The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton.

  • Morton, Thomas, 1813-1849.
Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of inguinal herniæ, the testis and its coverings / by Thomas Morton. Source: Wellcome Collection.

Provider: This material has been provided by Kings College London. The original may be consulted at Kings College London.

    138/162 (page 328)
    'I’lie treatment wliich is proper to be pursued in tliese cases consists chiefly in making free incisions through the integuments and fasciae wliich confine the effused fluid ; taking care after- wards that too much blood is not lost from any of the vessels that may chance to be divided. If the bladder should be dis- tended, a catheter ought to be introduced, but this is not neces- sary when the urine flows freely through the -wound, until the reparative process is commenced. Hannalocele. — Two varieties of this affection are usually recognised in the schools; in one of which the blood, that is effused, escapes into the loose cellular tissue of the scrotum, giving rise to a general and diffused swelling of the part, accompanied by an evident ecchymosis ; whilst in the other, — Avhich is the only form of the disease recognised by some surgeons,—the blood is collected in one mass within the cavity of the tunica vaginalis of the testicle. The treatment of the first case does not differ in any essential respect from that which is adopted in ecchymoses of other parts of the body, for it usually disappears by degrees when the parts are kept at rest, combined with the use of purgative medicines, and the local application of discutient lotions. If, however, in an aggravated case of this nature inflammation should occur in spite of these means, and be followed by suppuration, then a free incision should be made to permit the easy escape of any matter or sloughs that may be formed.*f* The second case, or that in Avhich the blood is contained within the cavity of the tunica vaginalis, is not unfrequently the consequence of hydrocele, upon which it may supervene with- second about a year after the first. On each occasion the complaint was at first treated as an inflammation of the testicle, by leeches and purgative me- dicine ; and his life only saved by going into the hospital, where he was re- lieved by free incisions, the cicatrices of which are still to be observed upon the scrotum and perinaeum. On account of the thickened and condensed state of the parts consequent upon the destruction of the tissues of the scrotum at the time of the former attacks, the present effusion was neither so rapid or so extensive as it other- wise would have been; but, as it was, the man was restored to health with great difficulty. For a strange misapprehension in case of rupture of the urethra, see Sur- gical Observations, by Sir Charles Bell, Part V. p. 25. t Vide the Surgical Anatomy of the Pennaeuni, p. 69.