Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Nerve Pressure; Anemia.+ That motor and sensory paralysis followed
pressure upon a nerve has been well known for many years, and this has
been utilized in the effort to produce anesthesia, artifically by
applying a rubber tube or bandage around a finger or extremity, with
the hope that “ligation anesthesia” would follow the arrest of
circulation. This, however, has been unsuccessful as all that was thus
accomplished was a slight sensation of numbness with no arrest of the
sense of pain. This method could only be successfully carried out,
were the nerves themselves subjected to sufficient pressure to injure
them. Return to normal sensibility and motor function could not be
expected for months.
+Cold.+ The addition of common salt to ice hastens its liquefaction and
consequently renders the mixture more cold. This knowledge has been
applied in a method of producing anesthesia of limited areas of the
skin. A gauze bag of the correct shape and size is filled with salt
and ice mixed, and applied to the area to be anesthetized.
This method was used as far back as 1848, by Arnott, but was soon
improved upon by Richet and others who used ether or rhigolene sprayed
on the part to be anesthetized. It was found that extremely low
temperatures could be obtained in this way, especially if a current of
air were blown across the field of operation to hasten evaporation,
and that a good local insensibility could be brought about if the
circulation of warm blood could be either stopped or retarded with an
Esmarch bandage or tourniquet. The method of obtaining local
anesthesia through the agency of cold was found to be best
accomplished by ethyl chloride and this substance is used in
preference to any of the others previously mentioned, at the present
time. Some years ago Dr. Martin W. Ware of New York experimented with
both ethyl chloride and ethyl bromide and he found that the former was
more serviceable in producing local anesthesia.
+The Sensibility of Various Tissues.+ Karl G. Lennander, of Upsala,
Sweden, shortly before his death, completed a chapter on local
anesthesia for Keen’s “Surgery” in which is set forth an elaborate
account of the sensibility to heat, cold, pressure, and pain of the
various nerve terminals throughout the body. In this great work he has
given the world the results of many experiments on living tissues,
experiments investigating the degree and kind of the tissues
sensibilities; thus it is learned that “all internal organs receiving
their nerve supply only from the sympathethic nerve and from the
vagus, below the branching-off of the recurrent nerve, have no
sensation, and that the abdominal and pelvic viscera are devoid of
nerves to convey the sense of pain, heat, cold, or pressure.”
From the same authority we are taught that the parietal peritoneum is
highly sensitive but that the visceral covering is devoid of all
sensibility, enabling the operator much freedom of manipulation within
the abdominal cavity.
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