A Manual of the Operations of Surgery: For the Use of Senior Students, House Surgeons, and Junior PractitionersBell, Joseph
Science
A Manual of the Operations of Surgery: For the Use of Senior Students, House Surgeons, and Junior Practitioners
Bell, Joseph
Surgery, Operative
(_a._) Attempts to plug the canal have, in most cases, been made by
invagination of the skin of the scrotum and its fascia. These have been
very numerous and various in their adaptation of mechanical appliances,
but have all been designed with the same object. Dzondi of Halle, and
Jameson of Baltimore, incised lancet-shaped flaps of skin, and
endeavoured to fix them by displacement over the ring. Gerdy invaginated
a portion of scrotum and fascia into the enlarged canal, by the
forefinger pushed it up, and secured it in its place by a thread passed
from the point of his finger first through the invaginated skin, then
through the abdominal walls, endeavouring to include the walls of the
inguinal canal, causing the point of the needle to project some lines
above the inguinal ring; the same process being effected with the other
end of the thread on the other side of the finger, and the two ends
which have been brought out near each other on the abdominal wall, being
tied tightly over a cylinder of plaster. The ensheathed sac was then
painted with caustic ammonia to excite inflammation, and a pad put on
over all.
Signoroni modified this by fixing the invaginated skin by a piece of
female catheter, retained in its place by transfixion by three harelip
needles, tied by twisted sutures.
Wützer of Bonn, again, modified this, by substituting a complicated
instrument, consisting of a stout plug in the inguinal canal, held in
position by needles which are passed through the anterior wall of the
canal in the groin. Compression between plug and compress, with the
intention of causing adhesion between skin, fascia, and sac, is then
managed by means of a screw. The plug is retained for about seven days.
Modifications of this method have been tried by Wells, Rothmund, and
Redfern Davies, all aiming in the direction of simplicity; but by far
the most simple and efficacious method on the Wützer principle yet
devised is that of Professor Syme, which he described in the pages of
the _Edinburgh Medical Journal_ for May 1861, in which the invagination
of integument is both simply and securely managed by strong threads, as
in Gerdy's method, while a piece of bougie or gutta-percha, to which
the threads are fixed, replaces Wützer's expensive and complicated
apparatus. Sir J. Fayrer of Calcutta has had a very large experience of
Wützer's method, and also of a plan of his own. Out of 102 cases by the
latter method, 77 were cured, 9 relieved, 14 failed, and 2 died.[147]
Mr. Pritchard of Bristol has proposed an additional step in operations
on the invagination principle, consisting in the stripping of a thin
slip of skin from the orifice of the cutaneous canal, and then putting a
pin through the parts to get them to unite, and thus close the aperture
completely.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account