Surgical cases and essays / by Rushton Parker.

  • Parker, Rushton, 1847-
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases and essays / by Rushton Parker. Source: Wellcome Collection.

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    and safely rescuing from this imminent danger a robust young man, as follows :— [Medical Times and Gazette, February 4, Case of Strangulated Inguinal Hernia—Reduction en Masse—Autiseptic Herniotomy—F<xcal Fistula Spojitaneously Healed. Richard J , aged twenty, admitted August 22, 1879. The patient, a farmer from Knowsley, had had a right inguinal hernia for three years, but had not worn a truss. The hernia had never given trouble until a month previously, when there had been difficulty in reducing it himself. On August 21, 1879, after a stool, he failed to reduce the hernia again, and having abdominal pains, went to bed and sent for a medical man, who also failed. The next day vomiting occurred several times, and, under chloroform, taxis once more proving unsuccessful, he was sent to the Liverpool Infirmary, where taxis under chloroform was a second time unsuccessful. Mr. Parker was sent for at ten the same night. There was now no vomiting, no abdominal distension, slight tenderness, little or no pain, but some uneasiness. A soft swelling in the scrotum seemed to have slight impulse on coughing, but was dull on percussion, and undiminished on gentle manipulation. Although something had been reduced, the House Surgeons were not satisfied that all was fairly back ; so, in spite of the absence of symptoms, the history, and the request of his medical man that the Surgeon on duty should see him that night, were responded to by immediate herniotomy under carbolic acid spray. The 9ac was opened at once, and nothing but blood-stf ined clear fluid found in the scrotum. On searching upwards, and pulling down the neck, bowel was found constricted at the internal ring, and lying within the abdomen before being drawn down. The neck was held with the forefinger-nail and nicked with the tip of a blunt-pointed knife, and the bowel gently examined. This was found to be small intestine, moderately congested, slightly ecchymosed, but shining; and it was reduced. A superficial catgut drain was put in, and another laid from the internal ring to the lower corner of the wound, and then sutures. Wet boraic lint dressings were used. Wind passed the next day, and every day afterwards. The bowels were first moved twelve days after the operation, for the first half of which time nothing but beef-tea and a few doses of sulphate of morphia were ordered. Bread was added on the sixth day. No bowel symptoms, or any other symptoms, occurred, and