Lectures on the principles and practice of surgery, as delivered in the theatre of St. Thomas's Hospital / By Sir Astley Cooper.

  • Cooper, Astley, Sir, 1768-1841.
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the principles and practice of surgery, as delivered in the theatre of St. Thomas's Hospital / By Sir Astley Cooper. Source: Wellcome Collection.

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    the periosteum, and spiculae of bone afterwards shoot into it. The fungous exostosis is rather a nest of bone enveloping the fungus than constituting the fungus itself. It grows from the medullary membrane. In the treatment of the fungous exos- tosis nothing can be done but to palliate; the growth will proceed in spite of local and constitutional remedies. Where the exostosis are cartilaginous, growing from the periosteum, they cease to increase beyond a certain extent, and usually form at the insertion of tendons into bone, as at the insertion of the triceps abductor magnus. You should make an inci- sion through the integuments, cut through the muscle in the direction of its fibres, and having reached the top of the ex- ostosis, you find the knife easily sinks into it, from it being still partly cartilaginous. Then slit down the muscle on each side, and apply the circular saw, invented by Mr. Machim, which is worked by a w'inch in the handle. When the exos- tosis arises from the cancellated structure of the flat bones, an idea suggested itself to me that it might be removed in the following way ; by making an incision through the peri- osteum covering the tumour, and then separate it further with the handle of the knife on each side, the exostosis is gradu- ally discharged by a suppurative process. But do not attempt this where the exostosis is excessively large ; but it may be done with safety if it be not more than three or four inches in circumference. MoUites ossium is an affection of which we know very little. There appears to he a defect in the assimilating ])owers of the system, whereby the proper portion of phos- phate of lime is not deposited ; whereas, in rickets, there is an excess of cartilaginous material. What is often called mollites ossium, is only rickets, and should be treated accord- ingly. Of Fmpotencf,. Although this affection has been arranged in the syllabus with the sequelae of gonorrhoea, yet I consider it a point of importance for you to become acquainted with, and shall speak therefore of the causes usually producing it. There are several causes which produce a destruction of the virile power. These may sometimes be traced to a peculiar slug- gishness of constitution, to a general toipor of the procrea- tive system, on which the usually attractive animal affinities exert no influence. I’o such persons a Venus might display her charms, and on such her son might exhaust his quiver in vain. No genial spring is here, no blooming summer or fruitful autumn, but all is winter—a dreary, desolate, and barren winter—in which the springs of life are frozen up.