Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme.

  • Syme, James, 1799-1870.
Date:
[1830]
Catalogue details

Licence: Public Domain Mark

Credit: Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme. 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.

    18/31 (page 17)
    ly half the tumour still remained. The lower part had subside ed so that the testicle could be felt all round, but the upper portion still existed as before. Having reeognized fluctuation, and ascertained that there was no hernial protrusion through the external ring, I was satisfied that there must be two hydro- celes, one of the tunica vaginalis, and another of the eord. Having injected the bag already evacuated, and allowed the port wine, diluted with an equal part of water, to remain four or five minutes, I punctured the other swelling, and having drawn off its contents, which were clear and colourless, I threw in some wine and water, whieh was retained but a very short time, as the history of similar eases tends to show that the dis- ease is not so apt to return in the upper as in the lower swelling. The subsequent irritation was rather within proper bounds, but nevertheless proved sufficient for effecting a cure, so far as the hydrocele of the tunica vaginalis was concerned; and the pa- tient was dismissed on the 14th of January, labouring only un- der the swelling of the cord. He returned a few days ago anxious to have it also cured ; but as there was unfortunately no room in the house for his reception at the time, I was obliged to postpone the operation. John Eryce, set. 42, weaver, from Carnwath, w^as admitted on the 1st of February, on account of a moderately sized and distinctly marked hydrocele, whieh had existed for seven months. As the patient seemed to be an irritable subjeet, I threw in but a small quantity of wine and water, and retained it for little more than a minute, remai’king to the gentlemen present that they ought to be guided as to the time by the constitution and feelings of the patient, rather than by their watches. On the day following the operation, the scrotum was very much swelled and red. Next day these symptoms were aggra- vated, and a slight bluish tinge was observed in the centre. On the third day the whole anterior surface of the swelling was black. I made a free incision through this part, and directed warm fomentations to be applied to the scrotum, and four grains of calomel with one of opium to be given twice during the day. Next day there was a line of demarcation between the sphace- lated and living parts. The patient had enjoyed some sleep, and felt in all respects much better. I directed the resinous ointment with turpentine to be applied on caddis, and covered with a poultice. The slough has now separated. Ihis ease is interesting as an instance of the violent effects which proceed from slight causes of irritation in peculiar con- stitutions. As a contrast with it, I may mention that of a gentleman, in whom I unfortunately injected the cellular sub- a