A retrospect of surgery, January 1886-January 1890 / prepared by Francis J. Shepherd.

  • Shepherd, Francis J. (Francis John), 1851-1929.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A retrospect of surgery, January 1886-January 1890 / prepared by Francis J. Shepherd. Source: Wellcome Collection.

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    prefers his own cautery-puncture, which, he says, is an admir- able method of treatment for large softened glands superficially placed. He also advocates scraping out diseased glands where sinuses exist, and advocates the opening of strumous abscesses and other collections of pus in the glands by cautery-puncture. I cannot agree with Mr. Treves in his remarks on excision of glands of the neck. My colleagues and I, at the Montreal General Hospital, have frequently removed numbers of scrofu- lous glands from the neck with the best results. The patient has always borne the operation well, and has rapidly improved in general health afterwards. We have never had any bad results follow, or any accidents occur during the operarion, although in some cases the dissections were most extensive. Having never employed cautery-puncture, I cannot speak from present experience, but I should fancy that in the treatment of deep-seated glands its use would be much more dangerous than the knife. Treatment of Aneurism hy the introduction of Steel-wire into the Sac,—Last February Dr. Cayley brought before the London Medico Chirurgical Society a case under his care, in which Mr. Hulke had introduced 40 feet of steel wire into the sac of an aortic aneurism, with the result that the portion of tumor acted upon became solidified. Three important points were established by this case : 1, That the introduction of foreign substances into aneurisms is usually easy. 2, That, so far as present experience goes, this proceeding appears to involve very Httle danger when it is carefully carried out. 3, That only nine cases in which this operation has been performed have yet been published, so that our experience of it is far too limited to warrant any con elusion as to its real \a\\xe.—(Lancet, July 17th, '86, p. 120.) In the number of the Lancet above alluded to is a very in- terestino- report of a case of aneurism in St. Bartholomew's Hospita? under the care of Mr. Howard Marsh. The aneurism appeared to be one of the carotid, just as it emerges from the chest. After consultation, distal ligature was proposed and agreed to. Mr. Marsh operated on December 19th, 1885, and tied the carotid on the level of the cricoid cartilage. He divided