Author: J. H. Pooley

Publisher: Forgotten Books

Published: 2018-03-17

Total Pages: 584

ISBN-13: 9780364750186

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Excerpt from The Ohio Medical and Surgical Journal: December, 1878 I now proceed to notice the second form of operation - viz, by incision. This is done for empyema, pyothorax, or suppurative pleuritis. These names denote a variety of pleuritis, characterized by the accumulation, in the pleural cavity, of purulent fluid. The term empyema only ex presses the existence Of pus, without indicating its situa tion. Pyothorax is a better name, but this does not express the existence of inflammation. Suppurative pleuritis is a simple title suggested as more fully expressive of the affec tion. It is not necessary for me, her to go into the clinical history of this disease. Suffice it to say, the pathological character is suppurative - acute, or sub-acute inflammation being the cause. A positive diagonsis, perhaps, may be made in cases in which spontaneous perforation of the chest does not occur, or, without waiting for the occurrence of this event, a small exploring trochar may be introduced into the chest, and a few drops of the liquid withdrawn; the gross and microscopical characters of the Specimen thus oh tained will at once settle the question. This procedure is warrantable as a means of diagnosis in view of the bearing on the prognosis and treatment. Indeed, the operation is so slight as to be in no wise objectionable. In both the cases on which I operated by incision, the relief was immediate - one made a quick and perfect recovery, the other suc cumbed from secondary cau es. The greatest objection to incision has been the fear of admiting air into the pleural cavity, and thereby increasing the inflammation, indepen dent of the effect on the suppuration. In my experience, this has been exaggerated, and, in future, I shall never delay the Operation on this account. I Opened the chest of my first patient about thirteen years ago. He fell under my care after an acute attack of pleuro-pneumonia, from which he very imperfectly recovered, having a cough remaining, with some dyspnoea, for nearly five months. He gradually grew worse, but his former attendan't Opposed surgical interference, until his great emaciation and short ness of breath demanded it. I made the Opening in the intercostal space on the left side, below the nipple, evacuat ing six or seven pints of fetid pus; it kept flowing during the next day. I then washed it out with carbolic acid freely, and for the patient ordered quinine and iron, with generous diet. He sank in about a week from inflammation of the right lung, followed by gangrene. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.

Download or read book The Ohio Medical and Surgical Journal written by J. H. Pooley and published by Forgotten Books. This book was released on 2018-03-17 with total page 584 pages. Available in PDF, EPUB and Kindle. Book excerpt: Excerpt from The Ohio Medical and Surgical Journal: December, 1878 I now proceed to notice the second form of operation - viz, by incision. This is done for empyema, pyothorax, or suppurative pleuritis. These names denote a variety of pleuritis, characterized by the accumulation, in the pleural cavity, of purulent fluid. The term empyema only ex presses the existence Of pus, without indicating its situa tion. Pyothorax is a better name, but this does not express the existence of inflammation. Suppurative pleuritis is a simple title suggested as more fully expressive of the affec tion. It is not necessary for me, her to go into the clinical history of this disease. Suffice it to say, the pathological character is suppurative - acute, or sub-acute inflammation being the cause. A positive diagonsis, perhaps, may be made in cases in which spontaneous perforation of the chest does not occur, or, without waiting for the occurrence of this event, a small exploring trochar may be introduced into the chest, and a few drops of the liquid withdrawn; the gross and microscopical characters of the Specimen thus oh tained will at once settle the question. This procedure is warrantable as a means of diagnosis in view of the bearing on the prognosis and treatment. Indeed, the operation is so slight as to be in no wise objectionable. In both the cases on which I operated by incision, the relief was immediate - one made a quick and perfect recovery, the other suc cumbed from secondary cau es. The greatest objection to incision has been the fear of admiting air into the pleural cavity, and thereby increasing the inflammation, indepen dent of the effect on the suppuration. In my experience, this has been exaggerated, and, in future, I shall never delay the Operation on this account. I Opened the chest of my first patient about thirteen years ago. He fell under my care after an acute attack of pleuro-pneumonia, from which he very imperfectly recovered, having a cough remaining, with some dyspnoea, for nearly five months. He gradually grew worse, but his former attendan't Opposed surgical interference, until his great emaciation and short ness of breath demanded it. I made the Opening in the intercostal space on the left side, below the nipple, evacuat ing six or seven pints of fetid pus; it kept flowing during the next day. I then washed it out with carbolic acid freely, and for the patient ordered quinine and iron, with generous diet. He sank in about a week from inflammation of the right lung, followed by gangrene. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.