Volume 1

The cyclopedia of practical surgery, including an etymological and critical terminology; detailed descriptions of instruments and apparatus; a copius bibliography; and an historical view of the progress of the science to the present day: ... a complete digest, alphabetically distributed, of the doctrines and practice of surgery / conducted by William B. Costello ; assisted by numerous distinguished writers ; illustrated with numerous engravings and wood-cuts.

Date:
1841-
Catalogue details

Licence: Public Domain Mark

Credit: The cyclopedia of practical surgery, including an etymological and critical terminology; detailed descriptions of instruments and apparatus; a copius bibliography; and an historical view of the progress of the science to the present day: ... a complete digest, alphabetically distributed, of the doctrines and practice of surgery / conducted by William B. Costello ; assisted by numerous distinguished writers ; illustrated with numerous engravings and wood-cuts. Source: Wellcome Collection.

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    less, an arduous, often an anxious one, de- manding, as it does, on his part, a ready, almost an intuitive familiarity with its nume- rous and diversified complications. The na- ture and bearing of the local symptoms can only be determined by information, precise and circumstantial in regard to their history, and by exploration of the other organs which may participate in the disease either as cause or effect. When our information on these points is complete, we may form our prognosis in the commencement or early stages of the disease with some assurance. Thus, the acute cys- titis arising from a wound, a blow, or a fall, will vary in its local symptoms according to the situation and function of the part in- jured. If the inflammation interests but the mucous membrane only, the prominent symp- toms will be the painful and frequent micturi- tion, with more or less abundant mucous de- posit. If the attack has followed a fit of gout or rheumatism, and invades the muscular structure, the symptoms will be retention of urine, with deep-seated and severe pain in the region of the bladder. If the affection is circumscribed within the region of the neck of the viscus, and extends to the urethra and prostate, it is ushered in with sharp rigor, and malaise, followed by fever, with frequent pulse, hot and dry skin, inappetency, and sleeplessness. Sometimes the perspiration after the hot stage is abundant, at other times but inconsiderable or partial. If the attack take place on the part of the bladder covered by the peritoneum, pressure upon it causes intense pain, it feels hard and like a ridge to the touch, but the excretion of the urine is not particularly painful, though it may be frequent. In the more advanced stages, when the inflammation has invaded all the tissues together, the power of making any distinction in reference to origin or situation is, of course, out of the question. Under such circum- stances all the symptoms are aggravated, the rigors succeed each other, the pulse becomes accelerated, tremulous, and intermittent, the skin dry and hot, the tongue brown and glassy, the patient is agitated and anxious, and wan- ders from time to time, though his conscious- ness remains; the urine muco-purulent, floc- culent, scanty in quantity and of a most offen- sive odour; the abdomen is swelled, and painful to the touch, especially in the hypogastric region, and hiccough supervenes, with cada- veric features, low delirium, and death. Treatment.—In acute cystitis, particularly in the young and robust, prompt and vigorous measures are imperatively required ; bleeding at the arm or in the foot, and repeated accord- ing to necessity, with leeching in the peri- neum, anus, and hypogastriurn, or cupping in these situations, or over the loins, constitute the resources of the first order. To these, the warm bath, emollient fomentations, and mild enemas should come in aid ; and reten- tion of urine, if present, should be relieved by the catheter. Internally, calomel and opium should be administered in doses of two or three grains every two or three hours. When the attack has arisen from the metastasis of gout, and there are symptoms of hepatic con- gestion present, great relief will be obtained from the use of the acetous extract of colchi- cum, combined with a mild mercurial. When the symptoms have yielded, external stimu- lants should be had recourse to, such as vesi- cating or rubefacient applications to the neigh- bouring regions, dry cupping, dry friction, &c. Demulcent mucilaginous fluids, such as barley or gum-water, linseed-tea, or marsh- mallows-tea, should be freely allowed, and will be most relished, and satisfy the thirst best, if given cold. If the disease has been caused by poisoning with cantharides, in addition to the general means mentioned, camphor julep, or emulsion, will be a proper drink, and should be taken in considerable quantity. The patient should also be constantly fomented, or placed in the warm bath for hours. The disease in the chronic form but seldom requires, and can be therefore but seldom benefited by active measures. Perhaps the utmost extent to which they can be safely allowed, even in those cases where an active irritation is occasionally manifested by signs of local congestion in the neighbouring parts, and high-coloured, strongly acid, highly viscid urine, should be limited to the local abstrac- tion of blood froip the perineum, or hypogas- triuni, by cupping or leeches, or from the prostate gland itself, by leeching within the anus, a sort of depletion which is readily effected by means of a long scoop. Consti- pation should be carefully obviated by castor- oil in moderate doses, and emollient bulky enemas ; but purging should be avoided. The patient should be confined as much as possible to the recumbent posture. The internal medicines upon which the most reliance is placed are of a balsamic, as- tringent, or sedative character. Amongst these, the Diosma has been of late years stea- dily gaining a reputation for its efficacy in this disease. The Tolu, Peruvian, and capivi balsams are also much employed. Chian tur- pentine may also be ranged in this class. Singly, or in combination, these remedies are found to agree very well. The remedies of a tonic or astringent character are the pareira brava, the uva ursi, and the lythrum salicaria. They are certainly beneficial in the purely chronic state of the affection, as in the catar- rhal condition of aged persons ; but their value is, to say the least, very doubtful when there is much pain, heat, and scalding, with alkaline urine and accelerated pulse. The next class of remedies is that of nar- cotics, amongst which opium, when not for- bidden or controlled by individual idiosyn- crasy, is entitled to the first rank. Indeed, opium in one form or another, or combined with the balsamic or astringent remedies, will prove generally of great benefit in this affec- tion. It may be exhibited, as the Dover’s powder, under which form it mostly agrees very well, or as a watery extract, as Batley’s sedative liquor, tincture, or crude opium;