Pg. 342

Admin_LH

November 2, 2020

¶ 1 Leave a comment on paragraph 1 0 342

¶ 2 Leave a comment on paragraph 2 0 NEW INVENTION : A NEW EYE DOUCHE.

¶ 3 Leave a comment on paragraph 3 0 NEW INVENTIONS.

¶ 4 Leave a comment on paragraph 4 0 A NEW EYE DOUCHE.

¶ 5 Leave a comment on paragraph 5 1 It would be difficult to say how long affusion” has been used as a hygienic agent. Hippocrates alludes to it.  Celsus, in speaking of it, tells us of a Physician, who lived about three hundred years before Christ, having employed it. 

¶ 6 Leave a comment on paragraph 6 0 The douche, by which is meant a continued current of fluid applied to or made to fall on some part of the body, would seem to be of modern date; and we have douches named after the parts of the body to which they are to be applied. A new eye douche, by Mr. Haynes Walton, which is a modification of an old pattern, now lies before us. It is simple, as the continuous stream of water is by hydraulic pressure; it is easy of application, and withal portable.

¶ 7 Leave a comment on paragraph 7 1 The reservoir, made of metal, holds about five pints of water, and has a loop at the top for suspension. The pipe, of caoutchouc, is thirty-six inches long, and terminated by a small brass stand, mounted with a stop-cock having two or more holes.

¶ 8 Leave a comment on paragraph 8 0 The stand can be placed in any basin which is large enough to receive the return of the water.

¶ 9 Leave a comment on paragraph 9 0 A continuous stream is afforded of twelve or fifteen minutes’ duration.

¶ 10 Leave a comment on paragraph 10 0 We understand that the instrument, with another stop-cock, has already been used in the accoucheur’s practice for washing out the vagina and applying lotions.

¶ 11 Leave a comment on paragraph 11 0 We shall be glad to hear Mr. Walton’s experience in the use of this instrument.

¶ 12 Leave a comment on paragraph 12 0 THE LONDON

¶ 13 Leave a comment on paragraph 13 0 PRACTICE OF MEDICINE AND SURGERY.

¶ 14 Leave a comment on paragraph 14 0 THE LONDON AND ST. MARY’S HOSPITALS.

¶ 15 Leave a comment on paragraph 15 0 UNSUCCESSFUL EMPLOYMENT OF ANAESTHESIA BY COLD.

¶ 16 Leave a comment on paragraph 16 0 [Cases under the care of Mr. CRITCHETT and Mr. WALTON.]

¶ 17 Leave a comment on paragraph 17 1 The employment of cold as a means of preventing the pain of operations has been repeatedly advocated in our columns, and we, therefore, feel called upon to report prominently, instances of its failure. Two such have occurred during the past week. In the first, the patient was a woman, under the care of Mr. Walton, in St. Mary’s Hospital, from whom it was wished to remove a fatty tumour on the abdominal wall. The tumour was subcutaneous, and felt quite as loose as such tumours generally are; it had a size of about an. adult fist, somewhat flattened. Nearly an hour was wasted in unsuccessful attempts to freeze

¶ 18 Leave a comment on paragraph 18 1 the skin, but as this was due, of course, to mistakes in manipulation, it should not be charged against the process. At length, a mixture, properly made, was applied, and in about four minutes the requisite area of skin was frozen, as white and hard as could be wished. Without the loss of a moment’s time, Mr. Walton made a deep incision through the whole required extent of skin into the tumour. This gave no pain. The tumour was seized at once, and forcible enucleation attempted. It could not, however, be extracted so easily as had been expected, and adhesions, both to the skin and to the deeper parts, required to be divided by the knife. At one part, where it appeared to have been pressed upon by the edge of the woman’s stays, the adhesions between the tumour and skin were very close, and a careful division was needed. The operation lasted perhaps altogether about four minutes, and during the whole of that time, excepting the first cut in the skin, the patient was making loud cries and protestations of pain. It should  be stated, that she was a remarkably quiet person, and one who did not complain for little.

¶ 19 Leave a comment on paragraph 19 1 The above operation took place on Wednesday last; and on the Friday following, we witnessed an almost similar one in the theatre of the London Hospital. Mr. Critchett’s patient was a man of middle age, and the tumour was a fatty one, about the size of a large fist, and Situated beneath the skin in the upper part of the front of the thigh. The freezing of the skin was very complete, nearly five minutes had been occupied in the process, and the incision into it appeared to be quite painless. The tumour had, however, rather intimate adhesions, more especially to the integuments ,* and the man complained much of almost every touch of the knife excepting the first.

¶ 20 Leave a comment on paragraph 20 1 We had witnessed before the above several cases of partial failure in the case of cold, but were inclined to attribute them somewhat to timoressness in its use; in these, however, it was fairly and sufficiently used. Their evidence seems clear to the effect, that, unless the tumour be so loose, and almost instantaneous enucleation can be performed, a painless operation must not be expected. The anaesthesia does not extend at all deeper than the skin; and even in it recovery of sensibility is so rapid during the manipulations, that the division of adhesions to its under surface will not be painless unless made without a minute’s delay. There are, doubtless, a large number of cases in which, despite these drawbacks, anaesthesia by cold may be made very useful; but the Surgeon must always be careful not to promise to his patient a painless operation. As it regards the excision of tumours, it will probably, in a few instances, be completely successful, and in many others sufficiently so to afford a good pretext for avoiding the use of chloroform. It is, perhaps, adapted best of all for use in the very painful operations which it is so frequently necessary to perform on the fingers and toes. Here it can be applied from several sides at once, and a more complete and less transitory degree of anaesthesia produced.

¶ 21 Leave a comment on paragraph 21 0 SERIES OF CASES OF ABDOMINAL TUMOURS.

¶ 22 Leave a comment on paragraph 22 0 (Continued from page 242.)

¶ 23 Leave a comment on paragraph 23 0 In our previous reports in the present series (Medical Times and Gazette for August 12 and September 2), there have been comprised examples of abdominal tumour resulting from—1. Perityphlitis ; 2. Pelvic abscess; 3. Encysted suppuration after peritonitis ; 4. Abscess connected with diseased bone; 5 and last, Abscess in the kidney.

¶ 24 Leave a comment on paragraph 24 0 Before passing on to the narration of other cases, we may add a few words regarding the latter Affection, of which the case which has been given is, excepting the short abstract of one about to follow, (Case 14,) the only example we shall have to bring forward. Abscess in the kidney is practically not very important as a cause of tumefaction within the abdomen, on account of the great rarity with which it produces that condition. In the great majority of cases in which, either from the irritation of calculus, from stricture of the urethra, from the deposit of tubercle, or from the operation of lithotomy, inflammation of the kidney ensues, its products escape freely by the natural channel, and no tumour is produced. It will be remembered, that, in the case we had reported, there was an almost close stricture of the ureter. Such a condition, indeed; is almost essential to the production of a tumour. Dr. Bright has recorded in his Papers on Abdominal Tumours, seven cases in which suppuration in the kidney was the cause of the swelling. Of these, in two cases, no autopsy was obtained ; in one, the ureter was found of natural size, but had been obstructed by the pressure upon it of the abscess-cyst, which hung downwards; in one, the pus had escaped by the urethra and bowel before death, and the condition of the ureter