The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Certain remedies have been at various times supposed to be endowed with
specific properties, and for many years clinicians have endeavored to
find that substance with which the system could be safely saturated
and prove inimical to the parasite causing this disease. Such agent
has not yet been discovered; nevertheless, much has been done in
this direction. Of the remedies highly spoken of for this purpose,
_creosote_ and _guaiacol_ are considered the best. These are somewhat
difficult of administration, but if the latter is given in the form of
the carbonate, generally known as _benzosol_, it comes the nearest to
the ideal for which we are striving. _Benzosol_ should be given to the
adult in doses of at least a gram a day, perhaps more. It is better
tolerated and less offensive than the guaiacol from which it is made. I
have never seen anything but benefit result from its use, and yet would
not extol it as a positive cure. Nevertheless in conjunction with other
local and constitutional measures its administration may be followed by
complete recovery.
Of the various _local measures_, _physiological rest_ should be placed
first, and can be achieved in some places better than in others. The
various forms of apparatus resorted to by orthopedists are simply
mechanical measures in furtherance of this purpose. Some surgeons have
faith in _iodoform_, used locally in solution or suspension in some
menstruum like glycerin, oil, etc. The benefit which has been claimed
in some cases is not duplicated in the experience of all surgeons;
nevertheless, it has undoubtedly been of service. A recent and most
promising method of treating tuberculous disease of the extremities
has been suggested by Bier, and consists in the establishment of a
_permanent hyperemia_ by the application of a rubber tourniquet on the
proximal side of the lesion. (See chapter on the Joints.)
It would appear that the access of more blood which is thus permitted
is inimical, presumably by the presence of the oxygen which it brings,
to the development of the disease germ. The method depends for its
rationale upon the fact that the congested lung does not become
tuberculous. Lannelongue has suggested what he calls the _sclerogenic
treatment_ of tuberculous lesions, by injection of a very dilute
solution of zinc chloride, which serves as an irritant and produces a
tissue sclerosis that serves the purpose of a prophylactic membrane,
while at the same time the solution is fatal to those germs with which
it comes in contact. This treatment is painful and has not proved
acceptable.
Public-domain text, read in full here on John Shaqi.
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