Operative versus therapeutic treatment of strumous cervical glands / by Bertram Thornton.

  • Thornton, Bertram.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Operative versus therapeutic treatment of strumous cervical glands / by Bertram Thornton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Often I have seen glands that have defied all treat- ment for several months in London and the Provinces, yield to the unaided influence of “ change to the sea- side,” without a drop of medicine, or any local treat- ment. It is my impression that this favourable result can only happen in “ simple hypertrophy ” of glands, but how to distinguish this condition from glands in which tubercle is deposited, or in which caseous degen- eration or pus exists I am not able to point out. Tem- perature is an untrustworthy guide, for over and over again I have seen cases with a continuous normal temperature in which many of the glands were full of pus. Palpation is equally unsatisfactory, either as regards positive or negative evidence. The only criteria as to permanent enlargement and disablement of glands appear to me to be positive indications of the presence of pus, or the continuous enlargement of any gland or glands for more than six or eight months. The period mentioned must necessarily be arbitrary and elastic, some glands are permanently damaged in as many days; but few cases that have existed without temporary diminution in size for six or eight months ever resume their normal condition, and even if they do not immediately break down they are a constant source of weakness to a patient, and will probably suppurate at any time when his condition is brought low by illness or want of tone. The surgeon having in due time, and after due consideration satisfied himself that the glands are permanently diseased, the debateable subject of