Report on Surgery to the Santa Clara County Medical Society — John Shaqi
Report on Surgery to the Santa Clara County Medical SocietyCox, J. Bradford (Joseph Bradford)
Science
Report on Surgery to the Santa Clara County Medical Society
Cox, J. Bradford (Joseph Bradford)
Medicine -- California -- Santa Clara County; Surgery -- Case studies
On returning to town, I stated the case to doctors Brown and Thorne,
giving my theory for the hemorrhage,--that it was secondary, and probably
from a lumbar artery. They were of opinion that it would be almost an
impossibility to find the artery and tie it, and without seeing each
other, concluded that pressure was the remedy to be used. I would state
that at the last visit the pulse was 74, and temperature 99. This was at
about 9 A. M. I visited him again about 5 P. M., and found the pulse and
temperature the same. There was by this time considerable increase in the
quantity of fluid. I re-adjusted my compresses and bandaged again. On
Saturday morning I found the quantity of fluid about the same, perhaps
slightly increased. There was now considerable inflammation of the
integument, over a large part of the sinus, the skin appearing tense, and
the small blood vessels distinct and purple. The patient had a slight
chill last night, pulse 100, temp. 102; did not remove the compresses.
Saturday evening, Feb. 7th, condition worse, pulse 112, temp. 103, tongue
furred ash-colored, countenance typhoid in expression, loss of appetite,
no abdominal symptoms, mind clear. Sunday, Feb 8th. pulse 120, temp.
105.4, tongue same as yesterday, had a chill last night. The skin over the
sinus is inflamed somewhat more than it was yesterday. With the advice and
assistance of doctors Brown, Thorne, Benj. Cory and Kelly, sixty-eight
ounces of blood was removed from the sinus, by aspiration. One hour after
this operation, the pulse was 140 and the temp. 104. The specific gravity
of the blood removed was 1030, and after standing for two or three hours,
a grey or ash-colored sediment settled, the proportion of this being about
20 per cent. of the whole amount of the blood. This sediment consisted of
corpuscles that seemed to be undergoing decomposition; they were a little
larger than the red corpuscles; contained granules or spots, from three to
four and seven and eight in each corpuscle. Some of them seemed to be
simply swollen red blood corpuscles, ready to burst, or as it were,
suppurate. If there be such a thing as inflammation of the blood,--and I
believe there is,--then this change must effect the red corpuscles
themselves, as to size, temperature and perhaps pain, thus supplying three
of the well known characteristics of inflammation, expressed so tersely by
the old latin formula, _rubor, tumor, calor cum dolore_. Owing to the
color of the blood, the rubor, or redness, is not produced by inflammation
here as it already exists.
But to return to the patient. After the blood was withdrawn, compresses
were carefully applied, and the body bandaged from the lower ribs as low
down as the bandage could be applied with the legs flexed at right angles
to the body. The patient stood on all fours, as it is called, while the
bandage was applied.
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