On rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / delivered at the Royal College of Surgeons of England in the years 1860, 1861, and 1862 by John Hilton.

  • Hilton, John, 1804-1878.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: On rest and pain : a course of lectures on the influence of mechanical and physiological rest in the treatment of accidents and surgical diseases, and the diagnostic value of pain / delivered at the Royal College of Surgeons of England in the years 1860, 1861, and 1862 by John Hilton. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    several times without the splint, and could bear his weight upon the limb without pain. Here, then, was a scrofulous constitution, but there is no evidence of tubercular deposit in the bones, and the repair is good. This case is also very encouraging to the pursuance of a persevering plan of treatment by rest. The medical treatment of the case was very simple. Whilst the boy was suffering from a febrile condition, he took the ordinary fever medicines, and subsequently we gave him for a short time a small quan- tity of bichloride of mercury with sarsaparilla, and after that cod-liver oil and steel wine, securing at the same time rest to the hip-joint. Absorp- tion of the abscess was proceeding in this case. The remains of the abscess were found in the form of a small quantity of sero-purulent fluid and a layer of semi-solid deposit upon the floor of the contracted abscess- cavity. This cavity communicated, by a very narrow, tortuous canal, scarcely larger than a probe, with the parts surrounding the joint, but we could not detect its exact termination. Several of the cases of hip disease which I have related occurred some time ago, and I selected them for the purpose of showing that they did wTell, and have since done well, the patients being alive and in good health, with the exception of the one whose anchylosed hip-joint I have placed before you. I will now direct your attention to three other cases of hip-joint disease formerly under my care in the hospital, and from which sketches were taken. I think you will perceive they give some important evidence of the value of rest in the treatment of such cases. Diseased Hip-joint; lAmb much bent; straightened under the influence of Chloroform y Splint applied; cured by Rest. The first case is that of a little girl aged seven. She was admitted into the hospital under my care in June, 1860, with rather acute disease of the left hip-joint, and in very bad health. Three years ago she fell down-stairs, and was supposed to have hurt her hip ; she had been more or less lame and in pain ever since. By irregular rest Fig. 70. and quiet, and get- ting about upon crutches, she was, after some time, recovering, when she was knocked down by accident. This was followed by pain in the hip. She then became an out-patient at St. Thomas's Hospital during three months, and at Guy's during nine months, without any benefit. When admitted into Guy's, in June, 1860, she had all the indications, local and general, of severe hip-joint disease, with deep suppuration in the anterior, upper, and outer part of the thigh. The limb was flexed and adducted; the patient was suffering great pain in the hip, had little sleep at night, and little or no appetite. Chloroform was administered, and the contracted muscles of the joint yielded steadily and nicely to carefully applied extension. The flexed limb was made straight, and a long common iron splint (Fig. 70) applied along its outer side, extending from near the axilla to the foot, with a transverse bar to prevent rotation; the recumbent and supine positions to be strictly maintained. Immediately after the application of