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ADHESION.
THE STOMACH. Too much attention
cannot,be paid to it in
operations or in disease though were too much nethy’s views
practice in the
pital.
Some
Mr. Aber-
confined by his
east of London and the hos-
peculiarities of constitution
succeed bleeding to relieve over-action by watery stools. Proceed through the neutral salts and their combinations, viz., the red mixture of the hospitals, the black draught, &c.; or employ calomel, jalap, and James’s powder. When evacuations dare not be carried further, then resort to antimonialas; join them with the saline purgative)- or with mercury. Avoid full vomiting, unless in
which defeat all proceedings of the surgeon do not owe their origin to the stomach. If a man must limit himself to one remedy, Aber- particular cases, as in swelled testicle. Mr. nethy’s "’ blue pill" was the best. There is Pearson longed to have a cure for inflamma. We have it an influence at work before the stomach be- tion that would not debilitate. comes deranged. Remove that cause. Con- in antimonials. They subdue the pulse, finement, bad ventilation, depression of mind, soften the skin, and permanently take no may precede and occasion disordered func- power. Mercury offers a powerful check to tions. ’ The blue pill and the bitter draught inflammation. It is used when we dread the are not the whule of medical practice that is deposit of coagulable lymph on delicate texnecessary to surgery. The universal prac- tures, as in the brain, eye, larynx. It joinstice of evacuating the bowels after an acci- well with opiates. Use opiates only after dent, or before treatment, generally arises evacuations, or when long suffering bas,5ub. from the fact, that there is a condition of the dued strength. Opiates are best joined with intestinal canal which, though natural during relaxants, as ippcacuanha.—Lectures of Sir health and activity, becomes highly injurious Charles Bell at Edinburgh. during the circumstances which consign the individual to the care of a medical man. ADHESION. When the powers fall low, chemical change of the ingesta is checked, and mild laxatives FIRM junction, between cut surfaces, re. are necessary to disburden without debilitatfever quires time. An inflamed intestine will ad. ing. Otherwise fever ensues. When attends injury of a vital part, then " critical here in seven hours; the lip in twenty-four evacuations," active purging, is necessary, the flap, in amputation, in three days. We producing dark and foetid stools,-not a mere seldom have to promote inflammatory action, evacuation of the intestines, but a purging but often to moderate it. Mr. Huuter said into them of secretions which were locked that the medium of union was blood. Let Up. Before an operation look to the eye, the not this opinion make you careless of the countenance, the skin, the evacuations, the coagulum between cut surfaces; for it will aecretions. If ever a blister or a leech-bite lead to bad suppuration. Therefore, in all has been followed by erythema, give a warm wounds, where you desire immediate adheon the day preceding an operation. sion, clear away the blood. Bleeding having ceased, approximate the surfaces. But i3ever For example,— R Powdered rhubarb; indulge the idea of procuring adhesion, exRelax the Carbonate of magnesia, of each, j; cept by mechanical means. muscles to retain the surfaces in contact. Tincture of senna; Compound tincture of cardamoms, The adhesive strap, the dry suture, the unitof each, 3j ; ing bandage, the use of the needle, are the Then enjoin perfect rest. -Study means. Peppermint-water, 3x. Make a draught. dressing in the hospital. Don’t huddle it oil If the bowels be habitually loaded for some , after an operation. It involves an important days, order small and largely-diluted doses duty. Hurry is dangerous. This I say of sulphate of magnesia, with air and exer- after having been induced by Mr. Abernethy cise. -If the secretions be deranged, unde- to neglect my brother’s precept. I object to bilitating doses of the blue pill, or mercury what Mr. A. has laid down in his lectures 6i with chalk, with a morning draught of rhu- this point. Avoid retaining discharge barb and sulphate of potass. Let the diet adhesive plaster. Either adjust it a little be varied and simple, in addition, and allow apart, or so snip it as to open in the centre. the gesh-brush to the skin, in all surgical Avoid putting ligatures through the integu" complaints, and before all operations.- In ments with the needle, if pussible? though the progress of some surgical cases there is they must be used in the cheek, the eyelids, A ligature to unite a a want of tone in the hollow viscera, at. the abdomen, &c. tended with 11atulent distention, where wound should have two needles, passed from oxtive purgatives would destroy the patient. within outwards. Support the ligatures in For example, if cold saline purgatives be ad- the interval by adhesive straps, to take of ministered then to procure stools, instead of the strain from the swelling integuments. carminative and stomachic purgatives, and The quilled suture is essential in the enemata of assafœtida, and medicines to perineum. In dressing, one give strength, the belly becomes more tym- t&ken on, and another put tp replape it, and
purgative -
by the
pamtic,
and the
patient sinks. Purgatives
so on
in succession.
strap should be When the natural pas-
895
sages have
phagedena, perineum
opened
in
:been opened by sloughing or portant operations in surgeryand during or the, trachea divided, or the Mr. S.’s four years’ resideSce in Cambridge
two in
urethra, he has performed several operations with -the most marked sucçess, including amputations, When, by paring the turnours, fistulæ, and hare-lip. Mr. Southee
labour,
the
or
fistula, you have perhaps to excite
secondary adhesion. edges and by sutures you fail, touch the edges with the caustic, dress with the cantharides ointment, and cover all with a poultice. This will bring the edges to suppuration and granulation. Then peel off the thin cuticle from the granulations, make a bleeding surface, and keep the surfaces mechanically in contact. I have succeeded by a slower process,-more like that of adhesion after burns,—sometimes by nitric acid, sometimes by laying a hot iron in different directions on the mouth of the opening, inducing gradual condensation and contraction.—Sir
may be consulted
personally at his residence, 26,« Green-street, or by letter pre-paid. Cambridge, Aug. 22, 1842." _
CHANCRE IN THE
’
URETHRA.
To the Editor of THE LANCET.
writers upon syphilis mak mention of chancres within the urethra (vide Mr. Lane in the current volume of THE LANCET, p. 501 ;Sir A. Cooper’s lectures.; ,. Va.de-; p. 488 ; and Mr. Druitt in his " besides the Charles Bell. mecum," p. 159, note, says, cases in which chancre exists within the urethra, as recently stated by Colles, JohnAN ORNAMENT OF THE PROson, and others") ; but no author that I FESSION. have read points out the ordinary situation of such sores. Will yon kindly infortn me To the Editor of THE LANCET. at what distance from the orifice of the SIR,—The subjoined MtofcMM was printed urethra they are iisually met with, and at in the Ctimbridge Chronicle, just underneath what extreme distance from the orifice they Mr. Lane, in THE the advertisements of the candidates for the have been detected. three surgeoncies to Addenbrooke’s Hos- LANCET, p. 598, says (when speaking of pital. I regret to find, on looking into the secondary symptoms occurring wherethe pa London College list, that the advertiser is, as tient has been unconscious of a primary sore). he states, a member of the college. Com- " But when the surgeon examines for him· I know self, he either detects a small ulcer, or a ment from me is unnecessary. nothing else of the man; and my reason for recent cicatrix." Now, if chancres do occasending it to you is, that his quackery may be sionally exist in the urethra, secondary exposed to the profession. It was the great symptoms may occur without any evidence failing of Sir Astley Cooper that he gave of a primary sore, and without the patient " testimonials" to anybody. I am, Sir, your knowing that he ever had such. During my obedient servant, attendance upon one of the largest London A MEMBER OF THE COLLEGE. hospitals, I saw several hundred chancres, but not one within the urethra. A few obSept. 20,1842. servations on the symptoms, progress, and To the Governors of Addenbrooke’s Hos- termination of chancres within the urethra will be thankfully received and duly apprepital, the inhabitants of Cambridge and ciated by, Sir, your obedient servant, its vicinity-. A JUNIOR PRACTITIONER AND " Mr. Okes having retired from the proSUBSCRIBER. fession, Mr. Southee (licentiate in medicine September 13, 1842. and surgery, and member of the Royal Colof the orifice of the urethra lege of Surgeons,) is the only surgeon now are notChancres of in who has had unfrequent occurrence, and have Cambridge any practising practical experience as an operator. Mr. S. been noticed by most writers on venereal diswas fur a length of time a pupil of the late eases ; but we are indebted to M. Ricord for Sir Astley Cooper’s, subsequently engaged out to us their occasional presence in the Russian service,* where he was ac- pointing at points much deeper in the canal. Such tively employed in performing the most im- cases have hitherto been mistaken for ordiabscesses con°I have great pleasure in bearing testi- nary gonorrhoea, or for simple of the nreithe nected with portion spongy mony to the acquirements of my young and of three thra. hundred Out Mr. Richard and eighty-nine friend, warmly Southee, recommend him to the patronage of the cases of chancre in the male subject, from chief medical o6icer of the Russian army, as which M. Ricord succeeded in producing a: gentleman highly qualified to perform his the characteristic venereal pustule by inocuduty as a surgeon, and anxiously desirous of in as many as twenty-one the chancre obtaining the approbation of his superiors.- lation, was situated either just within the orifice of ASTLEY COOPER. " London, l5th May, 1826." he urethra, Qr a greater distance in the canal
SIR,—Various
most ,
,
-
_
cannot,be paid to it in
operations or in disease though were too much nethy’s views
practice in the
pital.
Some
Mr. Aber-
confined by his
east of London and the hos-
peculiarities of constitution
succeed bleeding to relieve over-action by watery stools. Proceed through the neutral salts and their combinations, viz., the red mixture of the hospitals, the black draught, &c.; or employ calomel, jalap, and James’s powder. When evacuations dare not be carried further, then resort to antimonialas; join them with the saline purgative)- or with mercury. Avoid full vomiting, unless in
which defeat all proceedings of the surgeon do not owe their origin to the stomach. If a man must limit himself to one remedy, Aber- particular cases, as in swelled testicle. Mr. nethy’s "’ blue pill" was the best. There is Pearson longed to have a cure for inflamma. We have it an influence at work before the stomach be- tion that would not debilitate. comes deranged. Remove that cause. Con- in antimonials. They subdue the pulse, finement, bad ventilation, depression of mind, soften the skin, and permanently take no may precede and occasion disordered func- power. Mercury offers a powerful check to tions. ’ The blue pill and the bitter draught inflammation. It is used when we dread the are not the whule of medical practice that is deposit of coagulable lymph on delicate texnecessary to surgery. The universal prac- tures, as in the brain, eye, larynx. It joinstice of evacuating the bowels after an acci- well with opiates. Use opiates only after dent, or before treatment, generally arises evacuations, or when long suffering bas,5ub. from the fact, that there is a condition of the dued strength. Opiates are best joined with intestinal canal which, though natural during relaxants, as ippcacuanha.—Lectures of Sir health and activity, becomes highly injurious Charles Bell at Edinburgh. during the circumstances which consign the individual to the care of a medical man. ADHESION. When the powers fall low, chemical change of the ingesta is checked, and mild laxatives FIRM junction, between cut surfaces, re. are necessary to disburden without debilitatfever quires time. An inflamed intestine will ad. ing. Otherwise fever ensues. When attends injury of a vital part, then " critical here in seven hours; the lip in twenty-four evacuations," active purging, is necessary, the flap, in amputation, in three days. We producing dark and foetid stools,-not a mere seldom have to promote inflammatory action, evacuation of the intestines, but a purging but often to moderate it. Mr. Huuter said into them of secretions which were locked that the medium of union was blood. Let Up. Before an operation look to the eye, the not this opinion make you careless of the countenance, the skin, the evacuations, the coagulum between cut surfaces; for it will aecretions. If ever a blister or a leech-bite lead to bad suppuration. Therefore, in all has been followed by erythema, give a warm wounds, where you desire immediate adheon the day preceding an operation. sion, clear away the blood. Bleeding having ceased, approximate the surfaces. But i3ever For example,— R Powdered rhubarb; indulge the idea of procuring adhesion, exRelax the Carbonate of magnesia, of each, j; cept by mechanical means. muscles to retain the surfaces in contact. Tincture of senna; Compound tincture of cardamoms, The adhesive strap, the dry suture, the unitof each, 3j ; ing bandage, the use of the needle, are the Then enjoin perfect rest. -Study means. Peppermint-water, 3x. Make a draught. dressing in the hospital. Don’t huddle it oil If the bowels be habitually loaded for some , after an operation. It involves an important days, order small and largely-diluted doses duty. Hurry is dangerous. This I say of sulphate of magnesia, with air and exer- after having been induced by Mr. Abernethy cise. -If the secretions be deranged, unde- to neglect my brother’s precept. I object to bilitating doses of the blue pill, or mercury what Mr. A. has laid down in his lectures 6i with chalk, with a morning draught of rhu- this point. Avoid retaining discharge barb and sulphate of potass. Let the diet adhesive plaster. Either adjust it a little be varied and simple, in addition, and allow apart, or so snip it as to open in the centre. the gesh-brush to the skin, in all surgical Avoid putting ligatures through the integu" complaints, and before all operations.- In ments with the needle, if pussible? though the progress of some surgical cases there is they must be used in the cheek, the eyelids, A ligature to unite a a want of tone in the hollow viscera, at. the abdomen, &c. tended with 11atulent distention, where wound should have two needles, passed from oxtive purgatives would destroy the patient. within outwards. Support the ligatures in For example, if cold saline purgatives be ad- the interval by adhesive straps, to take of ministered then to procure stools, instead of the strain from the swelling integuments. carminative and stomachic purgatives, and The quilled suture is essential in the enemata of assafœtida, and medicines to perineum. In dressing, one give strength, the belly becomes more tym- t&ken on, and another put tp replape it, and
purgative -
by the
pamtic,
and the
patient sinks. Purgatives
so on
in succession.
strap should be When the natural pas-
895
sages have
phagedena, perineum
opened
in
:been opened by sloughing or portant operations in surgeryand during or the, trachea divided, or the Mr. S.’s four years’ resideSce in Cambridge
two in
urethra, he has performed several operations with -the most marked sucçess, including amputations, When, by paring the turnours, fistulæ, and hare-lip. Mr. Southee
labour,
the
or
fistula, you have perhaps to excite
secondary adhesion. edges and by sutures you fail, touch the edges with the caustic, dress with the cantharides ointment, and cover all with a poultice. This will bring the edges to suppuration and granulation. Then peel off the thin cuticle from the granulations, make a bleeding surface, and keep the surfaces mechanically in contact. I have succeeded by a slower process,-more like that of adhesion after burns,—sometimes by nitric acid, sometimes by laying a hot iron in different directions on the mouth of the opening, inducing gradual condensation and contraction.—Sir
may be consulted
personally at his residence, 26,« Green-street, or by letter pre-paid. Cambridge, Aug. 22, 1842." _
CHANCRE IN THE
’
URETHRA.
To the Editor of THE LANCET.
writers upon syphilis mak mention of chancres within the urethra (vide Mr. Lane in the current volume of THE LANCET, p. 501 ;Sir A. Cooper’s lectures.; ,. Va.de-; p. 488 ; and Mr. Druitt in his " besides the Charles Bell. mecum," p. 159, note, says, cases in which chancre exists within the urethra, as recently stated by Colles, JohnAN ORNAMENT OF THE PROson, and others") ; but no author that I FESSION. have read points out the ordinary situation of such sores. Will yon kindly infortn me To the Editor of THE LANCET. at what distance from the orifice of the SIR,—The subjoined MtofcMM was printed urethra they are iisually met with, and at in the Ctimbridge Chronicle, just underneath what extreme distance from the orifice they Mr. Lane, in THE the advertisements of the candidates for the have been detected. three surgeoncies to Addenbrooke’s Hos- LANCET, p. 598, says (when speaking of pital. I regret to find, on looking into the secondary symptoms occurring wherethe pa London College list, that the advertiser is, as tient has been unconscious of a primary sore). he states, a member of the college. Com- " But when the surgeon examines for him· I know self, he either detects a small ulcer, or a ment from me is unnecessary. nothing else of the man; and my reason for recent cicatrix." Now, if chancres do occasending it to you is, that his quackery may be sionally exist in the urethra, secondary exposed to the profession. It was the great symptoms may occur without any evidence failing of Sir Astley Cooper that he gave of a primary sore, and without the patient " testimonials" to anybody. I am, Sir, your knowing that he ever had such. During my obedient servant, attendance upon one of the largest London A MEMBER OF THE COLLEGE. hospitals, I saw several hundred chancres, but not one within the urethra. A few obSept. 20,1842. servations on the symptoms, progress, and To the Governors of Addenbrooke’s Hos- termination of chancres within the urethra will be thankfully received and duly apprepital, the inhabitants of Cambridge and ciated by, Sir, your obedient servant, its vicinity-. A JUNIOR PRACTITIONER AND " Mr. Okes having retired from the proSUBSCRIBER. fession, Mr. Southee (licentiate in medicine September 13, 1842. and surgery, and member of the Royal Colof the orifice of the urethra lege of Surgeons,) is the only surgeon now are notChancres of in who has had unfrequent occurrence, and have Cambridge any practising practical experience as an operator. Mr. S. been noticed by most writers on venereal diswas fur a length of time a pupil of the late eases ; but we are indebted to M. Ricord for Sir Astley Cooper’s, subsequently engaged out to us their occasional presence in the Russian service,* where he was ac- pointing at points much deeper in the canal. Such tively employed in performing the most im- cases have hitherto been mistaken for ordiabscesses con°I have great pleasure in bearing testi- nary gonorrhoea, or for simple of the nreithe nected with portion spongy mony to the acquirements of my young and of three thra. hundred Out Mr. Richard and eighty-nine friend, warmly Southee, recommend him to the patronage of the cases of chancre in the male subject, from chief medical o6icer of the Russian army, as which M. Ricord succeeded in producing a: gentleman highly qualified to perform his the characteristic venereal pustule by inocuduty as a surgeon, and anxiously desirous of in as many as twenty-one the chancre obtaining the approbation of his superiors.- lation, was situated either just within the orifice of ASTLEY COOPER. " London, l5th May, 1826." he urethra, Qr a greater distance in the canal
SIR,—Various
most ,
,
-
_