Surgical diseases of infants and children / by P. Guersant ; translated from the French by Richard J. Dunglison.

  • Guersant, P. (Paul Louis Benoit), 1800-1869.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Surgical diseases of infants and children / by P. Guersant ; translated from the French by Richard J. Dunglison. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    PERFORMANCE OF THE OPERATION. instance, we lost fronn convulsions, also after excision of the ton- sils, a child subject to that nervous affection, on whom we had verv frequently practised cauterization of those glands for the cure of the hypertrophy of which they were the seat. We may also add that preparation of the young patient is some- times indispensable from the very nature of the operation to be performed upon him. When, for example, we are about to estab- lish an anus in an imperforate rectum, we must first empty the bladder; when we are about to perform lithotomy, we must evacuate the rectum. In all operations, we should take care that digestion is properly accomplished, and that the bowels are freely opened. So far as the moral preparation of the patient is concerned, we are not usually required to interfere. Those, however, who are old enough to listen to reason should be brought to the operation by explanation of its necessity, and be made to understand, that if they suffer pain, it is with the view of curing them. But the ma- jority of children should be operated on by surprise. In every case it is indispensable that the surgeon should be surrounded with assistants capable of exerting a firm hold on the patient, and of displaying a force proportioned to that of the child. Some- times, even in a simple examination of the case, in inspecting the throat especially, we must act promptly and by surprise, boldly carrying the tongue-depressor over the base of the organ. Some- times, if we propose to administer chloroform, it will be necessary to attempt its use before the day of the operation. 2. Performance of the Operation.—In quite a large number of sur- gical cases, we can dispense with the use of anaesthetics. We gen- erally operate without chloroform in opening abscesses, in sounding the bladder, and in touching the rectum and removing a small polypus from that region. There are some operations, indeed, in which we should absolutely reject the use of that agent; those, for instance, performed on very nervous and excitable patients. In some cases, too, we may resort to local aneesthesia by means of chloroform, or, what is still better, of ice applied for a certain time on the point selected for operation. There are other opera- tions, again, in which anaesthetics are wholly inadmissible, such as excision of the tonsils, tracheotomy, etc. There is a very large number of Cases in which the use of chlo-