Practical manual of diseases of women and uterine therapeutics : for students and practitioners / by H. Macnaughton Jones.

  • Macnaughton-Jones, H. (Henry), 1844-1918.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Practical manual of diseases of women and uterine therapeutics : for students and practitioners / by H. Macnaughton Jones. Source: Wellcome Collection.

    660/756 (page 612)
    comparatively small matter. In my earlier operations upon women I did not take into sufficient consideration the condition of the uterus. I could relate many cases in which I was most grievously annoyed to find that the patient did not recover as I had anticipated she would have done. I have found that if the wounds heal there is but little relief afforded, the same bearing-down and distressing sensation exists as it did before the removal of the piles. More commonly, the wounds do not heal, and very painful, un- healthy ulceration follows; this will never get well as long as the abnormal condition of the uterus remains.’ With regard to choice of operation for haemorrhoids, I decidedty believe, if it even be considered somewhat old-fashioned, that the safest operation and most satisfactory is the ligature. For twenty years I have never had occasion to regret operating by means of the ligature, both as regards the effectiveness of the cure and the freedom from haemorrhage. I am aware that the clamp is a cleaner, more rapid, and equally effec- tive method (especially the new clamp, see p. 620)3 used after the ‘crushing’ method of Mr. Pollock), but to the practitioner, operating on women with relaxed tissues, and large venous haemorrhoids, and perhaps living at a distance from the operator, I would say operate by the ligature. The best silk is the strong non - absorbent, such as is used in the operation of ovariotomy. No matter how brilliant and pleasant be the results in the large proportion of cases with the clamp, or clamp and cautery, the surgeon may in some unexpected case be caught, and find it difficult if not impossible to stop the haemorrhage. * I do not think/ says Allingham, ‘ in the whole range of surgery there is any procedure worthy the name of “ operation ” which can show a greater amount of success or a smaller death-rate than the ligature of internal haemorrhoids.’ Of 4,013 cases of haemorrhoids ligatured at St. Mark’s