Institutes and practice of surgery: being outlines of a course of lectures (Volume 1).

  • Gibson, William, 1788-1868.
Date:
1845
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Licence: Public Domain Mark

Credit: Institutes and practice of surgery: being outlines of a course of lectures (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    TREATMENT OF INFLAMMATION. In every inflammation, the first object of the surgeon should be to procure resolution; and this may often be accomplished by removing the exciting causes of the disease. Two classes of remedies may be resorted to—constitutional and local. Among the former, are blood-letting, purgatives, diaphoretics, and low diet. Among the latter, topical blood-letting, blisters, and other exter- nal applications, as well as rest and position. General blood-letting .need only be employed where the in- flammation is high and attended with disturbance of the system. The quantity to be drawn will depend upon the violence of the disease and the constitution of the patient. Much will depend, also, upon the part in which the disease is seated. Vital parts suffer more readily than others, from depression being induced; but all vital parts are not equally liable to suffer. A good general rule to observe in' all inflammations of the vital organs, is to repeat blood-letting frequently, and to draw only a small portion at a time. In this way depression will be obviated. With respect to the continuance or omission of blood-letting, the pulse will, generally, be found a good guide. If it be»full and hard and frequent, and rise after the operation, a repetition •may, perhaps, be necessary. There are particular states of the pulse which may lead into error—especially the oppressed pulse.* The existence or absence, of the buffy-coat will, in many instances, direct us to continue or lay aside blood-letting. Its presence, however, is not always a sure indication of in- flammatory action; and, on the other hand, very severe inflam- mations, occasionally occur, without any appearance of the buffy-coat. Perhaps the most certain indication of the presence of inflammation is the continuance of pain; and so long as this remains severe, we can scarcely go wrong in the detraction of blood. Purgatives and diaphoretics, are very useful auxiliaries to the lancet. The best remedies of the kind are such as produce nausea. The warm bath will, in particular cases, be found ex- tremely serviceable. But, in using it, strict attention should be paid to the degree of temperature. * See Rush's Works.