The following case shows this disease in its most advanced stage. It is
extracted from the fifth volume of the London Medical Journal, and is
intituled, “An Account of the Fatal Effects produced by attempting to
remove a Ganglion by Seton.” It was drawn up by Mr. W. Dease, surgeon
in Dublin.
“In July 1781, a clergyman, aged thirty-seven, consulted me about a
moveable ganglion, of the size of a small nutmeg, situated between
the fore-finger and thumb of his right hand, near the wrist. He was
eager to have it removed, and had been advised, for this purpose, to
have a seton passed through it, as the best and most certain method;
but, as he was apparently a robust healthy man, and the ganglion was
attended with no pain, I advised him to consider it as a matter of no
consequence, and not to meddle with it. Four months after this I was
desired to visit him, and found him in a melancholy situation. A seton
had been passed through the ganglion, and the consequences were, that
the back of his hand had inflamed violently, that the ganglion had
rapidly and amazingly increased, and that the openings made by the
seton were filled with an ill-conditioned fungus, which sprung up as
fast as it was removed, and was attended with frequent hemorrhage, and
much pain. In consultation, it was agreed to remove this fungus by a
free incision, which was done, and the metacarpal bones appeared bare
and rough. Another opening was made through the thenar, and a seton
passed through it, in order more effectually to prevent the growth
of fungus. The bark was administered in large quantities, an opiate
was given at night, and due attention was paid to the regimen of the
patient. This method seemed to promise the most happy event. The fungus
appeared to be entirely destroyed, a laudable suppuration took place,
the swelling of the hand subsided, and the sores in a short time
were so contracted as to indicate their speedy cicatrization. These
favourable appearances, however, were not of long continuance; for,
after some time, the fungus began gradually to rise again, and any mode
of keeping it down, either by caustic, cutting, or pressure, seemed
to produce no permanent good effect, as it increased rapidly, and at
length degenerated into the most frightful cancerous fungus I have ever
seen. Every local application that has been recommended in similar
cases was tried in this, but without success; and internal remedies
proved equally inefficacious. He took, for a considerable length of
time, two ounces of bark in substance, in the course of twenty-four
hours, so that he took, in the whole, twenty-eight pounds of that
medicine. The extract of hemlock had also a fair trial, but produced no
apparent effect.
Public-domain text, read in full here on John Shaqi.
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