Clinical lectures: on scrofulous neck, by T.C. Allbutt; and on the surgery of scrofulous glands / / by T.P. Teale.

  • Allbutt, T. Clifford (Thomas Clifford), 1836-1925.
Date:
1885
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Licence: Public Domain Mark

Credit: Clinical lectures: on scrofulous neck, by T.C. Allbutt; and on the surgery of scrofulous glands / / by T.P. Teale. Source: Wellcome Collection.

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

    19/56 (page 15)
    skin warms, reddens, and fluctuates, then to make a clean incision, permit simple evacuation of the present matter, but not to squeeze, nor even press, the surrounding parts. We are to wait until a new area of softening be obvious, then repeat the process, and so on. Now, gentlemen, this is palliative surgery, but it is not curative surgery. It scarcely alleviates the cause of the disease ; indeed, it does little more than substitute a fine and clean for a foul cicatrix. My proposal is a curative surgery, and it is now founded upon a wide basis of successful instances. It so happened that some of my earlier cases were referred by their friends to Mr. Teale, and consequently he and I so thoroughly discussed the matter together, that we found it convenient to work together in like cases, though I need scarcely say that others of my colleagues would have led me forward with a like ability; so it was, however, that we fell together on the matter, and continued to co-operate.* My purpose, and the purpose of the surgeon, whoever he may be who holds my views, is radically to extirpate every caseous gland or portion of gland, and so quench promptly the smouldering fire. At first, we naturally had for our patients only those sufferers whose endurance was exhausted, and who willingly accepted any way, however doubtful, out of their sufferings. Gaining courage, however, by bur success even in the worst cases, we are advising the radical operation more and more, until, I may now mention it as one of our best means from the moment that caseation, however limited, is manifest. Recent instances lead me to hope that if such a practice become universal, scrofulous neck and all the hectic, asthenia, emaciation, and phthisical risks which belong to it will become matters of history. It is needless to say that the surgical procedure does not do away with the value of sea climates, good food and * I do not for a moment pretend that eradication of scrofulous mischief in the neck by the knife and scoop is an original idea of my own. It occurred to me independently, as it doubtless occurred to many other physicians. I believe, however, that the idea has never been worked out so completely, nor in so many cases, as by Mr. Teale. Indeed, on hastily turning up the subject with the aid of “Neale’s Digest” and “Virchow’s Jahresbericht,” I am surprised to find how little has been done by others on the same lines.