Volume 2

The first lines of the practice of surgery : designed as an introduction to students, and a concise book of reference for practitioners / By Samuel Cooper.

  • Cooper, Samuel, 1780-1848.
Date:
1819-20
Catalogue details

Licence: Public Domain Mark

Credit: The first lines of the practice of surgery : designed as an introduction to students, and a concise book of reference for practitioners / By Samuel Cooper. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    23/570
    CHAR. XIII. CASTRATION. The measure may be optional; indispensable; or unfit to be attempted) 155. When every other treatment fails, the operation generally proper, ib. Reason in favour of the observance of this rule, ib. Cases, in which more delay may be allowed, 156. Operation likely to answer only when the disease is local, 1.57. Its general unfitness in cases of fungus hmma- todes, ib. Of castration as applicable to scrofulous sarcoceles, ib. Knife not to be used, when the viscera appear to be unsound, 158. Enlargement of the inguinal glands a bad omen in every malignant disease of the testis, ■ib. State of the thoracic viscera to be considered, 159. The success of ‘castration depends very much upon the state of the spermatic cord, ib. When the disease leaves the upper part of the cord sound, the operation justifiable, ib. Kind of disease of the cord contra-indicating the at- tempt, ib. This not having been always discriminated from other affections of the same part, wrong conclusions have been drawn, in respect to the successful result of castration, when the cord was alleged to be scirrhous up to the ring, ib. Disease of the scrotum an unfavourable circumstance in removing a scirrhous testis, 140. Castration an easy operation for the surgeon, a most painful one for the patient, especially, as it used to be done formerly, ib. Description of it, ib. Cutaneous incision, ib. Branches ■of the external pudendal artery cut, ib. Exposure and separation of the spermatic cord from the surrounding fat and cellular membrane, ib. Cau- tions, on account of the possibility of mistaking a hernial sac, or a protru- sion of omentum for a thickening of the cord, or of the adjacent cellular membrane, 141. Of dividing the cord, ib. To be done above the highest point of the disease, ib. Old method of first tying the whole cord, ib. Of the amendment of excluding the vas deferens from the ligature, ib. Tying all the spermatic nerves improper, 142. No ligature should be applied to the cord, before its division, but the part should be held when it is cut through, and its arteries be taken up as separately as possible, ib. The operator may here imitate either Bromfield’s or Desault’s method, ib. The latter attended with the least chance of a retraction of the extremity of the cord within the ring, ib. The fear of such an accident has had great in- fluence over many operators, iZ>. B. Bell lost two patients by hemorrhage from this cause, ib. Mode of preventing the said retraction, which ought not, when it has occurred, to hinder the surgeon from securing the bleeding vessels, as the)- may be safely traced with the knife, 145. The passage of a igature through the cord recommended for preventing the retraction, when the part above the place where it is to be cut is very short, ib. Its pro- priety questionable, ib. Plan of dividing the cord by degrees, and takiim up befr*ll,ePart .«Ml <« through, ib. Desault's m&oS of operating, when the cord is diseased high up, ib. Reason why the cord is rftract so, considerably when divided, ib. When the cord was thus thn ?^<J,iDeSaU tl d'd ,no‘ dlVK C Jt’ until lle had dissected the testis out of the scioturn, and tied the vessels there, ib. The cord was then <mntlv diawn a little further out of the ring, taken hold of as* high as possible lbs rS h!ndrgfb “ S nger and. thumb> divided with the Life in he ad, the arteries taken up with the forceps or tenaculum with the mine light hand, immediately after it had done with the knife while we reverSrPrd and ?PP‘ied thc **“»**• Pl« to be adopfed! Sectiona drmppac,tlcal, e t0 t,C a11 the arteries separately, 145 Sed tvv !6 dlseascd test,s 0llt of the scrotum, ib. Knife to be i„. ~r idSt er lm?.’^ ,Whcn the tumour is large, advantage of Anv dcfrir1 i°f ^1C dlstended scrotum, ib. Manner of doing it, ib. vor n d °r har,dened part of the scrotum should be taken away, 146'.