Commentaries on the surgery of the war in Portugal, Spain, France, and the Netherlands : from the battle of Roliça, in 1808, to that of Waterloo, in 1815, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate. Revised to 1853 / by G.J. Guthrie.

  • Guthrie, G. J. (George James), 1785-1856.
Date:
1853
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image
    61. The practical points are, to draw blood to a sufficient extent, but with caution, on the accession of fever; to open out the stump as soon as possible, even by a division of the external adhesions, the inner parts being usually unsound; to envelope it in a large warm poultice; to apply cold above— even ice if procurable—in the course of the great vessels, and to soothe the system by calomel, opium, and saline diaphoretic remedies, followed by stimulants, cordials, quinine, and acids. Private A. Clarke, 79th Regt., had his thigh broken by a musket-ball a little above the knee-joint, at "Waterloo, and was admitted into the clinical ward of the York Hospital, in Lon- don, in Nov. 1816. The bone being in a state of necrosis, Mr. Guthrie amputated the thigh high up, on the 20th of Jan. 1817. Pulse before and after the operation 104. On the 25th, pulse 120; skin cool; tongue moist; appeared weak and irritable. During the 26th and 27th, symptoms of low fever came on. 28th, suffered severely from vomiting, general fever, greater prostration of strength; stump had not united, but discharged good pus. 30th, skin assumed a yellow tinge. On the 1st of February, had a rigor resembling a fit of ague, and Mr. Guthrie declared his suspicion of the formation of matter, probably in the liver, and of the inflammation of the veins of the stump. The symptoms gradually assumed the character of typhus gravior, and on the 8th he died. On dis- section the liver was found enlarged, and weighing six pounds; the other viscera were sound. On examining the stump an abscess containing four ounces of good pus was found in the under part, near the bone. The femoral vein and those going to that part of the stump were inflamed, and contained coagu- lated blood, lymph, and purulent matter, the disease extend- ing from the femoral to the vena cava. The rigors on the 1st Feb. marked the formation of matter, the typhoid symptoms its continuance, and the inflammation of the veins. Union was discouraged from the first dressing. The following case is so highly instructive on all points, that it is transcribed from the London Medical and PhysicalJournal for 1826:— Jane Strangemore, aged twenty-eight, was admitted into the "Westminster Hospital, Sept. 24, 1823, with an elastic swelling of the whole of the knee-joint, measuring twenty-seven inches
    No text description is available for this image