A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 1).

  • Cooper, Samuel, 1780-1848.
Date:
1810
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: containing a complete exhibition of the present state of the principles and practice of surgery, collected from the best and most original sources of information, and illustrated by critical remarks (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    not on the tendon, the ends of which being depressed by it, would be sepa- rated from each other, and, instead of growing together, would unite to the adjacent palls. The pressure should also operate so as to prevent the ends of the tendon from inclining either to the right or left. This kind of pressure, which the bandage ought to make, seems to have escaped the attention of all authors. Who cannot see, however, that the ac- tion of the muscles being by this means resisted, the upper end of the tendon will not have such a tendency to be drawn upward, and separated from the Ipwer one ? ((Euvres C/iirurgicales de Desault par Bichat.) The famous Petit seems entitled to the honour of having first devised the plan of treating the ruptured, or divi- ded tendo Aclullis, by keeping the leg and foot in a particular posture, with the aid of an apparatus. Seeing that the extension of the foot brought the tnds of the tendon into contact, it oc- curred to him that such extension should be maintained during the whole of the treatment, in order to bring about a permanent union. This happy idea, the simplicity of which should have rendered it obvious to all practitioners, once having originated, became the common basis, on which have been founded all the numerous methods of cure, which have been since recom- mended. {Desaultpar liicluit.) The celebrated Dr. Alexander Mon- ro, professor of anatomy at Edinburgh, happened to rupture his tendo Achillis. When the accident took place, he heard a lend crack, as if he had suddenly broke a nut with his heel, and he ex- perienced a sensation, as if the heel of his shoe had made a hole in the floor. This sensation, he says, has also been observed by others, though some have complained of a smart stroke, like what would be produced by a stone or cane. Immediately suspecting what had happened, the doctor extended his left foot, to which the occurrence had taken place, as strongly as he could with his right hand, while with the left, lie pressed the muscles of the calf downward, so as to bring the ends of the broken tendon as near together as possible. In tiiis position he sat, until two surgebftfl came to his assistance. The) applied compresses, and a bent board to the upper part of the foot, and forepart of the leg, both which they kept, as nearly as possible, in a straight line, by a tight bandage, made with a long roller. But, as this mode of dres- sing soon became very uneasy, it was changed for the following one. A foot- sock, or slipper, was made of double quilted ticking, from the heel of which a belt or strap projected, of sufficient length to come up over the calf of the leg. A strong piece, of the same ma- terials, was prepared of sufficient breadth to surround the calf, and this was fastened with lacings. On the back part of this was a buckle, through which the strap of the foot-sock w as passed, so that the foot could be ex- tended, and the calf brought down at pleasure. The leg and foot were wrapt up in soft flannel, fumigated with ben- zoin, and the bandage was kept on day and night, the belt made tighter, when the doctor was about to go to sleep, and loosened when he was awake, and on his guard. For a fortnight, he did not move his foot and leg at all, but, was conveyed in a chair on castors from one part of the room to another. After this, he began to move the ankle-joint, but in such a gentle manner as not to give any pain. The degree of motion was gradually increased, as the tendon became capable of bearing it, care be- ing taken to stop, when the motion be- gan to create uneasiness. The affect- ed limb was moved in this way, for half an hour at a time. In a few days, the hollow, between the separated ends of the tendon, became imperceptible, though the part continued soft much longer. It became, however, gradual- ly thicker and harder until a knot was at last formed in it, apparently of a cartilaginous nature. Though this was at first as large as a middling plumb, and gradually became softer and smal- ler, yet it did not disappear entirely. Having occasion to go out six weeks after the accident, the doctor put on a pair of shoes, with heels two inches high, and contrived a steel machine to keep his foot in the proper position. This machine, however, he afterwards changed for another, made of the same materials as the former. It was not till five months after the accident, that he thought proper to lay aside all assist- ance, and to put the strength of the tendon to a trial. (See .Monro's works, p. 661.) It seems unnecessary to enumerate the various plans, devised since the time of Petit. Suffice it to state, that