W. G. BROWNELL, M. D.
This value of the reports of surgical cases treated in the Rochester Hahnemann Hospital during the past year depends, not upon the rarity or interest of the cases, but in the fact that they have, without excepting, been treated according to the principles of Homoeopathy.
Antisepticism or Listerism has had no place in their management, as I believe that the principles, upon which those isms are founded, are not true, and are not compatible with the principles of Homoeopathy, which are true.
The paper, entitled “Listerism,” read before this Association a year ago, coming as it did so soon after the opening of our hospital, had much to do with the formulation of rules to be followed in surgical cases.
It is stated, in the paper referred to, that there are three objects to be desired in surgical work, viz: cleanliness, proper drainage and exact coaptation of wounds, and that good results, depend much more upon the attainment of these objects than upon the strictest observance of the popular fad antisepticism.
Methods which would secure these results have been followed in the cases that I shall detail. No antiseptics have been used, only the homoeopathically indicated remedy given. The patients have been cured speedily and without suffering.
CASE 1. –
Mr. R. H. D -, age seventy-two years, entered the Hospital July 22, w889. His right foot had been frozen in the winter previous and the frost bite had resulted in gangrene. Only one toe is black but the whole foot and ankle is enormously swollen, indurated and attended with intense pain. Owing to an unfavorable prognosis, given by a previous attending physician, he would not submit to an amputation of the foot, so that only that portion which was black could be removed. This failed, as the gangrene returned.
On August 20th, the leg was amputated at the middle third. A modification of Prof. Stephen Smith’s operation was followed, the arteries were ligated with catgut, a drainage tube Inserted and no antiseptics used except cleanliness. Convalescence was slow but constant, often assisted by the indicated remedy. Discharged perfectly well September 20th.
CASE II. –
Miss K., blonde, age twenty-four years; of general healthy appearance. For two years has noticed a tumor growing from the mons veneris. The growth has been gradual and constant. At present it has the size of a goose’s egg. As it is a source of great annoyance, it has been deemed advisable to remove it. This was done Sept. 18th, 1889, by making an elliptical incision around the base of the tumor and dissecting it out. The wound was closed with a rubber drainage tube in place. Union was very rapid, and she was discharged on the twelfth day. The tumor was diagnosed a cellular fibroid.
CASE III. –
Mr. A. B. -, age fifty-nine years, fairly healthy appearance, but with a family history showing a tendency to fibroid tumors, he having had such a growth removed from his neck, and has daughter suffering now from uterine fibroid. He presents a very large and hard tumor in the scrotum, having shown itself first on the right side. The aspirator revealed no fluid contents. There was no translucency. After anaesthesia had been produced an incision was made about four inches long beginning at the external abdominal ring.
The lower portion of the tumor was solid, but in the location of the cord and extending into the abdominal cavity it consisted of cystic walls about one inch in thickness and in closing a small elongated cavity which was filled with cells having the exact appearance of a honeycomb. These each contained a very small quantity of serum. The cord proper was obliterated and the testicle found unattached, except by slight adhesions. The mass was carefully dragged down, the vessels ligated, and the whole removed. A drainage tube was left in place for a few days. There was no material elevation of temperature. He was discharged on the eleventh day.
Mrs. Anna W -, age forty years, entered hospital on February 11th, 1890. Has been suffering from a laceration of the perineum extending to the sphincter ani. There is prolapsus vaginae and some prolapse of the rectum, accompanied by several large hemorrhoidal tumors. These were first removed, and on February 21st, Skene’s procedure for restoration of the perineum was followed. Cleanliness was the only antiseptic, but she made a good recovery and finds her health very much improved. Her own words very recently are: “I am as well as I ever was”.
CASE V. –
Mr. Wm. F., aged thirty-eight years, is a trainman employed on the Erie R. R. Entered hospital March 20th, 1890, with a fractured patella. Hamilton’s apparatus for fractured patella was used. The patient was discharged in nine weeks, with good use of his limb. The union was ligamentous. Homoeopathic prescriptions did much for this man, as various complications arose, which, had they not been relieved, would have seriously retarded a cure.
CASES VI TO X
Inclusive are all cases which presented themselves with various symptoms referable to some abnormal condition of the uterus. Examination showed in each case that there were extensive lacerations of that organ with consequent eversion of the cervical canal. The results obtained by restoring the cervix to something like its normal appearance amply justify the operation.
I am aware that the results often obtained by this operation are not of any benefit to the patient; in other words, that it is frequently a failure; and I think that failure is very often caused by not properly denuding the edges of the rent. The instrument generally used for this purpose being either Emmett’s curved or Skene’s hawk bill scissors. The best that can be said for these instruments is that they are inconvenient, inexact and bungling.
If a strong, large silk cord be inserted through the lips of the cervix the assistant can most easily control the organ. It can be drawn down sufficiently and the lips kept separate, thus exposing the surfaces to be denuded. A Goodwillie’s trachelorrhaphy knife perfectly adapted to the purpose of vivifying the tissues.
The cases under report have all been benefited, many of the reflex symptoms being soon relieved; but in general it has been found that improvement continues for a considerable time after the menstrual periods, which, in one case, seemed to bring back all the pains she had before the operation. It should not be forgotten that the homoeopathic remedy must also be given. After the mechanical injury has been restored it is found to be very much more efficient.