General surgical pathology and therapeutics, in fifty lectures : a text-book for students and physicians / by Theodor Billroth : translated from the fourth German edition with the special permission of the author, by Charles E. Hackley.

Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: General surgical pathology and therapeutics, in fifty lectures : a text-book for students and physicians / by Theodor Billroth : translated from the fourth German edition with the special permission of the author, by Charles E. Hackley. 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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    jaw removed for a malignant tumor, and, during tins difficult and pain- ful operation, she did not once cry out, although several branches of the trifacial nerve were divided. Women generally stand suffering bet- ter and more patiently than men. But the necessary exercise of psychical strength not unfrequeutly causes subsequent fainting, or excessive physical and psychical relaxation, of longer or shorter du- ration. I have seen strong men of powerful will bear severe pain without a grimace, but soon fall to the ground fainting; stUl, as previ- ously stated, I believe that some persons suffer pain much less acutely than others. You vdll certainly meet persons who, without any exer- cise of Avill, show so little pain from severe injury that we can only believe that they really feel pain less acutely than others ; I have ob- served this most in flabby sailors, in whom all the sequelae of the in- jury are also generally very insignificant. The quicker the wound is made, and the sharper the knife, the less the pain; hence, in large and small operations, it has always seemed, and very correctly too, for the advantage of the p^ient, that the incisions should be made with certainty and rapidity, particularly in dividing the sldn. The feeling in the woimd, immediately after its reception, is a pe- culiar burning. It can scarely be termed any thing but the feeling of being wounded ; there are a number of provincialisms for it—in North- ern Germany, for instance, they say the wound smarts. Only when a nerve is comjjressed by something in the wound, twisted or irritated in some way, there are severe neuralgic pains immediately after the injury; if these do not soon cease spontaneously, or after exami- nation of the wound, and removal of the local cause, or, if this is im- possible, or inefficacious, they should be arrested by the exhibition of some internal remedy; otherwise, they will induce and keep up a state of excitement in the patient that may increase to maniacal dehr- ium. To avoid the pain in operations^ we now always use chloroform. The method of administering this article, as well as the prophylaxis and treatment of the dangers that may arise from it, you Avill learn much sooner, and remember better afterward, in the clmic, than if I gave you a prolix account of it here. Local anoisthetics, which have for their object temporary blunting of the pain, in the part to be op- erated on, by application of a mixture of ice and saltpetre, or salt, have been again abandoned, or rather they have never been generally received. Recently, these attempts have again acquired a general interest, as it seemed that a suitable method of local anaesthesia had at last been found. An English physician, HicJiardson, constructed a small apparatus, by which a stream of pure ether [or, better, rhigo-