The radical cure of hernia : embracing a description of the disease, its varieties, peculiar conditions, causes, symptoms, dangers, treatment and permanent cure : together with a history of trusses, and an examination into the various kinds in general use : with a deduction of new principles, and a description of a new instrument recently invented for a radical cure / by A.W. Patterson.

  • Patterson, A. W. (Andrew W.)
Date:
1849
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Licence: Public Domain Mark

Credit: The radical cure of hernia : embracing a description of the disease, its varieties, peculiar conditions, causes, symptoms, dangers, treatment and permanent cure : together with a history of trusses, and an examination into the various kinds in general use : with a deduction of new principles, and a description of a new instrument recently invented for a radical cure / by A.W. Patterson. 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.)

    17/36
    CHAPTER XIII. AN EXAMINATION INTO THE VARIOUS KINDS OF TRUSSES IN GENERAL USE. \ Dukimi several years general practice as a physician, cases of hernia not unfrequently occurred to j us, as they do to all so engaged; and on account of the difficulties labored under by the Profession j for want of a good instrument, our attention was directed to the subject; and we accordingly deter- i mined to take it up and investigate it. In the first place, the various kinds of trusses in general u»e, ) were to be examined; and a line of distinction drawn between their merits and defects, that we ^ might know in what part of the construction an improvement might be attempted. To this, we, ) therefore, proceeded. And soon a motley many had we around us. Our litlle professional domicil became a truss store to appearance. Here were some with back-pads, and there some with front-pads only. Some with tliis kind of construction, and some with that kind;—as multifarious and d as the oontei ora's box; and perhaps many a patient has declared, possessed of as many plagues, Sorely the idea of adding another to the list, held out no flattering promise, espe- cially while we yet had no conception of what it might be. Although the want of an improved one became, to appearance, doubly urgent. En masse, the whole collection before us seemed to divide off into two grand olasse i namely, son pads and hakd tads. Under these two heads, we accord- ingly look them up, and briefly found them, as follows: SOFT FADS. Defects. I. They will not make a perfect retention.—The first thing indispensable in every truss. The pad being large, is generally more or less intended to rest on the pubic bone, and by virtue of pressure there, prevent the descent of the hernia. Therefore, though the bowel may not descend .my lower, it is nevertheless, scarcely in any instance, at the same time perfectly retained in the abdomen. If it. does not indeed remain in part in the inguinal canal, it is almost certain, in less or greater amount, to he found in the internal abdominal ring, or orifice of escape, if it should be lower; as in the Direct or Ventro form. Which, generally being the case, there can of course be no perfect retention. And when the hernia is of the Femoral variety, the adaptation of the instrument is still worse, and necessarily the retention still more imperfect. II. The Spermatic cord is more or less injured.—The continued pressure it receives, being S constantly pressed against the pubic bone, must inflict this in greater or less amount. For it matters ) not, though the pad is soft, it will have this effect. ■ III. The Soft Pad, as such, is defective.—Being soft, it soon looses its shape, speedily wears I out, absorbs the fluids of the body, an.I beside I oining offensive, produces a heated, sweltering, i w eakening effect, which, in addition to the severe pressure, must inflict a doubly injured, crippled state < of the part. s IV. They seldom, /J Radical Cure.—The process under which the part must go, to I arrive at a radical cure, is only instituted by a pad of the hardest material. The only instances / wherein a cure of this kind may be effected under the use of soft pads, may be said to be in the very young subject. But in snoh instances it cannot even be said to be by virtue of the Soft Pad. It is ] known, that a simple bandage would effect the same, if properly applied and worn. The part I strengthening by the rapid growth of the infant, becomes secure, and the hernia permanently retained, I and thus radically cured. These, then, are the defects of Soft Pa.ls in general. And the question ! mav have alrca.lv arisen—have they any merits at all? We answer, they have but one. * M«R1T.—Theu have ease, compared with the opposite class.—But they have not by any means I entire ease The injuries and severities before mentioned, are anything but ease; yet it is com- ! paratively such, when contrasted with the effects of the others. Soft Pad-, therefore, as a class, are i found to possess four PROMINENT defects, and but one imperfect merit. HAKD TADS. ( Defects I They likewise will not make a perfect retention—Their entire construction is i such, as will'not accomplish it; though the material of the pad is better calculated for that purpose. X H They wiU hue:, ,,, every sens I, often causing contusion and injury, not only * of the groin and spermatic, but femoral vessels; producing numbness, and even palsy of the \ {ov.(r -This is all occasioned by the hard unyielding pad, acted upon by a powerlul 1 sprin. These constitute the sum of defects. Merits I T »itt cr« radically.-Tbis, as will be seen, is effected variously, but by defined processes, though only capable of being instituted by a Hard Pad. \ „ ■;.;,,,„ ir;,! reta.n thei ■> cool and clean, and not become offensice.-Becnose \ *•-*! ,W,.-Their surface being unyielding, of course does not perm,, the rupture to channel its WUJ Ughit,as,l tends to ,«, on, underneath, and thereby .. retentive in their properties. 'I I spported by a decision to hat eflect, of the PhiladeLia Medical Society, published in the American Journal, for December, 1835. '.,.,.,., . perhaps, more than counter-balanced l,y (be « nous urged against them.