Progress in surgery

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Medical Press Company, Limited, 1892 - 56 pages
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Page 4 - ... be subjected to the trephine. 2. That trephining for traumatic epilepsy promises only palliation at best. 3. That trephining for Jacksonian epilepsy is to be regarded as only affording temporary benefit. 4. That trephining for abscess, in view of the fact that all such cases left alone almost invariably terminate fatally, is entirely proper, and that the earlier such operation is done the better.
Page 17 - The indication for laparotomy when perforation occurs in typhoid fever is imperative. 3. The only contra-indication is a moribund condition of the patient. 4. Collapse is often at least temporarily relievable by hot peritoneal flushing. 5. The stage of the fever is not to be considered as an indication or as a contraindication for laparotomy. 6. The severity of the typhoid fever is alone not a contra-indication. 7. Early laparotomy offers the most hope. 8. The symptoms of peritonitis should not be...
Page 16 - ... perforations in this case because it seemed to me that the woman had a remote chance of recovery if she could be quickly put to bed. Consequently not more than 2^ feet of the intestine altogether were exposed. The abdominal sac was now thoroughly and carefully washed out with nearly half a washboilerful of hot sterilized water. The omentum was carefully drawn over the injured coil of intestine, and stitched to the mesentery. A large drainage tube was passed to Douglas, cul-de-sac, and the remainder...
Page 38 - ... rock of experience. Primary osteotomy, astragalus resection, cuneiform tarsectomy, open incision, and prolonged and interrupted traction with intricate machinery, have all run the gauntlet of observation, and the roadside everywhere is strewn with lamentable failures. Why should this be so? Simply that method, based upon some pathological fact and data of experience, has been ignored. I do not at this time care to discuss the etiology and pathology of talipes varo-equinus. Permit me to say, however,...
Page 13 - If penetrating, median laparotomy as soon as possible after the injury, unless contra-indicated by nerve shock. 3. Signs of peritonitis, just beginning or well developed while diminishing the chances of success are by no means a contra-indication for operative interference.
Page 35 - ... it is firmly grasped by the dense wall. After acting thus for ten minutes at one part, the point of the pin, without being removed from the sac, ought to be shifted to another spot, and so on until the greater portion of the internal surface opposite to the point of entrance has been touched ; this ought to be done in a methodical manner. A single insertion of the pin through the...
Page 35 - Before performing the operation, the skin over the aneurism ought to be carefully cleansed and rendered aseptic. The aseptic pin ought then to penetrate the sac and pass through its cavity until it comes in contact with the opposite side. It ought to touch and no more. Then one of two methods may be employed, — either to move the pin over the surface of the inner wall so as to irritate its surface, or to allow the impulse of the blood-current playing on the very thin pin to effect the same object....
Page 4 - That trephining for cephalalgia, or traumatic epilepsy (medical measures having failed), should be undertaken with every prospect of success. 7. That trephining for hydrocephalus is a useless operation. 8. That trephining for microcephalus, independent of athetosis, confers no credit upon surgery. 9. That it is more than probable that as our observations multiply the sphere of the trephine as a preliminary for the removal of brain tumors will be lessened rather than be amplified.
Page 35 - ... in contact with the opposite side. It ought to touch and no more. Then one of two methods may be employed, — either to move the pin over the surface of the inner wall so as to irritate its surface, or to allow the impulse of the blood-current playing on the very thin pin to effect the same object. If the wall penetrated by the pin on introduction be dense, the former method will be preferable, as the force of the blood-current produces such a feeble action on the thin pin as to be insufficient...
Page 32 - ' two common glover's sewing needles armed with one piece of salmon silk -worm gut, are fastened in some convenient needle-holder at a very slight angle to one another, so that their points completely coincide, and can be made to enter through one hole in the skin. The left forefinger covers or occupies the inner aperture of the sac, the needles are made to enter from without, and are then separated. The outer needle is...

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