Hunterian reminiscences; being the substance of a course of lectures on the principles and practice of surgery, delivered by ... J. Hunter, in the year 1785 / taken in short-hand, and afterwards fairly transcribed by ... James Parkinson ... Edited by his son, J.W.K. Parkinson ..., by whom are appended illustrative notes.

Date:
1833
Catalogue details

Licence: Public Domain Mark

Credit: Hunterian reminiscences; being the substance of a course of lectures on the principles and practice of surgery, delivered by ... J. Hunter, in the year 1785 / taken in short-hand, and afterwards fairly transcribed by ... James Parkinson ... Edited by his son, J.W.K. Parkinson ..., by whom are appended illustrative notes. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    From an obliteration of the ducts of the glands of the lips, a circumscribed tumour is formed on the inside of the lips. From an obliteration of the ducts of Cowper’s glands I have seen a very large tumour formed at the entrance of the vagina : T once saw one very large, which had been mis- taken for a rupture : both in this and the former case an opening should be made as early as possible and as nearly as possible to the former opening of the duct: this should be either a crucial incision or a round opening made with caustic, which may serve in future for an artificial duct.. Duct of the Parotid Gland.—When obliterated, a needle and thread may be passed through the cheek and kept in as a seton until the wound has become fistulous ; then the wound may be refreshed externally and healed. The second kind of fistula is from disease, or is a deep-seated wound where there is a disproportion to heal between the two extremes of the wound. The causes of this kind of fistula may be, first, unfavourableness of the opening of the previous abscess, allow- ing part of the matter to remain, which by its pressure may produce a backwardness to heal; secondly, backwardness to heal, arising from parts which naturally are backward of healing, or from parts which are become so by disease, [t is not the matter lying between the sides of the wound which prevents its uniting; for if this were the case, it might prevent every wound from healing. Fistula in Ano.—Encysted tumours sometimes are formed near the anus, and may be distinguished from the more common abscess by the tumour having so long preceded the inflammation and ulceration. The not healing of fistula I apprehend to arise from the sympathy of the sound part with a diseased part deeper seated, stimulating it so as to frustrate any endeavours it may make to heal : the disease may, for instance, be in the prostate gland, and the wound at a distance in the urethra ; and then this will not heal. But if a person is cut for the stone, here is a wound in the urethra and another higher up in the bladder ; but the wound in the urethra will heal, because it does not receive the stimulus of disease in a deeper seated part: this is one proof that the constant discharge of matter through it is not the cause of the fistula remaining. Besides, supposing several sinuses, all reaching to the same diseased bottom, and proceeding therefrom : let but one of these be opened to that bottom, so as fully to expose it, and they may all heal. In removing the oblitera- tion or obstruction of the urethra, a bougie may produce a similar irritation with a dis- eased bottom, a circumstance which should be attended to. A diseased bottom, I have before observed, might have many fistulous sores leading to it; and that if one of these be laid open, so as to give a healthy disposition to the bottom of the wound, all the sinuses will heal. Now this must be a proof that the opi- nion I have advanced is true, viz. that the bottom of the wound being diseased is the cause of the fistulse, and that the cause of thefistulae is not to be found in the fistulous wounds themselves : for that, were this disease at the bottom, be it what it may, removed, it is my opinion that these fistulae would generally directly heal. The cure must,