Street, where he is in constant attendance, to adapt his trusses to the particular case of the patient.

After the experience of nearly thirty years, Mr. B. is now able to state to the public, that almost every person who has strictly followed his directions, has in a short time experienced, not only relief from pain and danger, but a partial closure of the orifice, and in many cases a total cure-some of which he is at liberty

to refer to.

Among the variety of trusses made by Mr. Beath, are Patent Elastic Spring Trusses, with Spring Pads - --Trusses without steel springs; these can be worn day and night. Improved Hinge and Pirot Trusses, Umbilical Spring Trusses, and Trusses with Ball and Socket Joints. Trusses for Prolapsus Ani, by wearing which, persons troubled with a descent of the rectum, can ride on horseback with perfect ease and safety. Mr. B. makes also Trusses for Prolapsus Uteri, which have answered in cases where pessaries have failed. Suspensary Trusses, Knee' Caps, and Common Trusses, are kept al ways on hand, charged at the lowest prices. Machines for remedying deformities, Artificial Legs, &c.

Surgeons' Instruments and Trusses repaired at the Manufactory.

We have often witnessed Mr. Beath's success, and have been personally benefited by his ingenuity.-Ed. Med. Intel.

THE following works are for sale at this Office.

TH

A Treatise on Verminous Diseases, preceded by the Natural History of Intes tinal Worms, and their origin in the Human Body. By V. L. BRERA, Professor of Clinical Medicine in the University of Pavia, &c.

BICHAT on the Membranes. Discourses on Warm and Cold Bathing. A Dissertation on Medical Education, and on the Medical Profession.

Remarks on the Dangers and Duties of Sepulture.

of Milk and Kilby Streets, has in his employment one of the first artists and most ingenious mechanics in the United

States,

Trusses.

purpose manufacturing

At this great depository may
be found every sort of Truss, manufactur-
ed either in Europe or America, made in
the most elegant style, and warranted to
accomplish every object which a good
To medical men it is
Truss can effect.
needless to state the important advan-
tages which arise from having the instru-
ment well adapted to the part to be re-
lieved.

Here the patient, if unable to
suit himself with those on hand, may
have one made agreeably to the exact
measurement of his body.

French Elastic Catheters.

Just received, from France, a few gross of the most approved Catheters, used by the first physicians and surgeons in the French metropolis; they are sold at a very low rate.

Bay Rum.

A few dozen bottles of this excellent embrocation in cases of hysterical and nervous affections, &c.

Also, Whitwell's Original and Genuine Liquid Opodeldoc. April, 1827.

CHARLES WHITE, 271, Washington Street, corner of Winter

Street,

AS received by the London packet,

Hhis Spring supply of DRUGS, ME

DICINES, & SURGEONS' INSTRU MENTS,-making, together with those in store, a complete assortment,-among them are-narcotine, morphine, acetate of morphine, sulphate of morphine, solution of acetate of morphine, extract of opium deprived of morphine; emetine, iodine, hydriodate of soda, hydriodate of potash, hydriodate of mercury, hydrio, cianic acid, colchicum seeds and roots, extract of elaterium, extract of belladona, extract of henbane, extract of hops, extract of hellebore, black drop, croton oil, blue pill, pneumatic nipple pumps, silver, ivory, wood, lead, glass, and gum elastic nipple shields, &c.

Strict personal attendance paid to Physicians' prescriptions, and medicines delivered at any hour of the night.

6w

Published weekly, by John Cotton, at 184, Washington St, corner of Franklin St., to whom all communications must be addressed, postpaid. The price will vary with the time of payment. If paid on subscribing, or within 3 months after, the price will be 3 dollars per annum; if paid after 3 months but within the year, it will be $3,50; but if not paid within the year, it will be 4 dollars. No paper to be discontinued till arrearages are paid. Advertisements, 1 dollar a square.

[ocr errors]

MEDICAL INTELLIGENCER.

JOHN G. COFFIN, M.D., EDITOR.

THE BEST PART OF THE MEDICAL ART, IS THE ART OF AVOIDING PAIN.

VOL. 5.

TUESDAY, MAY 29, 1827.

MR. ABERNETHY, ON EDEMA, AND
SOME OTHER LOCAL AFFEC
TIONS, ULCERS, &c.
Now the last local affection I
have to speak of is edema. In
every surgical book you read that
edema rises from too great depo-
sition, or too little absorption.
Now the question is, which?
That edema rises from too great
deposition, is probable. Mr. Hun-
ter remarks that edema disap-
pears frequently before death.

In books of Nosology this is divided into edema aquosa, edema solidum, and edema erythemata. This is merely saying that sometimes you have watery affusion into cellular substance, sometimes matter, &c. It is almost constantly connected with a bad state of health, and reducing measures are contraindicated. It will not do to use depleting remedies; in short, gentle friction and bandages are what we rely on for the cure of edema. A woman had this disease attack half of her face, in the same way paralysis sometimes affects one half. Some said it was erysipelas; but it was not. Many people die of diseases, dissection you cannot discover anything particularly wrong, and it only shows the deficiency of our knowledge, and the necessity of your deeply studying everything connected with your profession; it is a very useful, though at the same time a very

when on

NO. 2.

melancholy profession. I next go to speak of diseases arising from deficient absorption. Mr. Hunter speaks of interstitial absorption and progressive absorption by progressive absorption, I presume he means the passage which is made for the exit of foreign bodies. A woman swallowed some pins by accident, the number was exactly known; in six months they all came out at different parts of the body; during that time there was the greatest irritation and disturbance to the constitution. Some of these pins came out before, and some behind; when the last pin came away, she lost all her irritation, and got well.

I say these cases are curious, and ought to be borne in mind. I remember the case of a man who had an ulcer in the leg, and the surgeons in the country could not heal it; he therefore came up to London, and I perceived a black substance, which with my probe I took hold of, and drew out a long black thorn. The ulcer soon healed. On my questioning him he said he recollected, a year and a half before, while getting over a hedge, a thorn got into the calf of his leg. These extraneous bodies travel in a very odd way. A surgeon, in using a catheter, let it slip into the bladder; an abscess in the hip formed, and a black, rusty like metallic substance presented itself; it was

ing it up like the mouth of a purse, and giving it a very unsightly appearance; I say it puckers it up, this happens in circular sores. Prosecutions have been instituted against surgeons, for supposed malpractice; a child, for instance, has become burnt in the neck and face, and the chin and collar bone come in contact. The surgeon takes his fee, makes his bow, and if he did not apprise the parties of what would probably happen, he deserves, I say, to be prosecuted; another surgeon is called in, and he says,

so he cuts it, and lets it loose, but in a short time the same contraction happens again.

Mr. Earle in several cases cut away the cicatrix and made an elliptical ulcer, and there was no contraction. Mr. James, of Exeter, followed up this practice, and put a collar on. I was at Exeter this last autumn, and saw a patient at the county hospital with one of these collars on.

the catheter, and this took place a considerable time after the occurrence. I now speak of ulceration, which may be the result of weakness or undue action. Mr. Hunter fixed his mind a good deal on an anecdote which a man, not a medical man, reported. I mean the chaplain of Lord Anson's voyage. In passing the southern parts of America, they were short of provisions, and sickness and scurvy attacked most of the crew. The narrative says, that in those who had broken bones, the bones became disunited, by the absorption of callus, and sores O! I'll soon set this to rights, which had healed, to all appearance soundly, broke out again; which shows that newformed parts are not endowed with so much life as the original compages of the body. The story, by many common readers, was looked on to partake rather of the marvellous; but it is perfectly consistent with the phenomena observed in disease, and there is no reason to suppose this man reported anything but what was true; he was not a medical man, and had no new or favorite theory to support. Ulcers heal by granulation, and the process of granulation is tardy, as newly formed parts have less energy of life. In the process of skinning, the vessels shoot horizontally. Mr. Hunter called it skinning; some call it cicatrization-now this is not a good term, for the word cicatrix means a scar. Does the rete mucosum become reproduced? Some think not, for in the ulcers of Africans, the new formed skin covering sores is white; no part of the body is ever completely reproduced. Say that there was a circular ulcer, three inches in diameter; the skin puckers in healing, draw

Children, as you know, are sometimes born webfooted, and also webfingered-and great caution is requisite to prevent this puckering, when operations are performed in such cases.

It seems to me, that the tongue joins in this manner-a person may have a fit of epilepsy, and may bite his tongue two thirds through. Now, what would you do? Would you sew it up? No, certainly not, it would be absurd. Monsieur Louis made a little bag for the tongue-he had a horror of sutures--the patient should be enjoined to keep quiet, and if his tongue is not an unruly one, this will be attended to. I have told you of the filling up of an ulcer, which is a very compound dis

ease--when the granulations are
carried on healthily, they are
small and of a conical shape, and
red. I remember when I was
young, the patients were always
kept in a horizontal position-if
you let the limb hang down the
granulations become purple, they
have neither the healthy color,
nor the life of the other granula-
tions, differently treated. Now
the deviations in ulcers from a
healthy state are various, some-
times they discharge merely sa-
nies, often ichor, and not unfre-
quently an acrid ichor oozes from
the sore.
You are often obliged
to use an ointment to defend the
irritable and tender skin from the
action of the ichor; you generally
judge of the morbid state of the
ulcer by the discharge.

The most scientific work on ulcers I know is that of Sir Everard Home. I refer you to his book on the subject, for really I have no adequate powers of description; if one were to describe an ulcer that seems simply weak, one would say that it had a pallid aspect; that the process of granulation went on slowly, and that the granulations should be flat, and not pointed. There seems much less vigor in ulcers the further they are removed from the source of life, I mean the heartif, for instance, a man had two ulcers, one above the knee, and one above the ankle, that above the knee would get well first. Sir Everard Home speaks of irritable ulcers; that in this kind there is surrounding inflammation, that there is great sensitivity of the surface; it is ulceration going on which produces this surrounding inflammation; and it is of unequal depths. What is to be done in this ulcer? O! to sooth

[ocr errors]

the irritability, and if you ask me what is the best application, I should say a watery solution of opium, and apply it warm; for irritable parts do not bear cold applications. An irritable tooth, for instance, tortures one most horribly, if cold water be applied, but not so with warm water. This is the way irritable sores ought to be treated; by soothing, endeavoring to produce tone and tranquillity, as I am accustomed to express it. I now lay down a principle which I would have you regulate your conduct by in treating these sores; I may instance what happens in irritable ophthalmia, you first sooth the eye with tepid water, and then you use a weak solution of sulphate of zincO! the patient winces, and dashes down the cup, and swears he will not touch it any more-he washes it again, and it smarts it is true, but not so much, and he bears it tolerably on the third application. You diminish morbid sensibility the same way as you do natural sensibility. This is the proper surgery of susceptible and morbid surfaces in general. Now this requires a reference to principle to do it properly; and when a surgeon has once got an ulcer to bear stimulants, I may say he has got the whip hand of that sore. Sir Everard Home next describes an indolent sore; he, in short, describes the common ulcerated leg admitted into our hospitals. In fact, weakness is the characteristic of an ulcer from the beginning to the end. The irritable ulcers are to be soothed, the indolent are to be stimulated; an irritable ulcer will become indolent, and an indolent one irritable. I recollect the time when plaster of Paris was applied to sores, and

[ocr errors]

it is astonishing how well it succeeded with indolent ulcers; but sometimes it was applied to an irritable one, and then the pain was excessive. After all, nothing can inform a surgeon how he is to treat these sores but experience it is tact; he has been so long accustomed to them, that he says at first sight, I know what will do for this or that description of sore. I perceive this, that the morbid peculiarities are but the offspring of general indisposition from irritability in the system at large. The most effectual way of relieving the morbid state of the ulcer is by tranquilizing the general health; they are more likely to get well by medical treatment. I say there is something empirical in the management of ulcers; the applications are so various to sores. I have often said give me the "Materia Medica," and you can scarcely show me a substance which has not some time or other been applied to sores. The discharges from sores are also a good indication of the state of health. The bad quality of these discharges may be corrected by the different acids in water; Nitric Acid, Muriatic Acid, Verjuice and water, &c. O! there can be no doubt that many sores have this tendency corrected by acids. Acids should be used very weak, in a high state of dilution. If you sublime cinnabar, what do you convert it into? Volatile sulphuric acid gas, and an oxyd of quicksilver. Sores have been fumigated with the carbonic acid gas. The fermenting poultice with yeast is of this description; and charcoal fresh powdered has been sprinkled over sores. It is astonishing what great power

there is in charcoal to correct putrefaction. I once saw the wonderful effects of charcoal in this way. Some leeches had died in a bottle of water, and the water stunk most horribly; some powdered charcoal was put in the bottle, and allowed to subside to the bottom, and the water became perfectly sweet. I may mention also fresh vegetable juices; these seem to operate on the discharges of sores. Carrots and turnips are of this quality. I have an aversion to scraping carrots and applying them to sores. I would express their juice and mix it with crumbs of bread.

Balsams are applied with good effect to some sores.-These balsams seem to act on sores like cordials to the stomach. Balguire, who wrote on amputations, ordered balsams. The balsam of Peru is used, but this balsam acts in certain cases as a stimulant. This is a branch of surgery I would have you by no means to slight; but study to the utmost of your ability, and if you can get a dressing that suits the taste of a sore, O, use it! But there is something empirical in this practice, and all surgeons know this. A round of applications has been tried, and the last pitched on, has, perhaps, agreed with it.Tar is a good application. I remember once the case of a sore which nothing would cure, and the tar ointment agreed, and seemed to act like magic. Some years ago there was a medical man in this town, who gained great reputation by recommending and using a flannel roller.Thanks are due to Mr. Baynton, of Bristol, who improved on this practice, and ordered a manytailed bandage of sticking plaster.

« ZurückWeiter »