A clinical lecture delivered to the students of surgery in the Royal Infirmary of Edinburgh, at the conclusion of the winter course for 1827-28. Edinburgh, March 1828 / [George Ballingall].

  • Ballingall George, 1780-1855.
Date:
[1828]
Catalogue details

Licence: Public Domain Mark

Credit: A clinical lecture delivered to the students of surgery in the Royal Infirmary of Edinburgh, at the conclusion of the winter course for 1827-28. Edinburgh, March 1828 / [George Ballingall]. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    presume that inflammatory action would, for a time at least, have been suspended. As young men, who have necessarily much to read and much to learn, it may be well to caution you here against the extremes into which sur- geons have run in estimating the advantages of artificial interference in injuries of the head. “ Look,” says Mr. John Bell, “ into the books of the ancients, and you would believe that every capillary fissure was at- tended with peculiar danger, and that without the most adventurous operations the patient could not live; name me,” says he, “ one absurd or cruel measure—the amputation of large pieces of the scalp—the widening of fissures—the perforating the cranium with many trepans— and opening the dura mater for every idle suspicion or imaginary pur- pose ; name me, any extravagance for which their works do not afford us a precedent.” “ Turn again,” says Mr. Bell, “ to the works of more modern authors, and you would be persuaded that the more violent the fracture the less the danger ; that your patient, though he lie in a deadly stupor with fractures of the skull, or deep wounds of the brain, needs but to lie undisturbed or unassisted to insure his perfect recovery.” Even in very recent times we find the most distinguished surgeons of the day inculcating practices almost diametrically opposite, Mr. Pott, in England, encouraging a use of the trepan almost unlimited, and Desault in France, latterly renouncing it in toto,—his practice apparently becoming enfeebled as his experience increased. Nothing can possibly be more perplexing to students of surgery than such difference of sentiment between authors whose practical habits and extensive experience render it difficult to say which of the two is most worthy of your confidence. Nothing appears to me, Gentlemen, so in- jurious to the profession as sweeping and indiscriminate conclusions of this kind ; when patients are represented as generally or uniformly doing- well under opposite modes of treatment, the public will very shrewdly conjecture that they would do equally well without either. Of the numerous cases of simple fracture amongst my patients which have fallen under your notice during the present course, one patient with fractured ribs, and two with fractures of the extremities, have been at- tacked with delirium tremens, to which the two last mentioned cases fell victims. The first of these, Mary Kidd, aged 55, was admitted on the 2d of January, and her case entered in the Journal as follows : “ The whole of the left upper extremity is ecchymosed and much swollen ; there is a distinct crepitus near the upper end of the humerus, and during the ro-