Professional Documents
Culture Documents
"*"'''';""
tkfi
ftJt&tsfwiVr I
SURGICAL ESSAYS
BARON
D.
J.
LARREY,
\rr
Surgeon in Chief of the Hospital of the Roval Guard: One of the
Health; Pim Surgeon o' the Grind Aimv in Rmjia. Saxony
ancient
an-i
France-
riu.
tog the
ears iBia
1813,
1814;
Ronoiar) Memtrr oi the Council ol Hea.thol ire Amies; Commancei "I the Roy., Order of the la-nion of Honour;
Kniglv of the Imperial Order of the Iron Crown; Member of the Institute of Egypt, of the Koyal Academy 0*
Medicine, &c.
BY JOHN REVERE,
M. D.
Gen:
*
N. G.
* BALTIMORE:
MAXWELL, 140 MARKET STREET.
1823.
wo
16X3
.
That on -his tenth Hay of November, b the forty-eighth year of the independence
BE IT
D. of the said District, hath deposited in this oftV* the title of
of the United Stairs oi Ampiic. John Rever ,
a book, the right whereof ne lairm js proprietor, in the words following to wit-
Essavs by Baron D, J. Larr^v Surgeon in Chief o( the Hospital of the Rovai Guard; One of the ancient
Inspectors General on Service o f Mill tan Health) First Surgeon of thr GrinrJ Arrtu n Russia, Saxooy, and Fiance,
ihe Aimi' J-, Ccinn andri ol tj
u % al
Hopo. -i Ivien.bei of ihi Colo il o< Pi >i
dunng the years 1-12, 1813,
Order 01 the Lrgion of Honour; Knight of the Imperial Order o' the Iron Cio* d: Memi ei "' the Institute Oi Fgvpt.'of
Men.ler oi ihr Ko>. PhyTranslaten Irom the French, by John Revere,
the Roy*; Academy of Medicine &c
"Surgica
18U
M D
sical Society of
Edinburgn
fitc.
'
&c."
In conformity with the Act of the Congress o the United States, entitled, "An Act tor the encouragement ol 1- rr-ng,
by securing the copies of mips, charts, and boons, to the jutrmn ,od proprietors of such copies, during the rimes
"An Act Supplement ir to the Act, entitled *An Act for the
therein mentioned:*' -wid ^l-t fo the Act, ttiiitlpd
an'i books, to
encouragement ol fearninc, by seci. nng the copies o' maps, cnarts
thr auth >r* nod propi leturs of
such copies, curing the times therein mentioned/ and extending the benefits thereof to the iris of desiffnirtR engraving,
PHILIP MOORE,
Clerk oj the District oj
JOHN
P. TOT,
PU13TEH
Maryland.
TO
DAVIDGE,
B.
J.
M. D.
Sir,
You have
your
self
own
time, and
inferior to that of
our country.
a
hy
work on
which you
that
know
of no person to
whom
teach,
and
to
which your
talents
more propriety he
It
is
this
inscribed than
yourself.
I
take
my
REVERE.
ADVERTISEMENT.
Tt
will
following
Emperor
of the late
panied
in all
of France;
whom
he accom-
military expeditions.
his
He
has
work
entitled,
umes
of this work,
all at
in
these opera-
"Memoirs
The
of Military
three
first
vol-
were
Maryland,
in
1815.
volume,
containing
the
This work
is
not exclu-
some very
curious
movements
information
respecting
the
ADVERTISEMENT.
VI
In
the following
his observations
"Campaigns.'
To
inter-
have
extracted
from
the
fourth volume
of
the
Campaigns.
have entitled
for
two reasons;
this
term essay,
is
known
in this
country by the
title
of
"Me-
moirs," &c.
TRANSLATOR.
CONTENTS.
Preface
-----ESSAY
Page.
I.
....
17
In affections of Vision
28
31
ib.
In affections of Taste,
In diseases of Hearing, Voice, and Speech,
ib.
-----------
In Paralysis,
In Organic diseases,
37
-
Viscera,
80
1st,
Case 2d,
Case 3d,
82.
...--.
...
88
------
97
Case 5th,
Case 6th,
90
Case 8th,
-
98
99
Case 7th,
9th,
89
93
Case 4th,
Case
60
Abdominal
Rachialgia,
Case
50
57
-------74
Rachitis,
33
104
110
CONTENTS.
Viii
Sacro-Coxalgia,
Femoro-Coxalgia,
Case
-114
H&
135
1st,
Case 2d,
139
Case 3d,
140
Case 4th,
142
Case 5th,
143
Case 6th,
146
Case 7th,
147
ESSAY
II.
ESSAY
153
III.
ESSAY
Iris,
207
IV.
ESSAY
V.
in fractures in general,
of
247
ESSAY
On Wounds
fol-
VI.
certain
-
.f-
280
PREFACE.
Campaigns,
last
volume of
my
of researches
is
lume.
confided to
little
me
to
be
useful
Essays or Notices,
It consists of
known, and
have induced
my
the hospital
in
in
which are
The
of
first
the history of
Moxa, and
its
mode
its
object
of application.
PREFACE.
my
gery
consti-
at
cians
these lectures.
dence they
at
in
Notwithstanding the
first
felt
in
it,
it,
the
to
efficacy
of the
the evidence
in
method of
little confi-
it
as the
best
joint,
The
my Cam-
paigns, in
1812, the
first
of which contained a
Moxa,
in
have extended
and
employment over
all
Europe,
ing, that
from
its
it
many
unexpected success.
PREFACE.
It is desirable that in
repugnance
in
XI
less
much
more
The
prolonged.
moxa
effects of the
more favourable,
as
think
much more
are also
much
have demonstrated;
still
preferred
have good
who
cians
actually
all
will
convince
prejudices which
all
employment
of this
still
mode
of cau-
have
collect-
terisation.
ed a considerable number of
One
of
my
colleagues will
make known,
in
name
my ward
assertions.*
in detail,
of Lemaire.
for a
which confirm
facts
pulmonary consumption
wound; twenty-live to
this patient to a
thirty
in
the
moxas,
cure so perfect
Doctor Chardel
will
ThirLy-five
caused
,the subject of
case,
is
now
perfectly well.
and
Madame
de
(J
all
mo\as
this
PREFACE.
Xll
myself but
have allowed
moxa with
ployed the
fine myself, as
ing of the
much
of this work, I
title
Wishing
success.
in
latitude
little
mean-
have preferred
to
more
at
remedy which
of this
have recommended.
topical
take
I will
cele-
have presented
of the researches
in the
diseases
certain
in,
on
of the
this essay
appears
to
me
to
constitute a
indicate the
merit some
The
cases,
atten-
which
unquestionable;
ing light on
In this respect,
organ.
all
think they
may
assist in
and
throw-
mode
PREFACE.
Some
priate in each.
Xlll
particularly interesting.
The
perties of the
I
iris, is
first
who
oculists
Suciete Philo-
in 1817, to the
communicated
matique.*
membrane.
the
independent
The
properties
of this
which
es-
iris
dis-
in
this
to the physician.
collection
some
re- publication in
this
to
young physicians.
The
first
treats on
wounds of the
This subject
belly,
is
with
almost
PREFACE.
X1T
The
may be
ported
facts
that
useful to practitioners,
reflec-
have
and
fix
re-
their
gous cases.
The
the femur.
who have
those
less serious;
suffered
it
infirmities,
more or
it,
The apparatus
still
in dif-
entirely
to
itself.
equally injurious.
The method
subject
may
to either of these
affirm
that
it
employed
is
not
inconveniences, and
causing any accident, and of favouring the consolidation of the bone, according to the indication of
nature.
The
method,
It
may
modifications,
PREFACE.
XV
rior extremities,
pound.
Such
is
the result of
experiments;
my
latest researches
and
new work
give
me
a stronger
Paris, 1821.
title to
public esteem.
LARREY'S
SURGICAL, ESSAYS.
ESSAY
I.
During my
campaigns
in
North America,
travellers
and authors,
morbid
every
affections, I
suitable
was induced
occasion,
moxa
to
in
many
seize
upon
which offered
in
my
me
to indicate its
in its
mode
of action,
both
when
18
when
it
left
have myself
dead body
in the
by
cautery,
this
The
fortunate and
tained from
its
application, in a great
me
to
this essay,
it
number of
develope in
undertaking
this
public,
fatal
who have
bitants of Asia
its
power
in
many
curing
diseases
phylactic effects.
ful
not
It is not
which
ne-
had an opportunity
is
will not
imbued with a
Dic-
in the
The
Europe,
if,
as in
it
It
had been
is
by re-
mode
in deriving
of application, that
from
it
all
have succeeded
19
to possess,
it
and in
re-
made
to
it,
when
it
In the description
am
cautery, I shall endeavour to occupy the attention of the reader, in demonstrating its efficacy
in all the
inquire into
to
lost
in
the
which seems
origin,
its
night of
not stop
I shall
ages,
nor on
to
be
various
its
minutely related,
it.
These circumstances,
may be found
in
the Diction-
moxi-
body on which
it
out
its
mode
of
should be placed.
shall af-
moxa, and
its
its
which
some appropriate
cases,
Lastly,
which
I shall
its
relate
have collected
SO
it
be doubted,
will not
from
this cautery, if it
The
composed of a
sewed
and
This cylin-
its
size,
however,
An
to circumstances.
it,
is
intended to
the cylinder on
fix
The
from
metallic ring
the porte-moxa,
of
bad conductors
of
caloric.
balls,
tion, as it
To
a
in the
same
be made.
the
little
kept
kept up by
is
is
which are
After lighting
plate.
be made.
to
is
first,
The surrounding
with
is to
exposed;
this
protects
the
neighbouring
plying the
fire to
marked
out,
After apit is
then
and by means
21
its situation,
whole
is
To
consumed.
and
would be the
result, it is necessary
afterwards
to
to
immediately
we
think with
which
Here
We
the
itself;
from
result,
and of
Dehaen
relates
2.
only
by the cere-
upon
is
effects of the
tion
place,
first
bral
alkali.
all
which
suppuration,
According
others, that
kept up,
prevent deep
inflammation
profuse
is
while,
its
applica-
this region.*
we
it
on the eye-lids,
its
applica-
num, mammae,
tion,
linea alba,
the
and chronic
ii.
22
We
3.
superficial tendons,
to fear interfering
joints,
with the
capsular ligaments.
The
moxa are
the
of
effects
different
from
The
fire.
by the
and
thickness
which
it
of
is
and the
cautery,
the
applied.
It is
force
with
accompanied with a
with
difficulty,
and
sometimes followed by a
is
to
me
to
and a
is less
more gradual.
nerves,
communicate
to the
also
appeared
surrounding parts,
principle, furnished
by the
The
to re-establish
the
action of
the nerves
This
the method of
is
wish to obtain
to
to
it
When we
23
my
honourable colleague,
Baron Percy.
I
endeavour
shall
to explain
moxa, when
effects of the
During
indicated.
its
first
the stimulating-
it
appears
application,
to
I
me
to
be
have re-
this is
prepared
the
first
stant,
for
it
it,
the
The
howmore courageously, as he is
patient,
application, that
it is
removed
in
an
in-
The number
of
moxas
will
necessarily vary,
We
may apply
it is
number
ef-
same
But a greater
quite
sufficient.
phere
L
is
humid
state
of
atmos-
the
To
favour
many
cases,
it is
proper
to
precede
either
its
application
to follow it
As
cupping
is
there
is
by
its
revul-
make a
The
sel,
either of glass,
is
a ves-
intended
to
This
is
where
it
may be
applied.
to the cup,
and
at others,
by a combustible sub-
Our
application.
medy,
is
to
it,
at the
%5
moment preceding
its
in
the
rior,
circumstances.
conceive that, to
fulfil this
indi-
vacuum should be
effect of rarefying, or
diminishing
same
apply
itse'f to
may
its tissue,
Thus, the
that they
com-
moved from,
become
slightly inflamed
loric
this
purpose,
The
pelas.
which causes an
most
simple,
artificial
prompt,
erysi-
and
use a
common cupping
We
may
glass, in
in the
which a
least
is to
little fine
26
alcohol,
this is particularly
Cupping with
the air
same advantages;
the
its
pump
besides
for,
the inconve-
may
be adapted to them,
pump
it
fact,
We
the temperature
is
sensibly diminished.
tion
the cutis
included
within
the
cupping
tion
nearly nothing.
is
pelled to scarify,
We
more or
less
deeply, to obtain
without
its
inconveniences.
sometimes small
which
veniences
are
attached
to
instruments
mand
of the will.
But the
scarificator that I
use,
scarifications
wish.
These
as
superficial, or
almost as
German
ence: those
made by my
as
scarificator,
deep as we
all
the sur-
much promptitude
English or
as
embrace
scarifications
ful
27
those with
with this
differ-
In
a word, experience
the
It contributes
is
the
much,
whom
remedy
this last
is
indicated.
It.
is
es-
it
and leeches.
I will
method
is
now
indicated; and
will
make known
the modifi-
application, in each.
I shall
much
mode
of
kind of fleam.
may
be em-
28
In Affections of Vision.
The
should
be
made
in
It
as the trunk
facial,
The
imparted
excitation
branches, propagates
itself,
to
these nervous
vital
is
gradually dissipated,
may
disease; the
be added,
if
we
is
To
the exciting
where
it
is
useless, or
It is
when we
suffer this
even injurious.
By
this
it
is
remedy,
stances,
it
to
instances of this
of
my
be found
29
the history
in
English
little
give a
summary
it.
I will
me by
to the
statement given
suddenly
in
more
eifects the
from Corunna
had been
to Valladolid.
motion of the
be
difficult to
father of
iris,
however, remained.
would
this child,
army, and
It
the
his
deep
As
at the unfortunate
the blindness
hope of curing
was
recent,
ward of the
hospital,
be washed carefully
to
the
moxa over
well
30
At
saw the
up with a
was completely
restored.
When, with
we have
it is
or temporal artery.
moxas must be
vulsives,
We
en-
The number
may
assist
of
and
the ef-
re-
light alcoholic,
circumstances, and
by
electric
sparks directed
31
In
I
of
if it
be paralysed.
sense of smell.
lost
the
It
the pituitary membrane, for receiving the impression of odours, render the nervous tissue of this
membrane
moxa.
of
effects
remedy
is
therefore,
that the
In
affections of Taste.
think,
will
apply
to the sense of
When
deafness
is
suddenly
humid
air directed
upon
moxa,
if
ap-
32
The
calorific excitation
of this cautery
it
number of cures
might re-
of deafness, in the
moxa;
shall,
to
the
af-
perspiration,
The
loudest sounds.
were, at
first,
The
feigned.
patient,
if
to
my
care.
sounds,
and
seventh and
restored,
and
applied a series of
At
articulate
ninth, the
the
cupping with
hear acute
some words;
articulation
hearing
perfect;
at
the
was nearly
after
the
back
to his
young
my
the
33
campaigns, in
whom
and hearing
loss of voice
to those
In Spasmodic
I shall
moxa
in
affections of the
now proceed
paralytic
to
Muscular System.
relate
affections
the effects of
of the
locomotive
I begin
with
first lesion.
When
tain muscles
(which characterise
tic
douloureux)
weakens the
the
moxa
is
it
should be
The
engorgement and
This
34
principle,
nervous
It is
fluid.
and tetanus.
it
augments the
have employed
I will
moxa
in chronic tic
ed by almost
young
all
in
blow with a
irrita-
without,
relate
some
physicians as incurable.
tic
was sent
Caillou,
now
te-
tacked with a
face,
it,
in
doloureux of the
to
left
side of the
nerve.
of leeches,
alkaline
liniments,
and vesicatories,
over the course of the sub-orbitar, and corresponding branches of the facial nerve, entirely removed
the involuntary and convulsive contractions, which
Madame
with a
tie
D***
was
afflicted for
many years
right ear,
itself in
36
diverging rays,
the branches
of
the
eye.
They were
violent.
The
paroxysm.
and
and en-
in Paris, a great
number
of remedies,
more
or less extolled.
Having seen
I
this
affected,
and
thing which
The
the disease.
violin cords.
The
hardness, small
slightest pressure
made upon
nal
life;
I,
indications
at first, devoted
which these
my
attention to the
36
thought
principal
applied
disease,
the
Three
moxa.
and
nerve,
facial
six
out.
amelioration, and
all
the nervous
symptoms had
to
This lady
second patient,
Madame
de
years with a
at a
doloureux of the
tic
left
many
side of the
face,
side, the
larly
perfect health.
ralgia.
great number of
unsuccessfully tried.
She
scarifica-
also un-
was continued
for
To my
now
37
was eleven.
small,
In Paralysis.
Paralysis, properly so called, varies much, both
and extent;
in degree
it
is
sometimes limited
to
loss
We
often
member.
In the
first instances,
appeared
to
me
which the
sensibility, arise, or to
their
own
texture.
The
this morbific
38
by
perties.
persons
I
have made of
ters of atrophy.
The
last affection,
doloureux,
I shall
having some
moxa
is
affinity
with tic
it.
in the
suc-
may here
nervous sub-
which attacks the sheath of the nerves, or the cerebral or spinal membranes, which produces, to-
Nor
acts in
moxa
two ways, by
This suppuration
is
not
But
gia)
it is
(where there
is
neural-
THE USE OP
part,
it
is
39
]V%OXA.
indispensable to precede
application
its
made
my me-
in
Mr. P * *
afflicted
his
*, an advocate of Paris,
had been
by a gradual wasting of
marked by an
violent pains,
treme
irascibility.
neuralgia,
power
all,
the tonic
of the muscles.*
extremities,
bral column
to begin.
This was about the tenth or eleventh dorsal vertebra, the spinous processes of which
*
The
trials
which
produced similar
results.
in
remarked
that
its
who
extol this
some
made an
paralytics,
from
that, so far
it
augments
and
it.
have
dissi-
have
'
think, contrary to
remedy, that
it
should be
40
was very
The
first
The two
and en-
to sleep
awake
The
had
cation,
sensibly increased.
sensibly
this,
every application
all
the
vital
tion
After
tion has
This ameliora-
influ-
suppurate a
little,
given above.
become as perfect as
conceived
possible.
for
41
The
pain, or inconvenience.
mities
were no longer
felt,
nomenon, which
moxa produced
and
have trea-
Every application
of the
as those which
legs,
from galvanism
result
directed
amputated limbs.*
At my
In one,
other,
the ball
In both of these
was confined
to the
of them, especially,
1.
in the
One
its infe-
la
muscular
was increased.
hand and
fingers,
Societe Pliilomatique,
May
with a
42
ties.
success.
The
parato in-
to,
as
I
my
soap suds,
applied the
moxa above
in
strong
the cicatrices,
and over the course of the injured nerves, proceeding from above, downwards.
The
pains and
One
in
who was
the other,
power of
months afterwards;
continued the
fell
under the
by authors,
until
it
pro-
It
itself.
is
43
this
have enabled me
to
the precaution to
much
have made,
make
have taken
during the
first
campaign
in
face paralyzed.
The eye
of
angle of the mouth of the opposite side was retracted, in consequence of the contraction of the
The
muscles.
The
cases of these
cervical
the paralyzed
young
soldiers are
lady
I shall
had occasion
to
to
that
of a
treat, in
them
young
private
44
with
practice,
The
same success.
the
disease
Miss de
M***,
since
Madame D***,
about
and very
been
fever.
Electricity,
The
gave
deformity was
the
countenance of this
beautiful, a disagree-
to
A desire
ity,
to
which
applied the
first
it
passes out
From
this point,
the
*
applications
at
suitable
distances.
used in France.
making
They
remedy much
45
young
patient,
who
moved,
The
moxa
in
dried, and
eschars of the
fell off,
by
At
change
was but
improvement, however,
After-
parallel; the
very
difficult,
now became
perfect.
The
paralyzed
this
were almost
entirely restored.
become chronic,
not recent,
is
much more
it is difficult
the portions of
the
brain,
obstinate.
to obtain
is
it
has
When
a cure, because
46
patient be
fat.
When
the paralysis
we may
is
recent,
and
obtain a complete
moxa, applied
on
the
sides
The
of
the
vertebral
of
the
principal
true,
my
In
campaign of Egypt,
have
have observed,
these paralyses,
the
it
becomes necessary
We
will
now
whom I
only. The
in
may be
observed a
loss of
right shoulder,
should insist
of this
all
its
character.
young
The
lost
their sensibility
soldier,
animal sensibility
re-apply
cicatrices,
to
in
this
had en-
young man.
pain; at the
pended
for a single
cuted with as
much
47
were not
sus-
clavicle, in the
mity of
this bone,
superficial, indeed
ly be distinguished.
the
that
There
instrument
it
The
could hard-
reason to believe,
is
to
Some
facts,
collection of
bulletins
d''Emulation,*
feel
to
of the
Societe
in the
Jledicale
Several
upon
this
it in
the same
4S
tremities
nal
may be
may
ment of the
spinal
this
This
serous,
canal.
the membranes, as
plegia
is
no inflammation in
observed,
complicated
is
is
with
when
the para-
neuralgia;
this
in
case the moxas alone are indicated, and suppuration should not be allowed to take place.
The
should be
made along
and extending
os sacrum.
it
to the lateral
They may
the
of
regions,
These paraplegias
when they
are not
in-
I shall
summary.
con-
49
was seized
art
unnatural projection of
urine.
were
in
the
in this region,
and retention of
Various
hastened
to
employ
An
was allowed
tic
to
elastic
gum
catheter
patient,
long suffered.
The
moxa induced a
two
first
applications of the
sensible improvement,
At
had
which en-
at the fifth,
he
well.
This cure
is
50
In Organic Diseases.
I will
now run
which
eases, for
In
its
all
endeavor to
shall
employed
this
In
success.
made
squammous sutures
of
These
young
may
It
which separates
what
is
called the
result from
it,
as
we
membranes, which
it
predisposes to inflam-
when we
51
pulpy consistence, we
when applied on
cautery,
which
is
organ.
I will
now
describe
some
young trumpeter
of
have pointed
for
much
disfigured,
fall
out.
from his
fits,
fre-
in a short time
become
too small,
by
The
eyes
and
difficulty,
all
the sensi-
in a word,
every
52
After a free
we
exhibition of calomel,
at
to
first
slowly, afterwards
gradually assuaged,
more rapidly,
so
as
and at
last
cured.
All
the
animal
very remarkable,
is
whole circumference.
of these bones
this
primitive conformation
trumpeter
was before
The
its
left
too small,
the
hospital, his
had become
hat,
which
whole circumference of
the
thorax,
after
the
we sometimes
operation
of
The
effect of
53
my opinion, by
camphor and
ca-
The
as
aci-
treat-
my
seau, one
pupils,
who attended
Doctor Bois-
my
old
of
this patient.
carried to
the
military
hospital
of
Gros-Cail-
my
Campaigns, p.
\7'J.
54
The
had frequent
vertigos,
and a
dull,
patient
steady pain in
the
tendency
was
The
slow,
pulsations in a minute.
five
pulse
or forty-six
we have
dis-
it to fall
either
backward
when an
it
straight,
suspended.
to ob-
The men-
tal
me
appear
his complaint
to
had
and
to suffer.
scarification at the
nape
55
moxas
had recourse
to the
We
to the appli-
To
these
made every
frictions to
his functions
all
having reco-
whom
Madam J**##,
occurred suddenly, so
as
left side,
second degree.
By
to
direct
produce apoplexy
carried to the
bleedings,
in
was not
effected,
ice,
I
and
hoped
this lady;
it
fifteen
The
assisted
me by
family.
mother of a numerous
56
A child,
English
lady, exhibited
M.
all
Walter, and of an
the
symptoms
of a
when
my
being
fulfilled,
He was
was desired by
care.
The
in
an alarm-
his father to
first
indications
and
lateral
This
fontanelles.
little
present, enjoys
perfect health.
The
It is
child, at
proper to
was proved by
My
dissection.
M.
B.
There was
also,
in the
cranium.
have removed
57
entirely?
number
of remedies.
however
tal
may
away from my
present,
it
would ex-
or produced
the
Chest.
wire not
In Diseases of
Of Asthma.
it
I shall
such cases,
in
If it
subject,
men-
when
it
seen
I will
it,
admit
has for
state of the
its
have
in-
58
malady has
ed
resisted the
to restore the
In this situation,
common remedies
if
the
indicat-
greatest benefit
moxa, which
it is,
may be
This
la3t
has for
organic
the
its
capillary
vessels
of
moxa gradually
We
increases.
the anterior
towards
The number
should
my
in point, of
who,
for
many
woman
of Paris,
of asthma,
accompanied
59
cation, the
scarifi-
to
afterwards
The
first
retarded the paroxysms, so that the patient considered herself cured, and wished to do no more;
that
the
number
is,
was carried
paroxysms disappeared
entirely,
to twelve.
The
spinal
moxa,
applied
by
THE
60
heart.
USE OF MOXA.
persons attacked
The moxa
this
cautery.*
affections,
especially
when
it is first
to
remove the
my
In
virus.
necessary to bring
very conv
is
shall
much more
seri-
In Consumption.
I
to the special
pulmonalis, but
shall
ledged by
ble,
all
and mortal.
No
one
who had
success I have
obtained
from
this
remedy,
in
lesions of the
heart, such as active or passive aneurism of this organ; for the curative
different.
61
haps, with
may per-
pulmonary con-
its
seat.
mena,
same
arise
effects;
it
moxa
abscesses, or abscesses
by congestion, when
produces a de-
It
it
stops caries
proportion, as
is
conducted
we
insist,
to
In a
a cure complete,
as long as
may
be
most
which experience
will
used cer-
little
shew
to
be the
The
illter-
62
nal remedies,
more or
by authors, as
less extolled
for the
If,
it will
be
first
to sus-
necessary
to attack
We
should select, in
it
shall
by the moxa.
its
would be favourable
to this research;
made with
care,
and
Percus-
habit,
and the
To
manner
assertions, in such a
as to leave no doubt, I
report a
I
my
summary
of
am now
some cases of
about to
phthisis, that
One
of
my
first
patients
tall,
with
an incipient curvature of the spine, with an unnatural projection of several of the spinous processes
63
more or
and a slow
symptoms announced a
sively emaciated,
or ten months.
All these
second stage.
to the
and the
had
chest,
scarification,
months,
to a
after
a treatment of eight
complete cure.
who
enjoy^
marked with
to various
weeks
the small-pox,
in the
the
scapula
my
was
care.
projected,
()4
same
and permanent
almost constant,
was a continued
in the evening,
The
emaciation
The
dis-
proached
its fatal
termination.
The
to
true, nearly
who
before
this treatment,
two years.
stooped
which lasted,
mark
the
The
par-
supposing that
common
trifling,
medicines,
65
without
call-
my
old pupils,
who administered
all
woman
died of marasmus in
last
disease.
On examining
was
we found
originally diseased,
had become sound, having contracted a great number of adhesions, by membranous leaves, with the
pleura
We
costalis.
points of
its
also
remarked, on many
cicatrisations,
in
one third of
which
it
of
its
natural volume.
cavity
We
The
its
The
6()
in
membranes
of these viscera.
H. B. on
vours,
whom
sex,
her
all
fa-
It
was even
warmly
my
young
solicited
patient.
How-
by her parents,
to
the disease;
symptoms
of
young patient
face, painful
expectoration
of
and
a
fre-
viscid,
apthse,
veil of
pharynx
which appeared
to ex-
67
left side,
an unex-
The
pected cure.
But
of health.
this case,
and
after a
to
when
year passed
in
state
recorded
a very satis-
seized, in con-
The
symptom
at
named P
had arrived
at the
who
The
symptoms
principal
frequent
and
painful
cough,
daily,
with
hemoptysis,
preceded by a
febrile
paroxysm, heat
It
was
in the chest,
by an
It
was followed
was frequently
in a
The
patient
To
68
There was no
specific
virus.
patient,
this
several physicians,
termined
for
its basis,
tion of
called in,
it
de-
had
chest,
fifteen
to
suppurate slightly.
After the fifteenth application of the moxa, the
under treatment
health
his
His
usual
One
first,
of the physicians,
consulted at
the cure
these ulcerated
points,
and confirmed
is
69
She was
advanced
in a state of
woman
who was
a young
to the third
marked marasmus,
Menstruation
gum
sound.
fluctuation.
The
slightest pres-
This
communicated, upon
The
action of coughing
this point,
an impulse which
we
Even
could easily
my
was
care,
at last
cavity.
induced to take
this patient
under
70
and by a wish
to ascertain,
if,
in this
very advanced
effects
its
stages.
young woman,
by my
wished
friend Laennec,
his cylinder.
who
my
diagnostic,
of this
consultation, at
were present.
elles
to verify
At
length
proceeded to
which
From
this I
which
tions.
To my
supposed
to
first
calmed
unhappy pa-
The
ed by the
until the
fif-
ribs,
the chamber.
walk abroad
to
M. Laennec
for
month of
fifth
71
this
She was
whole hours.
when
treatment,
as in the case of
M. P
in the superior
and
were obliterated
The very
found,
and cicatrised.
requested
He
in the
in Paris
to
go into
consented, as
At
fat,
first
been exposed
night, the
to the
of
air,
her;
grew
but having
during a stormy
to the
gastro-enteritis,
return to Paris.
ing,
open
left
better; she
north-east, she
tack
much
at-
to
the seventeenth
day
and
in the
On opening
the body,
we
some
hesions.
points,
The
itself,
compact
72
slips
of
false
The bronchi*
left
lung were
substance; and
filled
we observed
points.
shewed the
moxa
in
in
this
patient
cavities,
The
it
vanced,
it
was conducted
to
constitution,
was more
a complete cure.
in the
for-
He
King's Chapel,
when he came
the
to solicit
commencement
The
my
professional care, at
membrane
of the throat,
The mucous
73
felt in
word, he had
As
it
appeared
to
me
marasmus.
was
same
at a
suitable to
combat
this
morbid cause,
and
at
proper periods,
thirty-six.
it
The
his flesh,
fif-
for
health.
the
happy
in
first stage.
from
this
10
74
I
appear
myself
confine
shall
me
to
sufficient
these
to
to
facts
opinions of
the
fix
which
monary consumption.
remedy
drotharax,
if
it
is
my
only
in
readers.
when
memoirs inserted
I refer
in
my
it
in several
I will
to
produce
Of
the
Stomach
The
engorgements of
ease which
tion.
is
almost always
fatal
in its
termina-
all
orifice
75
frequent application of
moxa upon
the epigastrium;
now give
will
summary
to
of the
suppose
this
orifice of
At
least, I
was the
case,
One
I
of the
first
General Rutty.
He
He had
siderable time.
dom and
came
on,
The
small, of
and continued
for a con-
alvine evacuations
hardened
were
sel-
fre-
less
abun
76
The
fever,
patient
was
low continued
in a state of
When
lying upon
his
back,
he was
Any
hen's egg.
The
painful.
liver
appeared
to
me
also to project
false ribs,
and
thought
The
belly
was
made
Saxony.
It
and
paigns, that
we ought
to refer the
cause of this
trium,
commenced the
and
application of
I insisted
moxa
to
man found
77
himself per-
who were
means.
2d. Obstructions of the liver, spleen, or any
its
the
greatest degree of
developement.
I will relate a single
titis,
in a fortunate
crisis,
is
terminate
by means of moxa.
named Fer-
than the
tion.
side,
left,
He
in the
much more
little
He
The
to
called in a physician,
who
applied a plaster of
THE
78
USE OP MOXA.
drastic purges
continuing uninterrupted,
tation.
gree;
It
was
called in consul-
the right
all
of the disease
its
highest de-
ribs,
itself
of the size
from the
of a
fist.
tion,
frictions
Mercurial
was suspected
sented in fact
to exist in
all
to
however,
opening,
its
it
was
circumference,
After
the
application
of
the
second moxa?
tumour had
di-
we determined
moxa any
longer.
However,
new
cylin-
After the
violent cholic,
fifth,
alvine
first, bile
The
lent.
quantity was
79
entirely
estimated
at
puru-
about a
pound.
total
had
the patient
experienced
incessantly
until
that time.
It
is
moxa induced
inflammation which,
sive
the adhe-
unquestionably,
took
and
corresponding
the
verse
point
of
the
trans-
that the
testine.
in-
is
engorgements of the
liver,
saw
Egypt an hepatic
in
by the
intestines.*
third
patient
affected
pus was
The
case
is
*
also
preserved by one of
Sec the
evacuation of
first
volume of
my
my
pupils.
Campaigns.
80
3d.
We may
are
by the application
moxa upon
of
by cupping
region, preceded
depurative medicine.
lumbar
this region
in
have removed
several
the
this
dis-
by these means
am now
and
in
it.
which generally
affection,
persons
in
the
young
and
boney
fibrocartilaginous
such
structures,
attacks
as
the
spine
junctions
the
Of
The
effects
of
Rachitis.
rachitis are,
softening of the
more or
less gibbossity.
column,
The moxa
remedy against
is,
this
and
without
disease.
have spoken
illustrious
in
it;
but the
cess of this
remedy
is
celebrated surgeon
81
to
already alleged.
sons
to
is
requires
ap-
it
The
moxa.
applica-
it.
may be employed
ease;
we
In this intention,
It
the
ply the
tion
made by
is
in
however preferable
to
use
in
it
dis-
the
come
considerable.
moxa
placing the
It
is
necessary
denuded and
the
carious.
application
avoid
to
as
It
near
is
as
desirable
possible
become
to
make
upon the
to
nal
marrow.
Corsets,
They
than useful.
in pressing
down
mechanical means,
or other
if
as
in
retentive
this case
except
bandages,
or
more pernicious
develope
itself
towards
tl^e
opposite
11
S2
organs.
It
is
a tendency
to
second
effects.
its
The
intervals,
better that
the
treatment should
be
It will
be
prolonged,
than that the patient should be exposed to accidents arising from inflammation, or a traumatic
fever,
number
application of the
could
moxa
in this disease.
liachialgia.
The moxa
is
dorsal consumption.
of
making a
slight digression
upon
this
alarming
disease, and
all
I shall
physicians, as fatal.
It
du Pott.*
remarks made by
'
Notwithstanding the
it is
this physi-
ti.is
author, vol.
iii.
it
has arrived at
its
S3
when
third stage,
much
less
the
than at
tain notions
At
cause.
was
this
The
researches
practice in
abled
me
thirty years
hospitals,
have en-
minute
malady
details, the
at its
phenomena presented by
My
different periods.
this
numerous
it;
the repeated
This indeed
is
the princi-
me
appears to
are
now about
to substitute
racter.
As
to treat,
we
its
true cha-
The Pathology
of Mover.
84
organic vessels of the fibro cartilaginous and osseous tissue of the vertebral apparatus, or of the
when
when
it
according to
it
it
will,
rachi-
tilages;
when
coxalgia,
it
articulation, &c.
I
in
one
mation
is
in the fibro-cartilaginous
of the vertebrae;
it is
a true phthisis.
This inflam-
weakens their
parts, by engorgement,
appears
to
accelerate the
tissue,
and
process of absorption
where the
have a tendency
The
to separate,
spinous processes
left;
this is
in different directions.
lages are
first
by
to
The
intervertebral carti-
decomposed or dissolved;
to this
85
and developes
itself,
more or
less
rapidly, ac-
caries
At
the
moment
first
emitted, by
all
first
it
is
under the
texture.
Afcel-
it
remote, where
it
produces what
is
called sympto-
as
less
These
its
principal effects
The
progress of
cesses;
neuroses of the large muscles of the back; sometimes the pus passes under the pillars of the dia-
86
and
in
collects
it
to the nates.
In other instan-
and goes
to form collections on
of the chest.
from them.
employment
of remedies.
first
They
pains.
at last
propagated
in the
nerves
which
and
emanate from
it;
especially
The
added
To
these
air,
in-
are ex-
symptoms are
ema-
enter
progress of this
more
into detail
respecting
disease in speaking
the
of femoro-
same kind of
87
when
affection,
it
at-
observe here,
recommended by Pott
sess
in
The
moxa.
copious suppuration
sort of cauteries
occasions,
which the
first
before
If
these abscesses
efficacious
it
may
Now
vour
opened
are
is
early,
employed
be the process,
in the
adminis-
necessary to endea-
cient to produce an
fected,
to
change the
double indication.
to
inflamed parts.
and
af-
I shall
scarification,
now
content
known my mode
of treat-
The
scrophulous
vice,
and, generally,
to
every
or
thing
88
of the
and progress of
this
rare that
stopped in
it
is
spontaneously.
It is
which nature
The development
apparatus.
vertebral
is
affection
course,
its
it is
or cured
incapable of extricating
itself,
its
important there-
combat
me
taught
is
this
It
is
consequences
morbific
experience has
cause;
moxa.
were considered desperate, have owed their safety to this heroic remedy.
mary
I will
I shall
Case
General
1st.
exhausted by a
power
in
spine,
tremities,
This
and marasmus
affection
medies.
It
series of
tebral
curvature of
in
the
first
the
degree.
was decided
in
a consultation
that a
column,
of the
sacrum,
89
the
first
With
time administered.
that
at
proportion as the
in
At
ed.
alone,
tion
to
go
campaigns
Case 2d.
in a situa-
to the
He
were repeat-
applications
has
made
seve-
since.
Mademoiselle
first
aged about
stage of ma-
The
dorsal
side.
The
sca-
announced the
brae.
by congestion.
first
tumour, or
ed
soft
These symptoms
when
was
call-
to see her.
The
tient
debilitating
regimen
which
the
pa-
was
to
bark
*
combined
A centimetre
12
is
with opium
and balsamic
90
and
gummy
successively,
spinous
Twenty
upon the
inter-
after
sides of the
vertebrae, near
The
es.
first
scapula to
its
natural situation.
By
degrees, the
word,
I
organs
this
am now
red
Case
Gros-Caillou.
February,
the two
1816,
fists,
its
of
its
size
inferior angle.
There was
It
extended
this bone, to
a fluctuation
below
through
in the skin.
The
patient
was constantly
bent; the
91
little
When
the tumour.
little,
the patient
felt
to
enabled
it,
me
rheumatic
in
tracted
campaign
ment
which
result of a
this soldier
had con-
humid bivouacs
of the
in France, in 1814.
The
that
affection,
was the
It
its
moxa; nevertheless,
of
resolved to try
At
effects.
its
made
was
caused a drawing
made
I
The tumour
to
it
be
of it.*
tion of the
moxa,
until
my
Campaigns.
92
The
He
has expe-
to the
Society of the
In vol.
ii.
page 396,
my Campaigns, may
et seq. of
moxa
in rachialgia, or dorsal
consump-
was arrested,
of the disease
abscess, in
some
to.
manner described
cases, in the
It consists in
in
making
narrow
knife,
heated to incandescence;
all
the
my
* See
this process
more
Campaigns.
t Lady Morgan,
in
testified
her admiration of
remedy
in
at present not
used in England.
moxa, a
93
laid
already
down.
Case
4th.
Saxony, towards the end of the year 1813, contracted a rheumatic affection, which became fixed
mained of
The
a better regimen,
by rest and
May, 1816,
In
the fever
violence.
been under an
He had
then
the
first
inspection, the
by gibbosity, de-
lysis of the
recognised, at
viation
left side,
para-
inferior
extremities.
The
three centimetres in
projected nearly as
its
far.
The
fluctuation
was
uni-
94
form through
its
The
whole extent.
was not
skin
discoloured.
I
commenced
by applying along
the treatment
the whole course of the vertebral column, dry cupping, and cupping with scarifications,
and
after-
A favourable
applications,
to
first
improve.
However, the tumour, the volume of which underwent a rapid diminution by the fourth application,
went on much more slowly afterwards,
twenty-first,
until the
when a
small
and announced
to us a
until
phlyctena
its
surface,
Under
this conviction, I
ed
to
it
vessel
which
filled
with
floculi.
little fluid
which remained
in the cavity.
In
were
95
of one of
the
vertebrae.
state of
op-
ening
diet.
by frequent
chills,
announced
itself
It
of constric-
to believe that,
from the
to all
was
The
symptoms described.
belly,
anodyne substances, dissipated the imminent danger by which the patient was threatened, and restored him to a favourable state.
Afterwards, for
new moxas.
96
By
the twenty-fifth
of
He
ly cured.
to
bend
ed by the caries.
four centimetres.
tient,
of
who was
was
Another process
geous,
if
will
be
more advanta-
still
ct llular tissue,
which
This con-
it
is
entirely evacuated.
Then,
if
the
be stopped, as
we must suppose
will
this
Two
pa-
97
of
which
between the
left
at the
same time,
rapid
summer
upper part
at the
There appeared
of the back.
in the
it
in
which was
days
fifteen
over
its
whole extent.
dorsal column
The upper
to the alte-
approach nearer
dency
to
were
Twenty
ten-
made
to separate
paralysis.
so
This appearance,
part of the
it.
The
in a state of almost
supe-
complete
As
the
number
in the
of these
13
9$
superior extremities.
ber, the
By
the twentieth of
its
Novem-
original size,
fith.
a fixed pain in the lumbar region, with a remarkable numbness, and very great debility in the inferior extremities,
which terminated
in
an almost
complete paralysis.
it
When
nised,
he was brought
was
our hospital,
useless.
recog-
tioned, a well
three
to
first
marked case
of rachialgia.
The
weak
The
ordered to be
was
so
99
and
remedies, until
The
contractile
by the
paralysis,
was
were
re-established; so that
left
by the twentieth of
in a
good way
to
be
after.
first
regiment of infantry,
first
and
pelvis.
He was
inguinal
There was
in the left
fists,
with evident
100
at
all
discoloured.
and
same
side,
A distinct prominence, projecting about two centimetres, formed by the separation of the spinous
scess
as this
tumour originat-
Dry and
relieved
the patient.
first
was a
was induced
to
pass a
prehend
same
side.
deep
cells of this
appeared
to
me
to
communicate.
endeavoured
to
all
In
the fluids,
consequence of
in
thinness of
101
and the
softness,
its
its
its
me
absorbed, as to induce
walls
to
became
re-
much
so
apprehend their
opening spontaneously.
mined me
to
plunge
in
first
The
sup-
were dissipated;
well,
all
to
walk about
way
He was
ward.
he returned
his
to his in-
to intoxica-
and a comatose
affection.
The
fistulous,
suppuration of the
became
entirely sup-
The
after a
month of
10&
anguish,
and
the patient
exhaustion.
Twenty-four hours
the body, which
and
was
The
flexible.
after
livid,
death,
we examined
to suspect
had asserted
at the
moment
we
the pa-
dis-
which
The
sides
formed on the
The
reader
may
already referred
to.
It
work
103
may be
this ulceration
cicatrised; as
happens in
when properly
treated.*
It is evident that the caries
in the case of
syphilis,
soldiers,
who
in
in this
consequence of a constitutional
the whole thickness of the external table and diploe of the frontal bone;
in
another
it
had extended
its
ing a great loss of substance; in the third there was caries of the frontal
and
occipital bones.
All three
now enjoy
perfect health.
The
loss of
both by the eye and touch, under the integuments, which adhered closely
to them.
rates
its
The moxa
is
same time by
specific
means.
shall
it
is
It
accele-
have adopted
in syphilis,
and employed
with great success in the hospital, the surgical department of which has
been entrusted to
into internal
my care for
and external,
opium
in a sufficient quantity
pound of
of Hoffman's
in doses of
gummy
extract
mixture, dissolved
tered
I divide
The
The
syrup
is
for a
given in a dose
second preparation
is
adminis-
on the
lotions
by saponaceons
104
si-
This
where the
region,
illiac
fact proves, in
in
remove
of a seton.
its
I shall
we
to
when
we take care
Case
Sth.
tall,
and of a
light complexion,
in
one of
December, 1818,
to be treated for
for
two abscesses,
The
some months.
The
knee of
this patient
The
ninth,
A soldier
in
same symptoms,
He
is
in a
way
to get well.
is
now
tor a disease
105
siderable
vertebrae,
He was
emaciated,
&c.
From
all
became convinced
these symptoms, I
articulation, with
by congestion.
by a scrophulous
and onanism,
diathesis,
to
which
prepared him
of which, at
He
vere.
to
it,
and
first,
appeared
to
him extremely
se-
cations to be
At
stancy.
to receive the
all
which
abscess,
I after-
which was
14
106
The
The
abscess.
ed
was the
origin of the
itself;
soft
new
The tumour
mean
an
infant.
it
resem-
vertebral column,
commencing
at the
upper part,
The
first
having relieved
was encouraged
to suf-
Pills of the
had contracted.
security,
The
and
all
and, as the most projecting point exhibited indications of opening, after having arrived, at
the
thirtieth
case,
107
determined
to
to the
operate according to
my
method, that
is
descence.
selected one of
performing
this operation,
my
days for
clinical
baudre.
The
took
all
A regimen
remove them.
been described
in the
similar to
what has
He
and
better,
after a year's
the rachialgia,
in
way
to get well.
all
the usual
However,
did
devote
was
my
continued, there-
far
advanced by the
last, until
mean
time, having
The
disease
made great
108
attacked, deeply,
termined
to
patient
py
all
The
d.
operation,
stump (cnicite.)
ed
my
have recourse
to
attend-
were strong-
who
Several physicians,
should be obliged
as-
had
this projection of
tissue,
would
not.
be any
longer any cause of irritation; because the muscular fibre being then swelled out, and separated
by the
fatty substance
filling
anew
the cellular
a second
many
authors, and
less
much
sible,
but
as
to
much
operation, so
may
it is
extremely
fall
by some
It is
useless, inas-
difficult,
the saw
Thus,
is
practitioners,
be dangerous.
make
extolled
to a
exactly
above the
109
ever
little
its
of the sequestrum, or
have much
questrum remained
With
entire.
to
the
than
it,
hemorrhage,
if
the se-
respect to the
would be propor-
it
inflammation
or
of
the fibrous
it.
in Bulliard,
to be
in
very re-
one of his
amputated
for
came
also
and
in a
upon a
stump
remaining sound
the
first
of August, 1820.
He had
lost
about three
who
has
now returned
company with
case, enjoyed
that this
good health.
This
cure
is
remark-
110
Case
ing case
little
The
9th.
is
success
resemblance between
it,
it
is
but
I will
give a
in
summary
regiment of the
first
his barrack,
must be the
result of such a
fall,
fect of
and kidnies.
third,
It is
and the
anteriorly
upon the
in its inferior
dorsal
The
vertebra.
left
no reason to
though
soldier,
this
Al-
young
Ill
fulfil
applied at
several
first
series of cuppings,
around the
belly.
all
was
smoking.
still
oil
of camomile
to
embrocations of cam-
very warm.
All at-
Two
deferred
it
such cases.
am
five
conceived some
The
paralysis of the
as-
extremities
to
such an
112
and heat
The
by means of a
gum
But purgative
sufficient
constipation,
power
which
this
I
fall.
poor young
hardened
fceces,
of a scoop
with which
made expressly
also compelled
to
it
man
cessity,
was
which was
elastic catheter,
was
filled,
of the
by means
that
it
left
iliac
region
However, there
still
remained a great
menced
then com-
applied, two at
lumbar vertebra?.
By
moxas were
and
after eighteen
113
an operation which
dered unavoidable.
and
He
foot.
desired
removed by amputation,
performed
this operation in
tibia, as
the
Nothing interrupted
was
linear.
The
in
a state of paralysis,
difficulty
by the
after
assis-
wooden
At
leg.
He became
finger's breadth
The
first
last dorsal
vertebra,
which
This
which
the
is
have believed
dorsal, or
to
be complete, of one of
15
The two
first
are
114
inserted in
in the
my
curious
The
memoir which
propose to
Sacro- Coxalgia
sacro-iliac synchondrosis
especially in
young
effects
as to cause,
This, indeed,
spontaneous luxation.
is
where such a
it is
It is also
cause; such as
cal
the only
falls,
or violent compression
may
also
birth to
happen
to
uncommonly large
examples of
this;
This luxation
children.
in
giving
have seen
to
after a
in
female
Guinea
pig,
during parturition.
115
M.
by
L'Heritier, Professor
Practice,
The
is
patient
the School
in
a striking example of
of
disease.
this
for
M.
moved with
facility
up and down.
two
made
may
of
it,
be seen in the
which may be
have seen
this dislocation
since, in
two young
soldiers,
ball,
had under
my own
who
hospital of Gros-Caillou.
116
The
pains' increasing
is difficult;
by direct pressure,
happens, that
often
howev-
this disease
exists.
it
produces
It
in the
as
have described
and
in the vertebrae;
speaking of rachialgia,
in
which
speak soon.
I shall
If the
malady be recent,
it
may be
relieved
by
If the disease
be old, and
The means
to be
incurable.
employed
same nature.
is
in this affection,
But
which
is
of the
avoiding that portion of the skin which immediately covers the bone;
of consequence,
we must
eased symphisis, as
No. 3 and
paigns.
it
is
indicated
4, of the fourth
volume of
the plates
my Cam-
117
these bones,
is
ceding cases.
scesses,
more of
We
may
same
this disease,
as in the pre-
less
remotely
These ab-
their nature
and devel-
rachialgia,
little in
The names
properly so called.
costalgia,
of
sternalgia,
to these
diseases.
I
have remarked,
chialgia, that
when
in
all
On
out,
the contrary,
when
the
moxa
is
always
is
applied
is
IS
JFemoro- Coxalgia.
I give this
name
It is
hereditary,
or acquired scrophula;
syphilitic.
It is
is
it
necessarily hereditary,
is
rarely
when
we
it
see in
children.
With
ways
accidental, are
when
tic
same
as those
to those causes
same disease
Besides, the
produced by rheuma-
femoro-coxalgia in adults,
posed
in the
of a scrophulous character.
al-
ex-
affections.
young or very
old
persons;
it
manifests
itself.
Ill)
age of manhood,
when
i.
e.
nearly termi-
of this
disease takes
The development
nated.
when
to
are
felt
Young
effects of
which
long campaigns
exposed
life
to
in
cold
climates, are
I particularly
it.
observed
and
the most
this in the
many
coxalgia.
less
announces
It
deeply seated,
symptoms
itself
of femoro-
by pains, more or
hip joint;
to
manner, as
to
attract
This
circumstance
The
is
120
is
soon altered.
At
first,
This elongation
and paralysis
is
into
owing
may
It
of
affection,
more
as well as
which
especially,
upon the
fills
collec-
the sigmoid
During the
first
pe-
life
We
may
The
121
by their tumefaction, as some authors have asserted, (see volume xv. p. 33, of the Dictionnaire des
Sciences Medicales,) for
By
this general
is
is
tached from
its
from
its
fe-
Indeed, as soon
its
cur-
line, will
power
in
those
parts
which
of the femur
become entirely
not so,
what becomes
Before
it
of
or, if it
it?
16
22
l
But
pro-
duced by a
fall,
thigh, sufficient
it is
movement
or forcible
of the
its
does not
we
of dead bodies,
placed posteriorly,
cause of
it
effects of
to
find the
on dissection
we ought
fall,
If
It
liga-
dis-
the extremity of
felt in
Femoro-coxalgia
preceded or followed
which happened,
may
either have
luxation.
this
It
is
this
who were
my
illustri-
ous master.*
When
which characterize
internal
erosive process
ex-
it
this in the
have treated.
But the
accompanied with a
is
which
fills
at first
Memoirs
of the Royal
Academy
of Surgery.
12f3
its
surface.
It
spreads
itself at
it
extends
itself
by degrees
pelvis,
when
at points
more or
less distant
At
this
limb
owing
a sudden shortening,
the head of
the femur,
When
this
ed
to
phenomenon
occurs,
it is
stage.
often attributif
we examine
we
shall
characterize
not find any signs which decidedly
I repeat, except from mechanical
luxation.
this
had occasion
who had
to dissect
have
have
died of femoro-coxalgia.
124
The
third stage
is
more or
externally, at points
seat of the disease,
state
and by a
and cachectical
febrile
These
the patient.
of
less
when
become
and they
thin,
At
neously.
this
finish
time, the
by opening spontapatient
into a
falls
state of slow
On opening
Such
observed
When
it is
is
it
it
in
a great
number
first
of individuals.
or second stage,
if
the patient
have produced
it.
Campaigns.
many reported
am now about
to
But
if
in
my
make known
end of
this ar-
it is
much more
difficult to
known
125
stop
its
progress
we ought
I will
to try
now make
mode
of appli-
cation.
In the
first
stage,
it is
By
this operation, if
gorge, by
made
judiciously,
experiences a manifest
symptoms remain, or
dis-
it
will
if
relief.
If the
patient
inflammatory
of the disease, as
patients,
we
my
and
advantage
happiest
effects.
in
the
iis
crus ta-
126
now
M. Rust had
chanter.
lines,
it
its
pre-
whole
putting
it
He
of
any necessity of
restored to
its
the
I
to verify
German
in
whom
this re-
manner described by
professor.
may be
explained in
If the elongation
of the
its
surrounding muscles,
must have
127
and of restoring
to the
weakened ligaments
fix,
tempo-
rarily, the
which
to
it
What
traction.
ment
is; if
to the
quence of
the conse-
is
it;
and the
ed.
These
by one of
This sudden
is
no luxa-
tion.
But
have observed
also, that
when we
confine
ourselves to the employment of the metallic cautery, the elongation of the limb gradually returns,
moment
disease,
which had
We
may
pre-
128
ing in
by persever-
its use.
Shall
we say then
metallic cautery
undertaking
is
to
however
frightful
it
determine, and
definitely
may
powerfully in
which, from
its
moxa;
The moxas
the strength
if
will permit.
It is ne-
is
Foggy,
less suitable
than
to the effects
easy to conceive
first
how
its
have
al-
129
employment of cupping
homine:"
fiat,
is
cucurbitam medicam
in this,
proved in
"De
effects
locis
in
a fluxione
aflligere oportet,"
&c.
more
this subject.
The
blow pipe,
is to
made
to pass forcibly
oxygen.
It is to
which the
efficacy of the
remedy
is
attributable.
which
they communicate
to
17
away
them
130
Second Stage.
and there
the
moxa
is
If the caries
has commenced,
How-
to use
employment.
is
character-
it
or even
joint
have
The
less pal-
most depending points, where there may sometimes be distinguished a fluctuation, and incipient
depositions, at various distances from the joint.
is less
indicated;
it
is
ne-
The
employed but
because
its
opening
if it
is
will establish
which
will
result
air,
troublesome symptoms,
The
131
ment, which the moxas communicate to the diseased parts, stops the morbid process, and appears
to
it, if
am
ignorant of the
am
this
parts through
matter
it is
cases,
it
is
effected;
through the
In
all
these
is
which takes
The
is
cicatrised,
yet,
an ulcer of the
like
leave a depression
may be
soft
proportioned to the
parts,
loss
of
Wc
its
We read
Memoirs
in the
of a young person
of the Royal
\cademy
132
which are
pi ces
limb
If the caries
trisation.
in
will
lameness.
Whatever may be
gia,
it
is
bones composing
joint
this
takes
place;
which
these
less free,
is
duced;
in
ly solidified,
is
cured.
When
Third Stage.
sive,
dis-
the caries
is
very exten-
few resources.
However,
and
this stage;
the
means advised
ought not
we
it
to
is
our duty,
in the
second stage.
But we
we have no
reason to hope
which
will
is
be dried up;
stopped.
We
shall
by
its
this
133
local pain,
moved,
is
by the returning nutrition, strength, and plumpness of the patient, and, especially,
scess,
to
though
it
the ab-
about
is
open spontaneously.
If at this period
at
when
this
result,
we
are so
happy
as to arrive
which supposes
manner
described in
have
The
ope-
we must
it
ed
in
kept
camphorated
in its place
I think this
oil
of chamomile, heated,
and
method preferable
to that
used at
making a puncture
at
By
this
method
Page 399,
vol.
ii.
134
gangrenous
But by my
of
affection,
follows.
infection
The
by
fluid con-
by
all
more suc-
we
it is
necessary
fre-
As
far
as I
have described.
femur does not take place, except from some mechanical cause, acting in the course of the disease.
I
to treat
many
children affect-
my remarks
made upon
on this
soldiers.
disease
is
more rapidly
fatal.
its
termination
is
135
in the
effects,
stop
its
could cite
not
it is
many examples
to
add
to these
German
not appear to
me
to
much greater
method, a putrid
limit
small moxas,
will
therefore,
It is to
be ex-
produce a
individuals are in a
tions,
professor
in the
local
to
from
by
this
produce;,
affection.
ourselves
made with
may
state,
We
should,
the application
of
will
which appear
Cane
1st.
to
now
Mademoiselle de
St.
aged
13(i
pains in the
left
iliac
side; they
was
me
to
be called in
when
in an alarming situation,
striction of the
this
young lady
We
success.
were
Afterwards, we
scarification, the
nervous
dissi-
We
frequently
experienced, when
we
discovered a
There presented
to
itself
be in the
above the
little,
was an evident
at
fluctu-
ation.
to
with
THE USE OF
after
scarification;
The
first
137
MOXA..
We
opposed the
violent pains,
had
New
entirely disappeared.
There was a
conside-
The
diseased
extremity, which
was
at
first
The
twenty
cure was completed after the application of
moxas.
How
can
surprisingly
It is,
we
happy termination
undoubtedly
difficult,
of this
nevertheless,
disease?
I
think
principles which
that by applying to this case the
established, hypothetical^, in the course
I
have
of this article,
we
formed in
lected in the abscess which had already
that the cathe pelvis behind the acetabulum, but
had perforated the bone. This I observed in a
ries
18
138
subject
who probably
if,
moiselle de St.
his health;
,
like
Made-
patients,
to
moment when
there
to
and he sunk.
On opening
the body,
we found
the
we
marks of
ed
perceive
could
upon
its
external
cicatrisation, similar to
what
its
surface,
is
observ-
The head
of
its
volume by the
caries, to
which had
The
traces of a
ciety of
to the
So-
and Cloquet.
same
It
was
whom
of age, in
changed
man about
forty years
These two
lesions
rachi-
manner.
in a similar
constituted in
189
algia.*
But inasmuch
we
have occurred
it
selle
de St.
much
less
to
art,
had
when arrived
by
as nature, assisted
in this
Mademoi-
in the case of
was
the different
accompanied
symptoms which
it.
In, this
it
produced, or which
also
and re-establishment,
in a great measure, of
now good
all its
func-
health.
Case 2nd.
all
7, 1816.
140
The tumour
projected about
was about
The
diffi-
short of
fell
luxation,
have
patients.
The
preceded
fication
fii.
h,
the
until
the
But
ninth,
New
moxas, which,
was reduced
it
moxas caused
it
to
a quarter of
to diminish,
to
go away,
its
and
size.
entrusted this
him, leaving
Case
~&rd.
In October, 1814, I
saw another
M. de
141
affection,
wet bivouacs.
The
to
announce a sponta-
in such a
It is
by the
femoro-coxalgia,
down
in describing
the disease,
way
to Berlin,
advised
me
to
means of
length.
was necessary
to see
believe in the
result.
Three deep
part,
lines,
Immediately after
142
this cauterisation, to
my
unnatural length.
lost its
After
fifteen
days of
the
cauterisation
had
been
sufficiently
Jthe
professor.
The
thought
to the
it
number
half;
German
of twenty-one,
continued
Mmb.
soldier
was
In February,
Case 4th.
We
fe-
to
rheumatic affections.
Dubois (Jacques,) aged twenty-five years, entered the hospital of Gros-Caillou in February,
1816.
knee, flexion of the leg, difficulty of moving, tumefaction about the ilio-femora'
iculation, slow
"'
'
were
sufficient
143
coxalgia.
The
when
returned to
former position.
its
left to itself, it
At
immediately
the
first
ap-
my
its
elonga-
decided, as in
according
to the
The
began
pushed
However,
to
the
number
in
a few days
moxas, which
of twenty-five, prevented
Case
5th.
first
regiment
a femoro-coxalgia
in the
humid bivouacs
of Saxony.
in the cold
and
144
its
fessor Rust,
same
of Pro-
The
success.
limb
lost
Of
by the application
course, this
was preceded
My
me
to
occurred,
and
moxas
to obtain
was obliged
to
apply
fifteen
limb.
first
attacked with
reproduced
in
consequence of a long
first
lapse,
it
at the period
In this re-
145
phenomena, since the frequent application of cupping with scarification was sufficient to remove
them.
It is
we
ployed,
in
When
repeated
and
cation, it is
is
The
may supply
their
is
this local
146
The
irritation
and
we may
a
new
series of
Malo,
after
by the application of
This
moxas.
Finally,
is
what
did for
I insisted,
moxa,
until
when
the cure
this soldier
was returned
for duty.
Case
&th.
into a ditch;
the
wheel
five
side.
hours plunged
in ice,
same
side.
centimetre.
The
however, steadily
patient
came
to
to increase.
our hospital,
in
At
August, 1816, he
symptoms
147
Cupping
fif-
revulsive effect.
Case 7th.
Dunan, (Abraham,) a
soldier in the
tempera-
to
feel
deep
less severe
during
in the hospital,
Dunan
to his
148
to
walking.
He
felt also
and
it
was not
until the
change of colour
in the skin.
Dunan returned
to
pelvis,
answering
It
pelvis,
The
efforts for
From
coxo-femoral articulation.
149
experiencing
much
The opening
of the abscess
February,
fifteenth of
scribed;
pain.
manner already
in the
de-
fifteen
The
this operation,
At
this period,
dulged himself
to
entirely,
and
its
character
very
itself.
fetid matter;
cess by the
means indicated
became of a better
in a
quality,
His
flesh
now returned
feeling
daily, in a
any
remark-
an approaching cure, which was effectually accomplished by the end of July, under the influence of
ten or twelve additional moxas.
fit
for duty.
150
I shall
coxalgia, with a
who
on
of that of
M. R
>
whom
(t. e.
summary
manner
of Pott,
had
inefficacy of this
method,
stage; that is
place beneath the cauterised point; there was violent pain in this region,
and
In a
word, the cure was so perfect that, with the exception of slight lameness, the patient
almost as
this
much
disease.
facility
walks with
performed
this
of
very fortunate
cess in lymphatic diseases of the other articulations of the limbs, especially in that called white
We
l6l
very much the
assist
days at a time.
or
and the
fluids
accumulated in the
joint,
is
re-
is
at
This disease
immediately turn
my
to
me
will
which
attention.
for
may be
It is
suitable
task of determining
them
to
other physicians.
Moxa.
/>'y /
f''''/4-
Fry
Ft//
6'.
''"^l
ESSAY
II.
Every
Ttil.VIN,
RESULTING
CAUSES.'
brain, or encephalon,
all
have
satisfied
me
the
upon
great number
is
many
by very
distin-
Doctor Gall.
We
cannot doubt, in
mental diseases,
fact, that
exclusively
in
the
brain.
But does
nostalgia,
20
its
seat
and morbid
154
effects, establish
this organ;
itself in
and docs
it
This
is
now endeavour
solve.
to
self,
tive
to
this disease,
shall
relating
and
to
will
confine
my-
some
facts rela-
describing
all
between
this
which have
It is
morbid
affection,
may
the
it,
exist,
all
it is
either by the
immediately con-
From
this
it
first effects
of these sensa-
substance,
its
pulpy
alteration in
directly or
the
internal organs,
indirectly,
the
vital
which receive,
properties of
From
tion
this
may be
155
EFFECTS OF NOSTALGIA.
Thus, the
first effect
more
unable to gratify
it,
when he
in-
creases.
affect
first
the circumference
of the
The
first
brain,
of induction.
sions
engorgement and
cavities;
its
the
first
pathological
it,
and
line
phenomena,
weak-
also,
ness
These
effects
afterwards
propagate
themselves
sense
Wounds
of the
its
periphery, or on
its
anterior or superior
Hereafter, I
156
shall
endeavour
sustain
them by
to
to
cases.
its
interior
all
of
is
the
nerves of locomotion; upon those of the mixt organs; and of the senses, the functions of which
may be
disordered or weakened
in
a proportion-
it
may be
said of
may and do
I will
act separately.
phenomena or symp-
the brain.
may be
These
wounds of
the head.
EFFECTS OF NOSTALGIA.
Thus,
for
example,
it is
well
157
known
when
that
its
more or
the
power
and that
if it
be in
by
it,
the intellectual
same proportion.
to verify these
in the
phenomena
have
With-
shall
I
have
first
have ob-
life
become altered
at first;
aberration;
it
may
it,
in
At
first
there
is
an
15b
exaltation;
this is characterized
by a spontane-
movements
of the
To
constipation,
in
different
To
and torpor of
all
succeed compression
fall
in health,
into a state of
gastritis,
The
as water,
when the
character of hydrophobia.
At
last, life
becomes
it
if
vital
EFFECTS OF NOSTALGIA.
159
number
of
whom
of our companions in
On examining the
nostalgia we find.
with
The
surface
in a state of
suppurating
points,
of the
deep
infla-
mater participate
in this inflammation.
sub-
is
The
fluid blood.
Second.
The
heart very
much
agulated blood.
are
tines
Third.
distended
with flatus
intes-
do not
die,
as
is
These
individuals, there-
generally supposed, of a
The
morbid
in the brain.
160
The
consequence of
troops
this
of
these
nations,
moral susceptibility,
to
in
suffer-
we
which
soil
contrary,
all
symptom
there
are
persons
it
as a second
who
this climate.
to the hospital to
the
Many
exhib-
On
of nostalgia.
home;
who
be treated
talgia.
cumstances, also,
all
Under
these cir-
The
first
and most
Swiss regiment.
He
entered at
my
first
re-
in the
the fever
General Description.
EFFECTS OF NOSTALGIA.
161
appearance alarming
to
its
One day
this unfortunate
suicide in his
ran immediately
bathed
to
his assistance,
that
visit,
him.
left
in
in
The
wound was
breast;
it
for-
seventh
ribs.
The
large quantity of
still
This
induced me
to suspect
con-
The
lips of the
and the
To my
great
different incisions,
21
lost,
into
162
From
parallel slips,
this,
it
two or three
was evident
that the
by the
loss of blood, to
in the wards,
repeat
it.
If the patients
and had not found the instrument strongly grasped in his right hand, the
not have believed that the patient could have possessed the power of performing such an action.*
endeavour
I shall
phenomenon
to
at the
tient, I
to simplify the
away
to cut
wound
as
much
me
to
air.
six incisions
all
intestines.
result
was
and so
was a pupil
having opened
almost
The
* While
or
as possible, in or-
Although the
in the
In
this cavity
remem-
same
line,
made
one of them
The
EFFECTS OF NOSTALGIA.
163
of the
powers.
camphorated
belly,
indicated a cessation
lips,
oil
vital
warm
he paid no attention
if
he desired
to this proposal,
He was
in so absolute
But
which
appreciate.
it.
his
him
to
a state of in-
doned himself
for
any thing;
and appeared
to his fate.
all
He
to
have aban-
displayed no desire
life
of rela-
internal
life
He
was, how-
But having
suffer
away
torn
symptoms of
all
fifth
164
between the
the lung;
it
first
penetrated, as
The
ribs.
blade
pierced a portion of
left
and seventh
sixtli
pounds
About two
phrenic nerve.
left
blood, mixed
mem-
The
to
its
much
black and
fluid
extent.
The
dilated,
The
blood.
liver, (heputise,)
left
cavities of
and
filled
with
The cranium
was
marked
Many
in
was implicated
in the dis-
and
all
The
sinuses
EFFECT* OF NOSTALGIA.
165
There was
blood.
From
these facts
we may
tis,
by
his
Swiss
dour
in this
I will
now endea-
phenomenon.
at
as
had
strips into
cut,
preparatory
not
painful
knife.
If
been extinguished
and
in
to
to
in-
dressing
the sensibility
this
he
soldier,
difficult
which the
for the
in this case,
muscular
when
the
to
swer
to the questions
lables, in
proposed
to
him
in
monosyl-
66
This
will
to
fact,
be related
me
to
in
to
it,
which
which seems
thesis
proposed by
to
brain,
or
its
prolonga-
me
presented by this
after his
wound, equally
which occupy the surface of the anterior and superior half of the hemispheres of the brain.
The
In
vol. iv.
EFFECTS OF NOSTALGIA.
count of
my
my own
eyes.
167
in the fifth
regiment of
fall.
He was
scarce-
fit
for
same time
duty immediately,
to
In consequence
promising at the
withstanding
my
But
not-
symptoms
of nos-
became
all
exertions,
had risen
and some
lines.
young
this
soldier
manifested themselves
his
The barome-
He
spoke but
passed
at
first,
168
his hand,
however, habitually
insomnia.
in
to his forehead,
were
tiva
injected;
eyes watery.
repugnance
He
to use
felt
a great
ed ptisans.
To
succeeded a
so that the
pa-
to
fell
same pro-
into a lethargic
was reduced
ployed, at
first,
to almost
nothing.
termined
to
and
cupping
de-
era-
hypochondria and
belly;
mucila-
oily
embroca-
169
EFFECTS OF NOSTALGIA.
dies
These reme-
tions
made
stimulus
exerted
The
were
essential-
mem-
branes, and
all
pulmonary angina,
gastritis
is
and
my
less facility,
which
enteritis,
subject
plete ataxia,
the patient
fell
But
to
return
com-
into a state of
The
dissection,
first
case,
to
me, as
in the sub-
mem-
was a brown
22
ribs.
170
On opening
I
had
it
taken
between
place
the
dura
puration penetrated, rather deeply, into the anterior lobes of this organ,
yellowish serosity
tity of
The
cles.
third patient,
at the
same time,
who died
in
of the
same
disease,
The
and
remarkable peculiarities.
after
death,
his
some
and born
in the
frontiers of Belgium.
He
had a
fair
complexion,
wounded ward
into the
left
last,
shoulder, accompa-
in
the corres-
EFFECTS OF NOSTALGIA.
He
ponding arm.
the
among
life
comrades a desire
To
171
these
his
of ex-
man, by
his
which
in
this
young
unreserv-
of
affected,
At
of the arm.
himself cured,
regiment.
left
Nevertheless,
recommend him
to the
hospital,
entirely removed.
He
but a
remained
new
for
some days
disease declared
in this situation,
itself,
and on the
first
sented
and placed
all
affection;
the
in the fever
symptoms of a
although
he had
all
ward.
He
febrile,
cerebral
lost the
pre-
use of his
172
and
all
To
to.
which increased
until it
succeeded stupor,
terminated
death;
in
all
The
plete prostration.
fell
and
I
was invited
to see
Such was
his situation
When
Questions,
w ere immoveable,
r
lated;
any motion.
be nearly extinguished,
We
di-
fric-
produce
was
it
is
when
slight
dull,
com-
into a state of
which
supposed
to
the.
it
soldiers use,
EFFECTS OF NOSTALGIA.
of flax
to different parts
applications did
D
in
not
nor could
any
the
of
17J
These
body.
change.
With
ment
made use
To my
it
of dry cup-
great sur-
and
iris,
cir-
caused
vinced, Hiowever,
same means.
was con-
patient did not remain, that he could not appreciate any of these sensations, and
was incapable of
spirit
The same
appli-
when made
in
them.
produce
it
determined a sensi-
iris.
This
state
174
for,
on examining the
contracted.
still
some time
in an
last
to the
remnant of
vitality,
organs of internal
life,
the
in
of the
inflammatory
chronic
There
engorgement.
points
the
intestinal
volutions.
tive canal
filled
its
of the diges-
whole extent;
colour;
con-
with
The
by membranous bands
heart and
When
to
me
to
its
of
old
it
state.
appeared
The
formation.
The
sutures,
of the
EFFECTS OF NOSTALGIA.
175
of
was very
the skull,
The dura
thin.
moved
They
to the brain.
base of the
quantity of serosity
and extended
itself
filled
was
large
of the cerebrum
was
in a state of
gene-
is
The
such
an extent at
all
its
periphery, that
it
to
projected into
it
was depressed.
Thus,
17G
in the
This dissection
galli.
furnishes incontestible
proof,
all
a true eccen-
tric
its
by
causes of excitement*
all
It is
not without
think
ready
this dis-
to burst.
ed to the constitutions of the subjects, and the period of their disease, &c. Continued exercise, and
own
to their cure.
rous, cured
him
all
the English
who went
by advising them
We
much
to
foot, or
to consult
make long
horseback,
ol"
trepan.
The
first
may he
in
called spo?ita-
I'his
affection
is
EFFECTS OF NOSTALGIA.
177
He
sometimes joined
to this
differently coloured,
valuable remedies.
Journeys
in picturesque situations,
to
mineral waters,
were recommended by
is
unaccustomed; slavery, or
all
the other
The
me
the brain.
To
have
who
pre-
is
who
are predisposed to
It is, especially, in
should be compensated.
It
some
23
which they
178
tions to their
own advantage,
of society.
exercises,
as well as to that
it is
It is in this
among
and the
to the soldier
state.
is
esta-
beneficial
soldier,
tions
and
much
to
effects
reflec-
which
the
happiness
had
to
in
North Sea,
the
in
pany, we did
tedious cruise
lose
quence of a shipwreck.*
nal solicitude of the
we made
in
since, of this
in
the
com-
conse-
it is
to ex-
In a word,
* See the
first
if
it is
insidi-
volume of
my
Campaigns.
EFFECTS OF NOSTALGIA.
in requisition the talents
179
it
their progress,
to dissipate
With
this
intention,
has declared
describe,
methodically, the
the effects
it
is
an individual,
itself in
In the
and
to
me
mode
to
period, which
is
will
now
treatment
of
first
it.
that of pyrexia,
to
condense
to
by means
of
semicupium^
Reaumer; cupping
life,
at the temperature of
to twenty-six
degrees of
lowed by camphorated,
fol-
Gym-
180
When
which
is
machics.
We
becontes necessary to
it
by
patient
light sto-
warm
The
patient should
infusions of cincho-
The
climate should
warm, airy
situations,
and
only look
to
we
little,
can
crisis.
We
this
dangerous malady,
to treat
To
more
will
them
of
success.
The
first
his
the
symptoms
It
was
in
the
EFFECTS OF NOSTALGIA.
midst of the month of January
rometer
181
when
last,
the ba-
inches,
two
lines.
The
lines, to
felt,
for a
his
comrades, joined to
may be
The symptoms
was
in
weeks he was
well,
out,
and
in less
and returned
than three
to his
duty; he
allowed him.
some moxas
me
to
and
appeared
to
in
this case.
The
ty three years,
who was
On
fall
His
had
been running
all
this
young
soldier
18 2
In
fact, I
all
the symp-
toms of an incipient cerebral affection, accompanied with mental aberration, and disorder in the
sensitive functions.
tions
did but
little
during the
first
after
in
running
He
was endeavour-
met by some
back
to the hospital
at the
He
hour of
was
when he was
my
visit.
restless
and
agitated;
an
unnatural
answered
lables,
pulsations
fifty
to the questions
question.
in a minute.
He
put
little
to
him
in
He
only
monosyl-
He
suffered
immediately
prescribed,
afterwards directed
183
EFFECTS OF NOSTALGIA.
was
to
mode
of treatment, and
when
expected
first
barometer having
lines,
new
after
of somnambulism,
he again
learned
since
where
I
consi-
sufficiently established to
that
this
soldier
reached
have
home,
weakness or
remain untouched.
difficulty
184
dif-
ferent degrees,
produce these
results.
my
Campaigns.
some
may
I shall
interest-
sixty- first
regiment of the
line,
by the name
of
occiput,
by a ramrod shot
his
at a distance of
together.
not deprived
upon
it;
remained untouched.*
I relate in the fourth
less
remarkable, of a young
Museum
this
pa-
EFFECTS OF NOSTALGIA.
with the
army
to
Moscow;
185
in
wound on
The
weapon penetrated
left
upon the
hours
where he received
tion required.
all
He
dead
field of battle;
after,
left for
to the
neighbouring city,
have described in
to
life
France.
and cured,
When
pre-
faculties,
On
which were
at first
suspended,
precision, as this
186
man answered
in writing,
with propriety, to
all
This
fact, in
my
opinion,
is
still
is
stronger proof
asserted by Dr.
and
elevation
organ,
not reach
wound was
received, could
it.
in-
stimulus,
tioned to
I will
ease of a
and suffered
add
to these
wound
above men-
shew
their lesions.
The
rampan, (Edward)
is
M. De-
e^r-officer of cavalry,
who, in
ed by a
organs
fall
the
foil,
breast piece.
foil
little
inwards, the
The
instrument penetrated
to
about
EFFECTS OF NOSTALGIA.
187
left
peared
to
to enter obliquely,
terior
anterior lobe of
left
At
fuse
the
moment
wound, a pro-
bly, a
sanguineous effusion
the cranium.
fell
of receiving the
In a
moment
into the
and
senses,
interior of
in
lost entirely
his
The
vision
was restored
By
The
in
a few days
was deprived
degrees
it
itself
anew
it
for
was restored
veloped
of
lost,
de-
The
was much
less ac-
manner
188
while the
left
was deprived of
This
this faculty.
left side, in
opposi-
right;
The
left.
first
lost in the
The remembrance
of things having
proper names,
with
motions.
its
was
totally
any analogy
extinguished;
which
is
fect.
Thus,
for
and features of M.
L^rrey, whose attentions he had frequently experienced for various diseases and wounds; he knew
hisn perfectly well,
his
his
the
forgotten
friends.
He
name, so that he
M.
names of
Chose.
his
He had
relatives
and
different pieces
The
in this officer,
first
occurred
EFFECTS OF NOSTALGIA.
189
him
and pro-
which related
to
his
family,
him the
friends, restored to
full
relatives or
exercise of his
intellectual faculties.
The
may
organs
offer,
presented the
most singular
Lecceur, a fusilier
infantry
in the
about
twenty-two
by the
foil;
wounded severely
his
com-
in the right
eye
The
ment appeared
to
me
to
left,
manner
190
Afterwards
foramen.
it
appeared
to
me
to
have
of the
first fold
sella
nerve.
left
more or
!s
foil
must
less extravasation,
phere, tow^r
terior
vessels,
under the
left
hemis-
and corresponding
perhaps further.
The
small
wound
and
in the fold of
which extended
itself
gion.
The man
did not
fall in
in
both eye
lids.
in
to the
also
pear
to
have
was carried
This
lost for
soldier,
who does
not ap-
EFFECTS OF NOSTALGIA.
191
paying
to
my
visit, so
was
that
was ready
his
to
administer
alarming situation
required.
The
paralysis
The apex
of the
an opposite direction
to
hemiplegia.
the
to
tended
itself to the
cranium.
full,
The
pulse
my
was slow
difficult;
and deglutition
his
accident.
lie
down,
my
eye-lid,
and
to
explore, as
much
as possible,
its
192
whole extent.
A stylet
the bottom of
this
wound, enabled me
to
to
dis-
cover, at the middle point, and behind the internal wall of the orbit, a perforation
ed to
me
to
which appearI
have marked
ims in practice
was
It
to
sufficient for
me
to
know
wound
me
to
my max-
in the
mode
it
that It penetrated
my
prognostic, and
indicated.
After this
to the
The
feet
and
to
legs
der
full
of
pounded
ice
was applied
to the
was
blad-
head
The
pa-
was bled
ice.
enemata
oil
was applied
to the belly.
EFFECTS OF NOSTALGIA.
The
night was
very alarming,
193
the
patient
he complained con-
movement he experienced
least
He
left side of
fect,
vertigo, and
the
was
convenience.
At
position.
The
in-
was per-
ticular alteration
after.
To
these
which
shall
make known
which compelled me
of urine,
to
retention
use the
elastic
At my
visit
here-
first
gum
days.
left
to the
35
of
late
against
cerebral
affections.
194
The
paralysis
of the
organs of motion
of the
first
had taken
then
substituted, for
chicken broth.
On
ease
lateral sur-
also
the
by embrocations of camphorated
oil
of cham-
omile.
On
became more
easy.
danger, in
fected.
The
and precision
ed
to
patient
answered
to the questions
with
propriety
EFFECTS OF NOSTALGIA.
I
195
The
the
perpendicular half
which received
of
is in
objects
which were
When
they
this axis
If,
still,
the
bodies
still
same precision
for this
it,
as those of the
left
eye.
seems
to prove;
First.
That
the retina
is
an
injured by the
foil,
which
of
seems only
to
nerve,
at
this
sella tur-
196
cica.*
organs
may experience
Third.
functions.
It
proves
that the
also,
in con-
it
fila-
ori-
particular stimulus,
Notwithstanding
individual.
this
in
remarkable, was
less
the exactness of his reasonings and the just combinations of his ideas, (for he
continued to play
still
had entirely
of things.
He
could not
tell
me
own
first
he could never
names
recollect mine.
daily,
wounded persons,
would be curious
was found
in the
to
know
if
was
its
foil.
EFFECTS OF NOSTALGIA.
who had
sonnet,
197
remember-
same por-
seat in the
its
tion
in
Lecceur and
suppose
M. Derampan.
who
cian, to
By
and
draw
Three
vesicatories,
which
To
these
me
applied successively to
to
produce excellent
applications,
ef-
added several
side,
and over
side.
The
pains of the
affection en-
in
Not-
every means in
the
first
cervical
my power
application of the
to
himself deI
had taken
encourage him.
moxa over
At
the anterior
in the leg
and arm.
198
which
could
make return
ed great surprise
under the
to the assistants,
weep with
patient to
at pleasure,
Tho
joy.
the
thirty-first
day,
with
The
assistance.
stored gradually.
The movements
them
entirely,
hoped
arms
of the
to re-
topical excitants.
walk
and even
in
were
last.
in other respects
The
internal func-
when
perfectly well,
he was suddenly seized with diabetes, characterized by the abundance of the urine,
its
transpa-
of this urine,
The
analy-
apo-
was produced,
in
Mindereri that
debi-
a great deI
had ad-
EFFECTS OF NOSTALGIA.
199
drams
at a dose.
followed, in this
who
commend
there
not
it
in
more powerful
be no doubt that
tifies
mucous membranes
the
had occasion
to
is
can
there
who advised
this
re-
this
all
and
diurectic;
of
now
remark
It
proves
that
in small
also, as I
have
in
in
viscera,
According
transmitted them to
league,
M. Lafond Gowzy,
my
to these ideas,
old friend
and
col-
of Toulouse, in a letter
I
was anxious
to
pre-
dry
frictions
region; and
moxa over
these regions,
if
On
all
the
first
not
means.
symptoms of
dia-
200
efficacious means.
to
an encouraging
state;
waited the
return of fine
still
At
ameliorated,
which M.
gradually
already very
much
approached a cure;
to
assistant surgeons,
who was
particularly charged
with the care of this patient, very much contributed, by his zeal and assiduity.
his conva-
so
when on Monday,
the
imprudence
whom
to
send
to
to
He was
lost his
EFFECTS OF NOSTALGIA.
speech, and
and
fell
all
accompanied with
in
201
chills, slight
convulsive motions
which
visit
artificial
Monday
on
the state
morning,
At my
hastened to
camphor,
in equal parts;
warm
of the body.
The
disease,
whole
life
may be
it
of relation was
were completely
the organs of
all
whole surface
ed
by
life,
The
func-
when
extinct
said
February,
This was
nium;
it
discovered to
26
me
Jfirst, all
cra-
the vessels of
202
discovered upon
al-
At
os frontis,
mammary
to the
process of the
ethmoidal fossetie,
upon which
The
this opening.
same
side.
It
lines.
left
latter
near
tery;
its origin,
erably dilated.
The
at this point,
point of the
ar-
and consid-
foil at last
stopped
EFFECTS OF NOSTALGIA.
the
arm
left
of the
203
medulla oblongata.
This
and a half
There was no
reddish
tint
little
serosity of a
fluid
traee of
left
hemis-
had extended
itself
The
vis-
The stomach
remarkable.
presented no morbid
appearance, but the jejunum had three intussusceptions, to an extent of from two to three or four
inches.
without inflammation.
ilium inflamed in
tines
were
all
its tunics.
The
large intes-
This dissection
It
furnished a
new proof
in
support of
effects of profound,
gia;
seat
and
It
204
wounds of the
fore considered
wound
brain,
mortal.
It
may be
of LeccBur
is
considered as cured, as
left
hemis-
doubt accumulated
when
all
stroyed.
these
at
the time
were de-
in
places
was
what proves
which had
entirely absorbed;
went
Lastly,
it
is
edly,
by the
he
was
effects of the
predisposed, undoubt-
wound and
the invagi-
Might
have
tion,
EFFECTS OF NOSTALGIA.
205
stimulus
its
life,
or the gangloinic
have determined
tic
in these portions
an anti-peristal-
remarked, seemed
to
may
have before
per?
Lastly,
this case,
which appear
to
me
to
be extremely interesting,
in
similar
cases,
preceding,
as the
as well
to
neglect any
they
demonstrate
not
since
Note.
acute
will
inflammation
of the
brain,
its
substance
If,
to
to
the
falls
into a soft
ESSAY
III.
I have
IRIS.*
life
more or
But
of relation.
evident,
less
life
or these effects,
nitely
if
the
infi-
examine
life;
comparative
influence
I will
now
which the
summary
matique in 1817,
This
conceive
iii.
p. 134.
208
REMARKS ON THE
to
question, I will
examine what
first
the
is
Until of late,
it
the
arises
iris
The
number
of
to
greater
when
the
iris
is
deprived of motion;
organ
is
also paralysed.
found by experience
But
that,
in
since
has been
it
before immoveable,
membranous
it
in
I shall
was
iris
endeavour
first
to
may
this
when
it
re-
take
demonstrate
is
influ-
PROPERTIES OF THE
am now
cases that
the
iris
my
and the
the
convinced, by
209
IRIS.
its
peculiar tissue,
lenticular
ganglion
belonging to the
exists,
when
great
sympathetic.
place
by
it
when
have seen
preserved
its
whose sight
motions.
The
little
English boy,
to restore in
example of
this.
page
2-39,
and
is
is
my Campaigns,
Moxa.
In fully formed cataract, the retina
serve
integrity, so as to be ready to
its
functions,
when
it
may
pre-
resume
its
upon the
because
lesion of a
to internal life,
27
this
last
affection
iris
be
depends
life
of
210
REMARKS ON THE
by means
of
contracted by the
iris,
of the
iris
facts
which go
to
support
of cataract.
The
may
also
be simultaneously
manner
One
the alteration.
ble as rare,
is
tis-
number
great
Two
soldiers
of
the
royal
guard presented
for
eclipse.
(Jean Baptiste)
being but
little
this
PROPERTIES OP THE
phenomenon, he used an opaque
transparent point in the centre of
made himself
for the
this celestial
phenomenon.
vivid, inconvenient,
211
IRIS.
glass,
it,
having a
which he had
Notwithstanding the
of the
he continued
Soon
after,
he perceived the
end of the
effects of
it;
eclipse.
he was
iris,
soldier,
continuing
Some weeks
to
or-
afterwards,
experience constant
my
care.
its
In this instance,
had
left;
but
it
of rays
his
preserved
At
lost.
we
fallen directly
that
its
the
optic nerve,
irritating effect
retina,
and
and even
upon the
to its
origin in
to
the
212
REMARKS ON THE
ment of
ice
established
to the
employed
re-
The
second,
Baptiste,)
charged.
left
He had
when
the
first
was
dis-
He
was
less
first,
because
through which but few passed; but the circumference of the lucid cornea, and especially the ocular
conjunctiva, had
membrane were
developed
itself.
Suitable
was considerably
its
visual functions.
These
its
FROPEFTTFS OF THE
evidently: First.
of this
of the retina.
its
213
THIS.
it
first
Second.
over
itself
entirely; but
more
deli-
cate,
its vessels,
except
a violent
in
now
relate
left orbit.
loss of sight in
the
perfectly preserved
iris
remained
tient
months.
same
in
However,
as he
The
motions.
its
this state
side, while
from ten
pa-
to eleven
apprehended the
loss of
to consult
it, I
left
After hav-
treatment: Cupping
me.
with scarification
and
commenced
placed the
first
the
on the
After a
bitters,
application of moxa.
left
side,
approaching as
REMARKS ON THE
<J14
same
side;
first
became
motions of the
had continued
iris
The
it
was
this
in a
to
be performed
principal subject of
my
reflections.
in fact,
he saw with
it
Alarmed
altogether.
cident, he again
came
to
claim
my
new
ac-
assistance.
at this
was formed
which intercepted
in
this
in
at the
had preserved
same time
its
motions,
There
iris
PROPERTIES OF THE
first
loss of vision,
while the
iris
The
in this case;
215
IRIS.
first
are independent of
t-he
retina;
the second,
for, if
the
not been
ruptured
it
transparency so rapidly.*
Besides, the
this side,
lost
its
move-
were always
in
right eye.
In tetanus,
when
nerves of animal
life
it is
is
not changed in
in
health.
In
it
proper-
as they
its
and enlargement
same as
all
same pheof"
imbibition.
itself bi
REMARKS ON THE
216
The
sensitive
functions
exam-
by the
remains uninjured
and preserves
iris
movements.
its
dilatation of
An
purges or emetics.*
disease,
this
by means of drastic
life,
two children,
which
have
also
guard,
this.
of
back of
the
his head.
At any
rate,
he presented
all
and advanced
cipal
to
symptoms were
a dull
The
prin-
all
the
in
vision,
iris
however, remaining
unaffected,
life.
PROPERTIES OF THE
was
lysis in the
cold.
succeeded
However,
in this
its
and habitually
whom
arm was
217
IRIS.
patient,
preserved
all
made
of pa-
tients
with wounds
number
have
animal
The
life.
iris, for
may
lose its
and execute
all
their functions.
wo-
to consult
me
an affection of
was
this kind.
The
iris, in
both eyes,
line in
diameter only, by
excitants,
withstanding
this
to contract to
light.
and by the
But, not-
28
REMARKS ON THE
218
had occasion
membrane
wound
But
iris,
it
while the
vi-
should also be
we have
vital
was even
gradually
iris
its
But
visual
will
the retina
properties,
for artifi-
be important to know,
if
case of amaurosis
PROPERTIES OF THE
My
remarks upon
iritis
which
is
its
all
go
to
219
IRIS.
been judiciously
diseased membrane.
segment.
superior
its
circular cut,
which
is
This
part loses
latter
its
non;
but
movements more or
its
has
wards. It appears
appeared
phenome-
me
to
be
in a grenadier treated in
my
never
this
less sen-
to
to
of the ciliary nerves and vessels which are directed, principally, from the superior part to
rest of this
all
the
membrane.
iritis.
at-
Slight
REMARKS ON THE
520
penis.
fully
iris,
paralysis of
visual functions
remained.
still
The
chemosis was
removed by excision around the whole circumference of the transparent cornea; but there
still
was necessary
remove,
to
to the other,
to restore its
which
trans-
parency.*
It is
undoubtedly very
difficult
to
determine
its
mechanism.
But, as in
independent of the
it
may
is
formed of two
The
first
is
in
is
the
other catarrhs; the second becomes inflamed with other parts of the eye,
PROPERTIES OF THE
221
IRIS.
exclu-
iris is
ought
to
many
membranous
this
belonging to the
branch of the
first
pair.
But we
life.
cerebral
fifth
this partition
appear
to
in the
membranous
of images
That
this
irritates this
veil,
more or
of an aspect
with respect
which
light,
influ-
their colour or
to
less
excitant,
form.
Third.
its
phenomenon,
in
paroquets.*
From
birds,
certain
these
iris
of the
reflections
is
family of
may be
it
but
it
this
tlie
opaque membranous
pupil at
Anatomy.
will.
leaf,
which
lens, like
veil is entire,
and
edge of
this fish
a lattice.
this ray
this
opening,
no doubt
lets
In the torpedoe
REMARKS ON THE
222
of which, to
tion
in par-
cutes
its
From
scribe in a
mode
structure,which
this
of distribution of the
curtain,
relaxation
the pupil
hereafter de-
membranous
the
I shall
of
we may
the
iris
or the
dilatation
of
is
or in
lines,
of
this
is
un-
of a purse.
which acts
to
be de-
The
We
ter of
in the
membranous
sac
is
oi"
animal
life,
while
life.
PROPERTIES OF THE
223
IRIS.
peared
as
we
to
me
often
remark
minous diseases.
Notwithstanding these two systems of nerves,
the
movements
The
We
facts.
the inte-
iris in
find,
is
of a pecu-
however, behind
gilded
strise,
This zone, of
almost imperceptible.
is
con-
to
line.
to
This pearl-like
have any other
wards the
crystalline lens;
is
while
the
external
attached to the
cir-
which
very
it
follows)
fine fold
tracts its
opening
to
REMARKS GN
24
TIfE
able
which
little elliptical,
There
is
if,
for example,
we
threatens
it,
and endeavours
to
avoid
with one of
its
its
The
enemy.
its
place, follows
little
it
it
it
its
prey
came-
least,
animal
with
its
with the
greatest facility.
In a dissection that
ing
my
made
residence in Eygpt,
of a cameleon, dur-
wanting
in this animal.
It is
me
to
be
to
it
with the
faits
PROPERTIES OF THE
225
IRIS.
which
jections,
I possess, that
iris
is
elementary muscular
the
fibre.
same
as that
These
of the
iris,
as well as
formed of a
perceptible
to
form these
These
which
substance,
by an extraneous
by
and
injection;
to
be fibrine
albumen
cellular tissue
in the arteries, and a strong thin
propriety,
as
hemorrhages,
iris.
We
have done
the' disposition
my memoir
of these
on
primitive
arteries,
and
at last cables.
selves by
These
fibres shorten
or by the afflux
29
of
blood
them-
of the vessels,
PROPERTIES OF THE
226
IRIS.
in
these means
for
we can
wards launched
By
water.
after-
facility.
As
have
when
its
is
a muscle
is
be sufficient
cut transversly,
The same
capable of contraction.
in all the muscles,
fibre, it will
when
in-
thing happens
circulation.
blood,
into
Besides,
we
unknown
produced by
in their na-
life.
ESSAY
IV.
Wounds
A.
ahdomen, with
considered by
all
However,
to
have been
remark
when they
susceptible of cure.
In
in
have had
my Campaigns,
result
from
fire
fre-
that
arms, are
re-
have
happy termination.
Suppose, for example, that the projectile
tra-
large intestine,
is
destroyed
at a
given point.
228
OBSERVATIONS ON
There
be
will
projectile,while there
bouring parts
,.
is
by
the
to
The intestinal
ly
part, of
which
collect at the
wounded
is
an admirable
stances.
in these cases, to
wounded portion
of intestine, to separate
bring
and
it to
men, and
to
keep
it
In both cases
we have
as internal
We
tion of the
belly.
It is
fecal
matter into
229
wound
we
of the external
should always
wound even
to
the aponeuroses.
to dress
this
way.
Until the eschars
fall off,
Then
clean.
it
becomes necessary
wound
is
to favour the
first,
and a
light compressive
at the
straps
come
first in
of that of the
parts
lips
wound
the interior
for the
The
primitive adhesion,
230
OBSERVATIONS ON
parts which
their
phenomenon which
their functions; a
noticed of
wounds
abdomen
of the
in
formerly
which the
wounds
of the intestines
same phenomena;
more
is
difficult,
they
if
are
of
prompt
assistance.
One
One
consists in retain-
wound
of the
abdomen by means
to
of a ligature
prevent the
al-
wounded
intestine, as
to
happens
in
gunshot wounds,
ed.
The
This
is
undoubtedly
antl fourth
of"
my
Campaigns.
231
lips of the
or an invagination assisted and sustained by ligatures passed into the thickest part of the two ends
of the divided intestine, and sometimes with inter-
This
nal supports.
by John
last
is
recommended
wounds
of the intes-
method
Without entering
that which
will
or incised wounds, as
The
tines,
nature,
undoubtedly the
is
least calculated to
augment the
it
irritation of in-
artificial
notwith-
Sometimes
also,
becomes speedily
fatal.
At
others,
also
that
232
OBSERVATIONS ON
company
For
it.
is
means we ought
and
to
mean
it
be
It only re-
employ
to
ac-
am induced
efforts,
made immediately
mains
symptoms which
these reasons,
all
the suture,
swelled, causing
is
necessary to keep
First.
cond.
in
it is
points:
To preserve the lips in exact contact. SeTo comprehend within the points of the su-
we
an obstacle
Third.
to the
The mode
ed
the
to
wounds
may be
is
that
assert-
of the intestines
is
effected, as in other
own
vessels;
and the
and preserved
in this state
by the suture
In
the
experiments which
it is
delivered at
in Paris,
experiments
tines,
made
Lectures on Surgical
in the
833
intes-
was demonstrated.
which was
by an incision
laid bare
these
wounds by means
du
of the suture
united
pelletier,
double, using
it
alternately.
These
It is
caution of leaving them of sufficient length to be retained out of the cavity of the belly, until the period of extraction.
fifth
day,
it is
prudent
remain
may even
tracting them,
we ought
to
may be
wounded
30
to
in
easily done, as
The
the
be allowed to
suture being
OBSERVATIONS ON
234
so that
it
may move
it
at
is
it
inflected in such a
engorgement of
I
tier,
propose in
its
contents,
manner
and
as to
to cause
an
its tunic.
commended by
authors, embraces a
much
larger
such
There may
of the
wound with
edge
may be
said to
them
of the
and thus
alvine matter.
to
mo-
phenomenon
in
wounds
of the belly in
which the
relieves
itself
of
whom
If
were not
it
its
235
original
tions of internal
would be exposed
life,
to
greatest dangers.
tificial
the
when
intestine,
say,
moves
This
of the anus
is
when
is
more
are recent.
It is
logical
by repeating
Nevertheless,
animals.
my
experiments on
we have
to
oppose the
nical irritation,
Certainly, from
produce.
my
experience,
we
can-
the
my
omentum
Campaigns
tlie
Memoir on Wounds
iv.
page 373.
OBSERVATIONS OH
23b
We
in
must apply
The applications
frequently as may be judged
should be repeated as
The
necessary.
scarifications
should
made
be
with the instrument, which has been already described, and in such a
manner
this
This method
made by
press-
my mode
and
of
entirely
To
we ought
to
add
oily
embrocations, luke
warm
bleeding
is
sometimes indicated.
ment recommended by me
low fever, addressed
cine of New-Orleans.
to
in an essay
the
I
treat-
on the
Academy
of
yel-
Medi-
will
WOUNDS OF
answer
my
pears to
tion,
237
THi: INTESTINES.
me
an inflamma-
to consist, principally, in
more or
less
the
severe, of
serous
mem-
vomiting,
intestines
its
and
in
The
sentially differ.
a
es-
upon the
When we
same
shall
results;
in all these
now,
the^ indica-
kinds of affections.
same progress,
we
shall
know by
have already
the cessation
in-
we
of those
may
tion
oil,
rated
oil
we
238
OBSERVATIONS ON
to expose
first
volatile
principles,
them
of their irri-
we
by the use of
light tonics,
is
strict
fric-
to
which remains
intestine,
The
same time
it
will
The
treated by suture,
this
mode
named
Jolin (Jean
years, a fusi-
This
by
the
of treatment.
fell
at
soldier, while
and
barracks of Courbevoie,
in
point
in his
of
his
sabre,
the abdomen.
He was
239
a neighbouring village,
first
assistance.
"This
soldier," says
M. Carre
"had a transverse
wound
in a letter to us,
The
of
tion
patient complained
there found a
suture at
this
make a
to
which
men.
was
black; the
At
at
stool.
of the
Guard
bloody
present,
Paris." During
and
Surgeon
this
OBSERVATIONS ON
240
belly without
much
The
effort.
intestine,
it
by
The
enemata.
patient, however,
bili-
At my
visit in
stools.
the morning,
me
who had
dressed the wound at Puteau had asked for a needle and thread
of a
present at
he
knew
he had
nothing of
felt
its
nothing.
However, conformably
cases, I unbridled the
to
my
wound
precepts in such
of the integuments,
in the apone-
wound and
241
several
remained,
adhesions, and
to
up these
arterial branches
which
therefore content-
the
wound with
and dressing
of reservoir,
opened
it
in the
incision,
The
the countenance
dull
cold;
the eye
he had
by small bloody
dejections,
despaired of relieving
minent danger
theless,
the
abdomen was
swollen.
I
accompanied with
tempting
31
in
wished
to
my
Never-
at-
OBSERVATIONS OX
212
intestine,
which
in cases of
had surprisingly
I
assisted
spontaneous volvulus
me.*
first
ed with
man-
To
the cupping,
added camphorated
em-
oily
cataplasms,
stria}
Through
bilious dejections,
also
mixed
of black blood.
that night
the patient
was
tranquil;
The
insisted
almost instan-
to
have recourse
to
it.
this; I
and the
regret
my
all
the
patient
not havin
243
They
came
be-
underwent
analogous changes.
In a word,
situ-
However,
and again,
To
obtained a
this sol-
On
the evening
from
this
moment,
all
the
In-
inflammatory
symptoms suddenly disappeared from the abdomen, and on the thirteenth dav, the patient had
copious stercoracious dejections, assisted, no doubt,
244
by
OBSERVATIONS ON
oil
tid
applied
large
of
formed
quantity
purulent
matter,
was
which
This salutary
crisis
wound;
at the
removed
it
in the
of black
bit
itself first
presence of the
Clinical
Lec-
The unexpected
proved
to
me what
discharge
of
this
ligature,
had
really been
made, and
induced me to write
first
to
had observed
This circumstance
the gentleman
who had
information of
dressing; I
all
his
first
answer.
grew
patient
245
The wound
of the
abdomen soon
cicatrised; all
of
the
accident,
patient
was
by the
the hospital
eightieth.
sions
left
the
which
tions of the
had
observed
at first
wounded
intestine,
in the
which
convolu-
think
was
in this intestine;
had com-
The
contributed
Under
much towards
this
happy termination.
we
fine, is
common sew-
at first in
The
John by
was the
a great number
abdomen and
intestine.
It is also
very evident
246
to
all
humid cupping.
In
a word,
am
can
abdomen and
to the
I
Society of
abdomen,
small intestines.
it
like
lost
its
the
of
ESSAY
V.
IN
FRACTURES IX GENERAL.
The
uncertainty which
of restoration
tarded very
in this
branch of pathology.
mode
to that
reached, at a period
trated
less
We
knowledge
degree of perfection
by so many discoveries,
if
is illus-
we had been
The
of our
of bones in fractures.
themselves in
my
elapsed,
have induced
ON FRACTURES OF THE
248
me
me
to
and
which have
of
have
Of
also
this
who
physiologists,
and Professor
of
my
first
masters,
in
my
The
honourable colleagues.
searches, and
my
me
to
pursued
me
to
in the
to
pectation that
may
in the ex-
work on
notice to
what appears
esting,
But
in
to
me
to
myself in
this
life,
when
is
the
ossification
first
who have
passed the
The
is,
at
density that
of
249
the insulated
life,
direction, enable us to
its
oblique
facility
may be
fractured.
Indeed
it
is
this portion of
it
ter-
Third. That
by an
That
lastly.
is
it is
it.
When we
we can
easily con-
liable to
be
when they
act
with
the
32
great
trochanter.
This
is
evident,
ON FRACTURES OF TIIE
250
opposed
tion
to the
which
it
experiences at the
in
the devia-
moment when
the
rise
riodal eminence,
direction.
On
and prevent
this sphe-
luxation in this
its
two designated
fragile
which compose
it
being
Thus,
for
example,
if,
after
limb
first
femur
is
inevitable.
to the
moment
it,
in the situa-
of the
fall.
When
25]
of the neck of the femur included within the articular cavity, (and
it is
which
of this part of
wish
it
and
are,
must always be
effects
it
differ.
young sub-
neck of the
when
this
this part of
at a
its
elasticity.
The
first
sign of fracture
is
the immobility of
his support.
we
find
it
it
it
it
in a state of retroversion
from
almost in a transverse
ral
elongation
for
afterwards with
line.
There
is
is
an unnatuthe
other
ceived,
when
we
the thigh
is
is felt in
the region of
&c
ON FRACTURES OF THE
252
I
we
for
we may
moment
rotary
of the fracture
movement from
experience at
This
behind, forwards.
will
evident, because
is
all
their tendons to
is
made
in
an oblique
line
from the
iliac,
of the articulation.
say, con-
throw the
The
elongation
is
symptom
is
uniform.
the
thigh
bone
253
The two
frag-
were
tion they
in
tinuity, in an oblique
its
rotation out-
it
little
bulum,
For
in the
same
this
any deviation:
its
which diminish
ibility of
It is
important
in the
and
flex-
same proportion.
For these
reasons, the elongation must be accounted a constant and primitive sign of this fracture, though
the limb
may
at last
frag-
Lastly, fracture of
The
advanced
in age,
and
in
persons far
any
254
ON FRACTURES OF THE
morbid
specific
the indication
vice;
is
alw
but,
iys the
however complicated,
same.
The
treatment
in
It is the
employed
Indeed,
if all
difl'erent
opinions
practitioners, as to the
means
to
membranes
them
internally,
we
be employed
to
line
But
if
sub-
name
of Jibro-
we must
which can
fulfil
necessarily
invent processes
Thus, according
tisans of ossification
to bring
255
capsular
endeavouring
ligament;
fibrous sac as
much
apply
to
this
it
a union,
however, a thin
more perceptible
destitute of
is
(There
it.
which are
and appear
ment.
fibres,
This
tissue,
which
is
differs nevertheless
According
composed of
parallel
neck
is,
to,
and
still
The
used, concur
One
of
According
to the
second hypothesis,
in
order to
made
ON FRACTURES OF THE
256
proper
to
produce
callus.
It is
manent extension
of different forms,
chanism more or
vented.
ture in
By
its
less
and of a me-
work
and Avicenna,
digious
number
From
is
aggravated, and
evil
crates
in-
not
is
is re-
exempt from
Whatever may be
the
mode
of extension, in
it is
It
not only
is
useless,
may
capsule,
projection
arti-
which
is
257
tabulum, where
is
it
is
The
very rare.
base
its
in the
because this
rior,
infe-
last
fills
kept in
this state
not
dis-
bury
itself
in
to
is
efforts,
before the
him
any
remain
to
in
In
few
lines;
most
place
for
and
it is
easy to bring
it
back by the
in
to
which extension
Extension
and
is
is
perfectly useless.
especially injurious
effects of it
when
it is
per-
extend to the
ON FRACTURES OF THE
258
which
new
which accompany
injuries,
the accidents
These same
it.
to
upon
But other
may
accidents
from
machine.
all
all
The
apparatus.
to
resist all
to
be
affect-
difficult to cure.
this
violence, there
in-
that
away from
which determines
served in
this elongation;
my memoir
its
as
obliquity,
have ob-
on femoro-coxalgia,* where
is
described.
This
chiefly
ment, or
from
the
erosion
of
this
ligament,
in
the limb
On
its
then determined by
is
259
its
weight.
founded
is
doubt
it,
in
may be 'resolved
Nevertheless, this/op'u-
do not
machines
for
When
be
the
union
necessarily
is
perfect
by
followed
and exact,
a
it
shortening
will
pro-
lines,
of the
soft-
may become
developed;
standing
thors
all
Notwith-
who have
all
au-
it:
ON FRACTURES OF THE
260
we
this
method.
mode
of treat-
to
last
abandon
my
illustrious master,
Thus,
caused
filled
means of
army
to the
strings.
means
of a roller,
Of
late,
in
permanent exten-
sion has
stitutes
to
another.
*
M.
me
a drawing
261
The
conveniences.
its
is
want of fixedness,
in the
by the
connexion, retards and even prevents the formaat least renders the union de-
tion of callus, or
its
natural
we suppose
is
which
oppose
consequence of
1
this
itself to the
exten-
and
difficult,
without assistance, in
permanent
formed
progression impracticable
the callus
in its length;
Mursinna,
who had
flexion.
neck
of the femur, and for which the method of Sabatier had been employed, a
false articulation
formed
in
M.
implanted
M.
accident
may
far.
method,
be reported hereafter.
me
femur
in
is
analogous to that
sinna.
will
The same
in
is
placed
in
the apparatus of
Mur-
ON FRACTURES OF THE
262
This
be easily understood
will
if
we
attend to
This
relation
is
such,
is
its frac-
Now
fractured surface.
in-
exten-
less
solid,
to this
method,
afflicted
in
consequence of
might
vations, a great
cite, in
this
permanent
I will,
at pre-
am now about
to de-
fact in
my
support of
respecting the
opinion
permanent
attending
inconveniences
263
serious
extension;
when
to his
I shall
translate
Doctor
it
to the
viceroy
was observed
"A
at
Edinburgh.
wall; but he
up
the garden
the top
when a
At
large stone
into the
unhappy man,
his leg.
several persons
The
sur-
used in fractures.
The
patient remained
tranquil for some hours, but then began to complain of the conduct of the surgeons,
He
who he
ac-
confined to assert
them
to take
so strongly
away
bound
his leg.
volumes.
Manual of
tlie
Army
silent,
and pretended
in
two small
ON FRACTURES OF THE
264
might be
During the
left alone.
and applied
it
in a pillow of feathers,
it
"On
straight.
view,
without
suffering
his
medical
atten-
wished
to
He
ways remarked
and as
to
The
in this
remained
it
was
in a favoura-
until
he thought himself
up
the pillow.
in
this
envelop,
to
perfectly
This
lesson,
covered
and washed
straight."
still
it,
it
from
the surgeon
was
certainly
and
a useful
65
of the neck of the femur, there are two indications to be fulfilled to facilitate the union of the
The
first consists in
er;
to
a cure.
The
relative
position
being established,
it
is
necessary to preserve
apparatus.
ing
it
mode
it
The
of apply-
tion.
The
indication are;
first to
is
parallel
with
the pelvis.
first
point;
so that
when
in contact
the inflammatory
form the
callus;
a condition which
is
absolutely
necessary.
The membranes, we
34
new
ossification
ON FRACTURES OF THE
266
they
fulfil
altered,
chronic
ossi-
in certain
of
differ-
ous nature
these
form
ural
it
will
or
having an osseous
appearance;
call
ossi-
concretions.
nat-
destined
to
by any cause, or
to repair
of substance in them;
performed,
and
in
an accidental
this ossification
fact
is
must be
actually performed
in the
loss
to the
same
ly be
acknowledged
must certain-
at present, notwithstanding
It
number
of physiolo-
diluted
muriatic
acid,
and the
disease's
which
Nature,
unite.
267
vessels are
many
ways proportioned
constitute
number
these points
which
ossification
many
al-
is
convex or
In every instance
of
so
develop themselves
uniformly from the centre towards the circumference, so as to have no connexion with the peri-
osteum.
extremities
of bones.
dinous
insertions
This
is
at
it
in
There
man.
is
Marine
the ex-
the pubis, as
many
different forms
insertions.
and
The
tendinous
is
con-
ON FRACTURES OP THE
26S
we
If
the
Cv
follow attentively
be made
in directions
principal nutritive
arteries
points,
ing
shall see,
very distinct-
sification to
the
transmission of
the
find
diverging from
towards remote
There are
is
bones.
the
osteum
of os-
of a
the
peri-
this
bird,
as
made
at
It is
in
which
remarked
this
pe-
It
consists
in
cylinder,
remain
Thus
bone
will
in the
No
reproduc-
in
con-
lost
269
its
separa-
loss of
substance in
portion of
cause, a
is
destroy-
a proportionate excavation or cavity, no reproduction of the bone having taken place. But there,
is
ing fibrous or cellular membranes, of the physiologists of the last century, from taking place.
fact
i^
that
the
new
ossification,
The
necessary to
cause the vessels of the two fragments being considerably distant from each other cannot elongate
themselves
sufficiently,
adhere together
loss of
to
so as
form
to
anastomose and
bone.f
my
Campaigns.
t See the design of the two bones of the ieg in volume eighth of "the
Journal Coniplementare."
ON FRACTURES OF THE
270
The
instances which
we
cylinders, after
by means of the
perios-
coj'tical
substance of the
bone remaining
oi*
is
in a
at
absorbents;
sult of the
but in
fact
to the effect of
when
was
in
cording
it
to the
itself
more or
less ac-
If the
removed
at a
proper period of the disease, the two broken portions of the shaft, in
which
it
fill
the
to the belief of a
271
But afterwards
reduces
itself to a
new
osseous portion
volume proportioned
to the de-
cal layer.
new
bone, which
may
new
then cause
corti-
disease in the
it
to
undergo
have before
said,
my
'
But
it is
not
my
upon necrosis.
reflections
purpose to extend
This subject
is
my
Be-
The
century.*
last
Thus,
or-
wounds, remain
same
form
and
polish,
instant
ot'
of their
for
whole
still
present the
(especially
when they
ON FRACTURES OP THE
272
belonged
to
the
fractured
bone.
I
might relate
truths, a great
in
number
of facts; but
it
will cer-
to
pericranium
raspatory,
removed by means
is
the
to close
How
of
up the
-hole
made by
then
is this
effected?
When
he
is
ner,
we
of
substance.
loss
may
be closed up entirely.
In
grow
all
thin-
This process of
first
membrane
at least is destroyed;
it
and
if
would
Besides,
we may
Oil
%jO
that
result to
the
disagreeable
consequences
functions
the brain
of
would
from
made
this
in the
cranium.
The
following case
is
an illustration of what I
have advanced.
Champ-de-
first
of
Marshal Bessieres,
in the corps
his horse at
When
company.
The
following morning at
a contused wound
near the
bone.
orbit,
in
my
visit, I
discovered
region,
of
all
was
also
The
ON FRACTURES OF THE
274
of the
The
He had
suspended.
all
fceces
was momentarily
expected.
With
freely,
was
the
known resources
situation, I
all
its
whole extent, a
Se-
surface, to
I
was content
common
dressing.
plied about
tions of hot
the
at
me
the
to
apply
the
trephine.
embroca-
to exhibit
some
signs of
life,
and
to utter a
few
275
of the left
side
urinary dejections
the patient was
still
much
agitated.
copious bleed-
On
This
last
blood, which
was torn
this
meninge
a considerable extent,
to
and there was ecchymosis of the external surface of the designated portion of the encephalon.
The
ly,
in a favourable position.
Af-
which he was
danger continued
totally
deprived.
The
ON FRACTURES OF THE
276
themselves in
all
fr
One
The
several
months;
however,
it
became gradually
from the application of the trephine, and the extraction of the detached fragment, as large as that
to
come
the
vacuity which
in contact
to close en-
before existed.
The
cannot be traced.
The
The
sight
was im-
lost.
277
vital
same
is
objects,
which
he could with
for
several
this
memory
of
The
names and
difficulty
months
restore.
to
remember
after
his
his
fall;
own name
this
faculty,
very imperfect.
still
teum of which
is
in-
ily
in contact, be-
cause the vessels of these bones are very numerous and develope themselves easily, in consequence
of the
number and
which penetrate
also
size
jects.
in
is
young sub-
think that
it is
Lastly,
ON FRACTURE? OF THE
278
all
jaw
In
by
left
we
this
destruction
is
Also
if
bony fragments,
the
the foreign
bodies, there
'a
have seen
in
many
patients, especially
young
laminae
first
having
by some
of a bright red
in parallel lines
colour,
arranged
These
la-
vas-
is
vessels, giving to
named Vaute,
a corporal
his
in
my
this
wound
posited in
He
For
army
of Egypt.
is
de-
a minute account of
it
consistence of bone.
new
cellular
279
membrane
of
new
ci-
of
substance.
The
patella exists
circumstances as the neck of the femur, the fracture of which constitutes the principal object of
That
this memoir.
is, it
equally destitute of
is
posed of parallel
tinuation
fibres,
of the
of that
muscles of the
which
it
evidently a
con-
It has
leg.
is
cannot unite
its
when
it is
divi-
whole thickness.
fragments
may
when they
reunion
is
effected by
spongy.
On
is
very
ON FRACTURES OF THE
280
becoming somewhat
thiner,
fracture.
common
to
fibrous
both fragments,
developed; this
is
is
embedded
These
like a
fibres,
is
sesamoid bone.
being at
first
lig-
the
Soemmering has
which
of the callus
vessels
to
unites
fractured bones.
Anchyloses of the
prolonged
joints,
immobility,
or a
latent and
age,
chronic
of
These bones
deprived
of
this
cartilaginous
points
envelop become
may
be
al-
and endeavour
to
Any
one
may
convince
deposited in the
2S1
museum
of
who
vertebrae,
cure
to
of
other
of these vertebrae.
portions
It takes
fibrous
vour
unite.
to
The
pressed down, so as
vertebrae
themselves
are
and union.*
The growth
of the teeth in
all
animals
is
com-
many
mutual adhesion
tact, after
cavities;
at the points
in
immediate con-
when
The
callus in
is
them presents
formed according to
it is
observed
*See
the
36
memoir on Rachialgia
in
my
Campaigns,
vol. iv.
282
ON FRACTURES OF THE
system.
alveolar processes.
If,
af-
may be
periosteum, no reunion
Again, though
life is
in fractures
until a consid-
very slowly.
It is
os-
itself, if it
ever
took place.
to the opin-
is not,
termediate substance.
As
it is
283
same manner
is
will ob-
made
in the
we
cicatrix.
parts,
ed, by
stance,
wound.
may
lips of the
facility.
will
to fractures of the
neck
and
it
to
is
to fix
immove-
its
This apparatus
consists of
compresses, which
ON FIUCTURES OF THE
284
tail
forms and
of
sizes;
of various
chaff,
which
it is
unnecessary to mention.
is
in
at
first
some repercussive
the compresses,
fluid, as
camphorated
fold
to
is
next applied, so
lastly,
we
ter-
in
a wooden
sole,
we
Instead of
permanent
flexion.
keep the
foot in a
to
being
after
instep.
tion in
which
it
first,
is
until
in the posi-
be judged proper.
removed
The
dissipated.
It is
may
observed at
important, however,
to
285
After the
twenty-four hours,
first
it is
difficult to
describe than
The
advantages.
first
it,
overcome their
we have no reason
to
apprehend a displace-
By
position
inconveniences
we can
when
much more
whether
in
in their
readily done
simple
it
or
retain
the frag-
this can
be
transverse,
fractures.
above.
painful compression;
whom
have treated
in
ON FRACTURES OF THE
286
this
This apparatus
ment.
manner,
and
of the thigh
fractures
be carried
to
in
considerable distances,
dressed in this
leg,
to
without displacement of
the fractured bones, and without the patients having experienced serious inconvenience.*
Finally, experience has proved to
apparatus, which
is
purely retentive,
ments
me
that this
fulfils
best
It
in contact,
The
extremities
is
is
liavc
shown
to the
(Dominique,) a canonier
the Invalides.
shot
wound,
in the
in
Academy of Medicine
in
a person
named
Justice
The two
artificial joint
ol the
same
formed
side, with
this limb.
employed
by a bandage
support
or
compound
the
to the
287
first, it
simple
is
In
little
back-
the scarf,
in
all
cases
The
last
person for
whom
aged about
is
lieutenant
This general
fifty-five years,
officer,
The
November, 1819.
to
preceded
it
to
acknowhastened
in, I
apply
it,
having
The
ed,
the
is
long and
difficult,
apparatus should
because
be
it
without
pain,
of an hour of fever.
all
applied
dured
if
and
well perform-
the pieces of
with
perfect
not
288
was
entirely
The
in
its
proper situation without any deformity, and without the least excoriation;
about three
began
to
lines.
it
has recovered
its
pei'iect.
ESSAY
VI.
TThe
ancients considered
aphorisms of
of the blad-
wounds have
Although
Ipfhale.
is
wounds
VISCTTS.
become
since
of fire arms,
made
it
the treatment of
wounds
ism
is
of this
in
has
this
in
aphor-
fully treated
by authors.
The
The
translated
land
in
three
first
1815.
A.
is
in
Paris, but
not translated.
Moscow,
The
first
37
is
Trans.
290
ON WOUNDS
tion of
it.
little
pursue
to
which
is
it
viate those
most proper to
effects,
and
when they
especiallv
the
to ob-
lesions;
is
empty,
If the bladder be
the
wound
it is
considerably
which
tants.
is
it is
The
But
excitement of battle
is
and
to
In this essay,
fill
this viscus.
propose
to trace the
phenome-
may
some point of
its
its cir-
parietes are
91
OP THE BLADDER.
However prompt
mortal.
immediately a
on the
fatal
to the cavity of
and produces
it
inflammation.
field of battle
many
have dressed
whom
soldiers in
the
first
all
But,
if
instrument
the
is
susceptible of
The
this injury
is
The
the
dis-
wounded per-
The
der.
wound
is
pierced at
its
come
moment
in contact
the
full, is
is
dis-
will contract
and
if
the urine be readily evacuated by the natural passages. Should there be any obstacle to the passage
of the urine existing in the urethra, the bladder will
then become
fiiled
and distended so as
to
open anew
292
ON WOUND8
The same
ing passed a
too soon;
wound and
gum
elastic catheter
after hav-
if
were removed
it
wound and
restore
it
Fi-
and perhaps
time, if the
wound
When
wounds
is
extensive
different
gum
elastic
the bladder.
Warm baths,
all
wounds
camphorated
oily
of
em-
may each
in
be occasion-
persons suffering
relate here a
appear
to
me
to
summary
this organ.
be interesting.
in
in
the
*>a?-guard,
OF THE BLADDER.
293
wounded
in
right
thigh
by the lance of a
Cossac.
This weapon,
after
the
glands
the inguinal
to-
That part
is
of
uncov-
a large
dis-
charged through the wound and the patient considered himself cured.
The
in
escape.
fistulous.
for a long
to
time
294
ON WOUNDS
attentions of
M. Champion,
my
one of
pupils, he
was cured.
Case 2d.
In a
bull fight
which we saw
who was
The
the arena.
in
Bur-
1808, a sol-
in
at
soldier,
fell to
and
who,
in
endeavour-
bull,
universal
dience, at the
with
his
and
sword,
animal,
killed
pier-
him
in-
stantly.
and ran
senseless
first
who
lay
which
intre-
attended him
dressing.
lit-
tle
On
a further examination,
OF THE BLADDER.
and buried
ty had
It
its
295
where
its
extremi-
portion of this
for a
membranous
at this point,
sack, formed a
tumour of the
to
present a
There was
its
which
The
patient
was
order
caused him
to
to
drink a
little
strong
the
dilated the
wound
internally,
and passed a
mour.
Before attempting
its
reduction,
took
gum
catheter, by which
ON WOUNDS
296
membranous
sack;
gradually into
its
proper cavity.
to
return
The system
then
lint,
be removed
wound
in
On my
fectly cured.
it
it is
will
and the
life
in
now endeavour
its
cavity;
and
me
ball, after
still
to
If
preserve
OF THE BLADDER.
momentum,
its
side,
it
will
297
itself in
will
be a diminution, or
total
he
will
to urinate
restless-
may have
there will
pass
out
through
the
wound,
its
when
where
it
is
covered on
its
posterior
part by the peritoneum, the urine generally extravasates into this cavity, causing an inflammation
of that membrane.
all
38
298
ON WOUND!;.
life.
The
life,
and those
first
The
is
particular odour,
this
volatile sub-
sort
of
wounds mentioned by
cutting instruments.
in
is
form-
have already
may
urine
said,
are curable.
rare that
it
membrane
its
Although the
infiltrates, at
first,
it is
wound; because
may
it
then
When
this fluid.
prevented by keeping
catheter; but
as for
ball,
its
These
in the
example, when
it
membrane and
effects
urethra a
introduction
is
it
may
gum
be
elastic
encounters splinters of
OF THE BLADDEU.
bone
in the
extended
It often
canal, or
to the
when
299
happens
that,
mem-
by the symptoms
by the smallness
face,
cavity
its
deep seated
We may
tion.
arises a
It
is
rare
it
may
anodyne
its
therefore be easily
In such cases,
warm,
beneficial.
difficult.
In every case,
wound
at
it
which the
is
proper
ball
out;
when
the
usifally
supervene
By
unloading
vessels,
it
leg;
#N WOUNDS
300
readily
course, be
the cicatrisation
are
of
will,
pledget of
lint
sary
form the
to subject the
nous
regimen,
first
dressing.
prescribe
to
It is neces-
emollient
enemata,
oil
The symptoms,
are generally
which
to
violent;
during this
that of inflammation,
is
it is
period,
first
not necessary
fully;
it is
better to wait a
has taken
separate, the
bladder,
its
gum
so
as
the
the
to
army
begin
to
imme-
to
prevent
urinous infiltration
wounds.
bladder.
cases,
eschars
trisation of the
much
the
suppuration
diately
and
When
place.
little, until
my Campaigns.
of this Hind
is
of
in
instance
whom
OP THE BLADDER.
301
who recovered
tum;
I will
give here a
entirely.
summary
campaign of 1813,
in the
me during
the
infantry.
of
This
officer
Hanau, on the
ket
ball,
was wounded
in the battle
thirtieth of October,
by a mus-
the right spermatic cord, and penetrated obliquely through the lower part of the pubis, near the
its
towards the
left
perforated
through both
its
side,
walls,
and
bas-fond, posteriorly
finally
rectum
the
passed out at
The
discharge of urine
tine,
left
The
patient
ence, where
was carried
I
his treatment.
by the
intes-
wound
had occasion
The
little
to the hospital at
to follow
May-
of the scrotum,
was
sufficient to de-
The
deep
scarifications,
life,
and
ON WOUNDS
30
gangrene.
all
who
until then
had but
little
kept an
elastic
gum
The
The wound
The
tor-
ster-
cathe-
M. Dugat,
The
frequently found
At
pletely cured.
M.
German Gazette
me
have
just related.
OF THE BLADDER.
"The
ball entered
303
The
The
inferior extremities
were
in a state of para-
lysis;
all
The
Academy
of the
Memoirs
that
men,
in
The
17^4.
left
wound
ball,
in
which
side of the
the abdo-
weighed
an
abdomen, about
the linea
alba*
der, and
finally
left
sacrum on
as
its
left
side,
and.
the anus.
the
the
The
side were
flammation in the
ceration of the
in-
The
la-
testicle
and scrotum.
the
wound;
ON WOUNDS
304
The
during the
first
few days.
It
haemorrhages;
&c.
In a
in a
abdomen,
most alarm-
ing situation.
M.
He
and
thought
wound
of
of the
From
it is difficult,
to
determine
employment
of the injec-
I will
not undertake
How
can
we
at
one of
its
305
OP THE BLADDER.
points and remain in
cavity?
its
We may
easily
ball,
may
edges,
angles or
its
body de-
flat
its walls,
it
into
by one
be turned upon
its
it
traverses, so as to pre-
stop and
fall into
with respect to
ed
its
this
it
its
largest surface;
But
balls,
spherical form,
when
through?
and thus
Must we
entirely
has retarded their motion; so that when they arrive in the cavity of the bladder, the quantity of
urine contained in
it
gress?
When
bodies
may
be spontaneously expelled
through
have entered, by
artificial
means.
The example
is
one of
"This
officer
had received a
pistol shot in
the
39
ON WOUNDS
306
The wound
patient
closed and
was cured;
but, after
to those
in the
urethra."
which
means of an
will
also be readily
elastic
gum catheter,
They may be
ment
employed.
is
thus either pass through the urethra or get entangled in the eyes of the instrument.
have
may
strument.
According
his time
calculi
to
were
ing instrument.*
when
in
It is
dilat-
may
But the
this art.
The
Vide chapter
xiv.
among
this
OP THE BLADDER.
my campaign
What
lowed
remain
will
be
and
irregular;
the
proportioned
of the
der
will
into
the
the ball be
if
bladder?
The
to
an inflam-
weight,
its
substance and
mass,
the
body
foreign
and with
common
peculiarly
may gain
ball
its
course
most
the
pass
will
stances, the
Ulcera-
form.
its
the
succeed;
undoubtedly
al-
effects
soon produce
will
it
suppuration
tion,
it
in
injurious, if the
mation
nature
in that country,
of.
to
307
in
the
army.
favorable circum-
the perineum,
proeith-
may
also pass
by the rectum
in a similar
man-
ner.
If the foreign
body be
small,
by
it;
its
matter,
much
affected
deposited
by the
and
New
urine.
it
will
lami-
thus
will continue
its
ON WOUNDS
308
presence
in the
more
ball is
difficult to
But
calculus.
The
pains
membrane
painful than
what
is
The
substance.
calcarious
more
to detect
it;
fond, so that
it
may
almost impossible
it is
also be covered
by a layer of
may
touch
without
it
to recognise
it;
towards the
so
Nevertheless, an
pellicle;
with
rectum, the
ball
may be
it;
so raised
besides,
may be made
which
about.
he
to
will
it
up that
will
be
the in-
felt
pro-
characterize a gun-shot
wound
OP THE BLADDER.
309
body
in this viscus^
Taking
body
is
by means of quicksilver,
to
attempt to dissolve
as
it
substances are brought in contact, in certain proportions, the lead becomes dissolved, forming a
liquid
the urethra?
The
partisan of this
this
Experiments of
difficult
to execute,
and
weighing
weighing
at least an ounce.
are
we
sure of finding
after
the accident?
trary
we
it
Certainly
not; on
it
first
the con-
twenty-
brane, which
it
mem-
ON WOUNDS
310
the bladder in
its
possible that
may
The
of lead.
with
it
ball
Finally,
course.
it
is
quite
may
also
it
In
itself.
all
these cases,
increasing
aggravating
the
all
will
it
become
symptoms.
We
weight of foreign
in
This
injurious,
remedy
such cases.
urethra,
it
what
doing
when
is
make an
this.
Shall
we
Many
authors, and
this.
OF THE BLADDER.
Whatever may be
nal
wound has
it is
311
it
should be found in
viseus.
moment
the urine
is
and
walls;
wound.
internal
it
wound
which render
Even
if
its
is
we
researches
all
difficult
and
fruitless.
it
be able
ment
if
would be necessary
to
enlarge
of the
to divide
so as to
This enlarge-
happen
it,
if
especially
we should
vessels rami-
would
membrane
of the pelvis.
way, supposing
all
ON WOUNDS
312
to its
accomplishment,
if
it
would serve
it
as the
would be equal-
ly
tomy
at
suffer
to
we may prevent
of which
two operations.
By
at a
depending part of
all
the inconveniences
advantage of
shot
I
wound
of the bladder.
tomy; which
and
I usually
slight
is
in
which
have
To
may be
we may
desire,
it is
all
necessary to perform
it
it
before
necessary,
lias
wounds
inflammation,
it
is
OP THE BLADDER.
313
it
has terminated.
single fact, of
which
am now
about to re-
trace succinctly the history, shews that this operation has been practised, with the intention of
Still
this did not take place until long after the acci-
my
dent; while
operation, of which
shall give
an
case,
first
after the
accident.
Case
ist.
"A German
1800.
The
ball
when
The
at first
experienced
Ten years
Wer-
40
The
opera-
ON WOUNDS
314
tion of lithotomy
which was
The
common
of the
following
occurred
was found
of a
size."
summary
is
size
of a case which
to myself.
wounded
distressing cries of a
officer,
M. Guenou,
went immediately
him with
on
care.
He
to
wound
The
careful introduction of a
was a
that there
lesion
of the bladder.
for,
This,
The
it
patient ex-
The
urine,
mixed with
caused
cries.
the
patient
to
utter
the
most piercing
febrile,
and heat
315
OF THE BLADDER.
with
were beginning
thirst
manifest
to
them-
Deprived
was
When
ety.
extreme anxi-
in a state of
he moved, either
he perceived a sensation as
something were
if
that these
symptoms
had received
at the battle of
ball
me
cumstances induced
to
out.
this point, I
cirball,
in the groin,
stopped
These
had
myself on
had some
dif-
last
perceived that the sound touched some foreign substance, though the shock
Before proceeding
which
wished
sultation;
conceived
to
have
my
My friend,
The
it
was
ON WOFNDS
316
determined that
it
ately.
and the
ball,
(which
have deposited
in the cabi-
It
its
sides covered
by a layer of
sufficient to
The
of
render
was pro-
extraction of the
ball
fragment of bone, a piece of cloth, and some coagulated blood; and afterwards two emollient
jections
were thrown
in-
Lint with
The
the wound.
patient
was placed
in
a conve-
With
Some
no accident occurred.
self
the
readily stopped,
fever manifested
it-
wound became
the
regiment.
hospital,
He
perfectly
wrote
to
and, on
M. Guenou
me from Moscow
to
thank
317
OF THE BLADDER.
me, and
to request
me to
procured.
the line,
left leg,
who had
received a slight
was lying
operated upon
in the
wound
same ward
M. Guenou.
in
assuring
me
that
Encouraged by the
upon
companion, he desired me
in the
which
his
to
he had suffered
for
twenty years,
in garrison
at different periods.
I
ficulty, I
became
satisfied that
he was correct.
had some
be enveloped
in
On
little dif-
It
in the
the opera-
same way
as
difficulty in seizing
appeared
a kind of membraneous
to
me
to
pellicle,
traction
was
The
ON WOUNDS
318
uncommon
respect to
cific
ed
characters, with
it
to the
Faculty of Medicine.
spe-
its
have present-
The
nucleus
which the
until
falls
removed by
where
it
is lost
in the substance of
But
far
re-
when
in
mains
The one
was
could
its
But the
facts
which
am now
deavour
I will
en-
menon.
* This essay on -wounds of the bladder was published thus far, in the
fourth
in 1817.
The remaining
part
is
D*Emulation, November,
taken
1822.
OF THE BLADDER.
We
may suppose
ped
319
after
having
less tortuous, is
stop-
The
tunics.
presence
of a
its
body soon
foreign
and prevents
pies.
At
its
it
occu-
undergone
fin-
The
process of ulceration.
ball
becomes thus a
deposited upon
weight of the
surface,
projectile, until
the cavity
ly into
its
which always
augmenting the
at last entire-
it falls
of the bladder.
tends
to
overcome
Or
all
nature,
obstacles,
may, by a spontaneous
made
The
easily, as the
effort,
so important,
may
close, or cica-,
in the bladder
suppuration extends
itself
more
most rea-
ON WOUNDS
320
parts
where
it
may
It
it
parts
when
and
bladder.
It
to
is
to the inflam-
tissues, to
It is
periods
the
which
mation of these
may
ball
it is
contiguous to the
elasticity,
it.
thus that
we may
may
elapse,
that
We
der.
may
falls
also
ball, after
in
urine
had existed
trised.
its
through
the
is
expelled to a
in them,
will
pro-
having communicated
the pain,
now
which
two
cica-
facts in support of
inserted the
Medicale
first in
d? Emulation in the
year 1821.
It
was
OF THE BLADDER.
M.
furnished by
321
The
patient
wound
ribs,
memo*
Halle, a gunshot
same
side,
no projectile found.
which occur
received, on the
line,
and a
little
into
behind the
After the
in all gunshot
first
symptoms,
to his usual
and other
local
by an urgent
A large
quantity of blood
The
some time.
41
ON WOUNDS
322
From
this
At
found.
patient,
also
sounded the
Notwith-
we have spoken,
own acknowledgment,
rather
exercise, he
all
the
of an
violent
after
calculus
in
the
bladder.
The
he could scarcely endure them; however, he supported them until the early part of the month of
August, submitting
which he was
sulted,
afflicted.
who, at the
first
M.
with
remarked.
at
to.
This surgeon
OP THE BLADDER.
#nd extracted the
ball (a biscayen)
323-
weighing four
The
rities.
by aspe-
arranged
patient
was
short time.
shall
Mr.
J.
my
M. Remy,
it,
summary
give a
which
this fact to
will
of
go far in
opinion.
about
fifty
years of age, a
his
battalion,
at
the
on the
left
jectile, after
was
rib,
and buried
pro-
The
hypochondriac region.
lost.
in the
followed by the
fall
wound.
to
M. Remy was
first
The
biscayen
incrustation
generally
weighs
its
the
calculous
324
ON WOUNDS
thing but a
little
From
water.
he was trans-
this
where he remained
same year.
end of Decem-
until the
During
of his cure:
the
first
few days,
While a prisoner
the wound.
in
The
stercoraceous matter
Belgium, in
saw
still
Towards
this pa-
passed by
first.
difficulty in
After two
ous odour.
The
found
relief.
The
it.
From
discharge
fre-
anus
gradually
The
OV THE BLADDER.
wound
of the
abdomen
325
By
cicatrised.
the end of
medical
aid,
returned
to
France, considering
Nevertheless, he never
These symptoms
M. Remy
me on
consulted
the
first
increasing,
of October,
1821.
After having related the above circumstances,
this officer
a very
informed
me
menof thfc
Waterloo.
On
This induced me
to
this
was
alba.
M. Remy
slightly pressed.
as
foresaw some
ration,
difficulty in
An
incision
But
it
called Dr.
in his
pres-
ON WOUNDS
326
by which the
linp'i
alba and
left
pyramidal
However, we
projectile.
dis-
through
dis-
covered a hard body, situated about three centimetres deep, between the
of the os pubis, and the
left
horizontal branch
did not hesitate to dilate inferiorly the aponeuroportion of this opening, to enable
tic
more readily
vered. But
at the foreign
it
was
which enveloped
body that
so closed
it,
that
it
up
me
I
to arrive
had
disco-
could be disengaged
The
be a
ball
biscayen of Dapret.
The
patient
was
perfectly
JF THE BLADDER.
327
From
That
these facts
it
appears probable:
First.
ing passed
through a part of
parabola, from
its
in
remained immoveable
of
its
bony portion,
it
have spoken.
had induced.
This abscess
side, that sur-
on the other,
affect the
rated by the process of ulceration, and the opening which then resulted, permitted the matter ac-
cumulated
bladder,
in the abscess to
and
have already
its
to pass out
by the urethra, as we
The
related.
its
ON WOUNDS
328
it
years: a portion
time
the
of
its
this
viscus.
it
at the bot-
The
cyst;
it,
and
part of
its
surface.
covered a considerable
At length a
violent exertion
where
its
voidably produce.
recognising
its
in
more
difficult;
easily
the difficulty
overcome by
art
When
qualities
are united
in
M.
Souberbielle.
WF THE BLADDER.
geons, the
first
329
But
in the
it)
subsequent examinations,
The
think
tion
it
had
it
It is, therefore,
by
bladder.
Besides we
it
Be-
had passed.
been exposed
With
respect
second case,
first,
to
it
Remy, the
appears evident
subject
me,
to
of
the
that,
at
its
laminae from
the urine,
nature, in
closing the
cicatrisation,
made
had exits
way
alba, to
330
ON WOUNDS
it
was extracted.
made
where the
pubis,
being detached,
it
we add
and
it,
retrac-
that, after
membrane towards
able, as well as
was stopped,
ball
The
ous
pro-
bladder was
the
as in the biscayen.
If
is
tion of the
lular
It
is also
remark-
to these cases
extravasations
the
the
into
effects of sanguine-
bladder, in
conse-
completed,
we
passages,
all
shall
have
the organic
wounds.
poured directly
ate in this
which termin-
agulum
so thick that
its
to calculi, or
But how,
it
a state
patient into a
may be
inquired, can
Without pretending
to re-
OF THE BLADDER.
solve this question,
may
we think
331
hae-
arterial
all
Secondly. Because
neys.
when
displaces,
by
its
late, in
febrile
as
is
coagu-
will
it
from
in a state of
is
plastic,
tutions.
The
dissolving
power of
urine,
and acquires
upon
its
surface; in this
case
it
operation of lithotomy
is
is
its
deposited
may become a
The
calculus.
certained that
consist-
we have
is
as-
such
may be made
cannot dissolve
it.
It
is,
M.
J. Cloquet,
332
ON WOUNDS
wounded by a sword
in the right
kidney, in
whom
coagulum
as to cause the
until death,
which
wound.
On examining
wound
made by
lesion of one
the point of
the
of
principal
man
this
in the bladder.
in consultation
Having seen
in
the bladder,
proposed the operation of lithotomy for the purpose of evacuating this organ, and to dissipate the
general spasm with which the patient was affected,
internal
haemorrhage and
proposition
was
rejected.
if
to
keep up the
adynamia.
It
is
But
the
very probable
Besides,
arisen from
it.
no serious injury
I
could
have
OP THE BLADDER.
333
formed
in
"Many
some
cases.
surgeons
may
M.
by a part of
its
Lar-
the bladder-
ball in
M.
may be
given of these
appear
We
to
me remarkable
Two
circumstances
in these cases.
First.
know, foreign
far as I
bodies
mucous
Second.
On
the other
to pass
out
quence of an abscess.
last fact,
recorded by
also seen
by Doctors
This
mary
*
The
ety, in
is
a sum-
of the case."
following remarks are added by one of the
members
of the Soci-
ON ROUNDS
334
"A
who
surgeon,
der.
re-
suitable regimen
But
the symp-
tion.
On
it
in
felt in
itself
suppurathe ulcer
ed
it.
extraction,
and continued
to
its
be discharged by the
But
a catheter, kept
in the
The
the
urethra.
"In
his report
upon
Deschamps explains
M.
'It
is
probable
OF THE BLADDER.
that
it
was
at first
335
this cyst
required by
tion having
been communicated
violent
his profession,
local
inflamma-
to the neighbour-
this
was formed.'
mass of inflamed
was permitted.
The same
and vesicula
fellis, &c.
"
THE EXD.
w*
L
>22?i UBRARY
0F MEDICIN
NLH OlOOlbfifi
EM
1
SB
,a
.*y
HI...r*-'i*.
,./'/>
;