A Treatise on Fractures, Luxations, and Other Affections of the BonesDesault, P.-J. (Pierre-Joseph)
Science
A Treatise on Fractures, Luxations, and Other Affections of the Bones
Desault, P.-J. (Pierre-Joseph)
Dislocations; Fractures; Surgery
32. The operation is seldom attended with much pain. Only one patient
manifested signs of this in the practice of Desault. Nor have those
operations of the kind performed in England been more painful, so that
it may be laid down as a principle, that in most cases no primitive
accident is to be dreaded.
33. With regard to hemorrhagy, as there is no large artery near the
place of the incision, there is nothing to be apprehended on that
score. Oftentimes there is scarcely any loss of blood at all, as may be
seen in the first case published in the Journal of Surgery. But, even
admitting that a small articular branch be divided, the reunion of the
edges of the wound will be sufficient to check the hemorrhagy, in the
same manner as in the operation for the hare-lip, the contact of the
divided integuments of the lip, puts an end to the hemorrhagy from the
small arteries of the part.
§ XIV.
OF THE SUBSEQUENT TREATMENT.
34. I have already said that but little is to be apprehended on the
score of accidents subsequent to the operation (26). Out of the
numerous operations of the kind performed lately in Europe, but few
cases have proved troublesome in their consequences, and even these
were influenced by some foreign circumstances. Thus, for example, one
of the patients of Simson rode out on horseback a few hours after the
operation, on a cold and stormy day, and thus produced a troublesome
affection of the part. A similar remark may be made respecting the case
formerly mentioned (27).
35. The apparatus or dressing remains untouched for the two or three
first days, during which time it is necessary to wet it frequently
with vegeto-mineral water. It is a certain truth, that the use of this
liquid retards the suppuration of wounds, and that, when continued a
due length of time, it keeps inflammation at that degree most proper
for the process of healing.
36. On the removal of the dressing, the wound is sometimes so perfectly
healed up, as not to exhibit the least discharge. At other times a
slight suppuration takes place; but, at the end of a few days, the cure
is complete. Under the care of Desault, it was always effected in eight
or ten days.
37. Let us bring the doctrine just laid down to the test of experience.
Five cases have been published on this point. I have selected two of
them, both which occurred in the same subject, where we find the same
operation twice performed with equal success.
CASE I. M. Vielle, aged nineteen, was attacked about the beginning of
the year 1790, by a spontaneous swelling in the joint of the knee.
Inconsiderable at first, but increased afterwards by a laborious
journey, it disappeared at the end of two months, discovering to the
touch, near the internal edge of the rotula, a foreign body, which was
hard and moveable, and which somewhat impeded the motions of the joint.
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