The topical uses of water in surgery : presented to the American Medical Association at its session of May, 1852 / by Charles A. Pope.

  • Pope, Charles A. (Charles Alexander), 1818-1870.
Date:
1852
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Licence: Public Domain Mark

Credit: The topical uses of water in surgery : presented to the American Medical Association at its session of May, 1852 / by Charles A. Pope. 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.)

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    established, but far oftener to prevent its accession, when likely to follow previous injuries. With this view are they especially used 1. In wounds. The more important the organ injured, the more we should strive to ward off inflammation, and consequently the more urgently are cold applications indicated. In wounds of the head, of the external soft parts, as well as of the cranium and brain, in wounds of the chest and abdomen, either penetrating. or not, and, lastly, in wounds of the extremities, cold water is a chief remedy, and should never, unless for major reasons, be neglected. Its beneficial effects are most marked in incised wounds, as amputations and the like, where we wish union by the first intention. This important and generally desirable process is not in the least hindered, but on the contrary is often promoted by the judicious use of refrigerants. In lesions im- plicating joints (especially the knee) and peri-tendinous sheaths, no other application is superior, although we should not neglect venesec- tion, and other means of cure. Did it comport with the plan of the present paper, we might cite many striking cases in illustration of the great benefit of cold applications. In contused, lacerated, and gunshot wounds, they are no less ser- viceable. Here it is true that a certain amount of inflammation must follow, nor is it intended, as some suppose, altogether to prevent its occurrence. We aim simply to moderate and restrain, not to prevent or absolutely control. In the first period of gunshot wounds—that of shock—cold applications ought, for obvious reasons, to be withheld. As this state passes off, they should, however, be sedulously made. While, on the one hand, there is but little doubt that in many a grave gunshot, or other injury, were the treatment by continuous irriga- tion or immersion in cold water, amputation might often be pre- vented, and thus both life and limb saved; on the other, in those com- minuted fractures, with division of large bloodvessels and nerves, and other serious disorder, we should not indulge the vain hope of saving by water or any other treatment, that which it would be both safer and more useful to remove. As to the length of time required for applying cold water, it will depend evidently on the circumstances of the case; a few days being sometimes sufficient, while in others a month or more is necessary. Instances are given in which the applications have been continued for three months. It is important to remember that, when from any cause it may be deemed advisable to discontinue the application, it should not be done suddenly, but gradually, and by the substitution of water of a more and more elevated temperature. By this means