Historical notices on the occurance of inflammatory affections of the internal organs after external injuries and surgical operations / by William Thomson, M.D.

  • Thomson, William, 1802-1852.
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: Historical notices on the occurance of inflammatory affections of the internal organs after external injuries and surgical operations / by William Thomson, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    teriorated ; blisters are employed, perhaps blood-letting, but gene- rally in vain ; and the patient dies in a few hours as in the last stage of inflammation of the lungs, in which effusion or suppuration has taken place. The first cases I saw of this kind, continues Mr. Guthrie, I believed to arise from the action of external causes after the operation; but I now believe it to depend upon a determi- nation to, or irritation in, a particular part, in consequence of the operation, and I conceive the viscera in each person most pre- disposed to disease will be the most likely to be affected. Mr. Guthrie refers to Mr. Rose, at that time Surgeon of the Guards, and to Mr. Boutflower, Surgeon to the Forces, as having made observations similar to his own relative to the occurrence of inflammatory affections of the chest, subsequently to amputation. When the viscus affected is not so immediately concerned in supporting life as the lungs, I do not believe the termination is so rapid: it runs into suppuration, and abscesses are formed, which are generally supposed to arise from the commotion and shock given to the different organs at the moment of injury. I know that inflammation taking place in one part of the body, when the injury has been deceived in another, has been often noticed ; and that this also happens in gunshot wounds, there can be no doubt, but it is by no means a common occurrence. Besides referring to a case related by Baron Larrey, Mr. Guthrie has re- lated a case of compound fracture of the thigh, in which Dr. Cherm- side of the 10th Hussars, performed amputation five weeks after the injury, when the man was in a very reduced state with profuse dis- charge, great pain, and severe hectic fever. On the third day after the operation, the stump being easy, he complained of difficulty of swallowing, and a little pain in the situation of the thyroid gland, which, the°next morning, was found to be swelled and inflamed. On the third day after the affection of the throat, the difficulty in deglutition increased, accompanied by some obstruction in respira- tion, and on the morning of the fourth he died, seven days after the operation, and in a state of great emaciation. On dissection, the whole substance of the thyroid gland was found destroyed, and crood purulent matter deposited in its place, which descended by The sides of the trachea and oesophagus to the sternum, and had all but found its way into the larynx, between the cricoid and thyroid cartilages on the right side. The surrounding parts were but slightly injured, and could be readily dissected. Mr Guthrie has related another case of secondary amputation, in consequence of a gunshot wound penetrating the knee-joint, in which death occurred nearly two months after the operation, and in which he found, on raising the soleus muscles of the opposite limb which appeared perfectly sound, and of which he had never complained, for considerable attention was paid to him, a membra- nous bag containing a fluid in the course of the tibialis posticus muscle and close to the interosseous ligament. « I punctured this shining, semitransparent bag, which appeared to be the fascia run-