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.)

    9/32
    M. Quesnay, in his Observations sur le Trepan dans les ces douteux (contained in the first volume of the Memoirs of the Academy of Surgery,) has related one case of injury of the head in which an abscess formed in the liver (p. 322, 12mo. edition). In this case there occurred hemorrhage from the nose and ears, on account of which very active blood-letting was practised. On the seventh day, the patient was seized with bilious vomiting and fever, but this diminished under the repetition of venesection. On the eleventh day, in consequence of great pain of head, deep, but inter- rupted stupor, and irregular shiverings, the trepan was applied and a spoonful of blood, extravasated below the dura mater, was evacuated. Repeated venesection (once from the foot) was prac- tised; but pungent pain in the right hypochondrium supervened, and fever followed by irregular shiverings, which led to the suspi- cion of abscess of the liver. The patient fell into a state of lethar- gic stupor, and died on the seventeenth day. An abscess was found in the substance of the large lobe of the liver. In the sixth volume of Richter's Chirurgische Bibliothek, (1782, p. 722,) is related a case of abscess of the liver, supervening to a wound of the head, by Dr. Michaelis of New York. In this case, the operation of trepan was performed on the nineteenth day after the reception of the injury, the patient having followed his usual oc- cupations during most of the intervening time, notwithstanding vio- lent pains below the seat of the injury. A portion of the inner table of the skull was found detached and lying on the dura mater, for the removal of which and other splinters, the trepan was repeatedly applied. On the eleventh day after the operation, he had an attack of tertian fever, which yielded, within fourteen days, to the ordi- nary means. In the fifth week, he was seized with a stitch in the side, which was removed by bleeding and blistering. But in the sixth week, a painful swelling in the region of the liver showed itself, soon followed by fluctuation. On this swelling being opened, more than a pint of purulent matter was discharged. Nothing re- markable occurred in the progress of cure. I do not find that Mr. Pott, in his Observations on the Nature and consequences of those Injuries to which the Head is liable from external violence, nor Mr. Abernethy, in his Surgical Observa- tions on Injuries of the Head, make any allusion to the occurrence of abscesses of the liver. Their dissections, indeed, never extend bevond the cranium. In Some Histories of Wounds of the Head bv John Williams of Redruth in Cornwall, (Falmouth 1765,) there seems to be no mention of hepatic symptoms or affections, and Mr. Samuel Cooper in his First Lines, (i. 397,) after referring to cas^s of this kind recorded by foreign surgeons, remarks, that -inflammation and abscesses of the liver, in consequence of injuries of the head, have not been so often noticed in this ;°HavL sufficiently established, by a reference to authorities, the fact, that the liver frequently inflames and suppurates in cases 2*