Seventeen cases of chronic (relapsing) appendicitis, treated by operation / by Hunter McGuire.

  • McGuire, Hunter Holmes, 1835-1900.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Seventeen cases of chronic (relapsing) appendicitis, treated by operation / by Hunter McGuire. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    iodine and blisters, massage, and an intestinal antiseptic as salol’ constitute the chief remedies, and by them individuals who have had one attack have escaped a subsequent one. It is only fair to say that persons who have had one attack, and who have not pursued the above remedies, but followed their usual course o^ life, have also escaped a second attack. I am frank to say, how- ever, that I believe the former are more apt to escape than the latter. ' The first case reported was not one of good surgery. The ap- pendix should have been removed. That she got well, and has remained well for several years, is evidence rather of good luck than good surgery. These conditions, you know, are sometimes confounded. It teaches, however, the value of persulphate of iron in preventing reunion of separated parts—a fact that I have had repeatedly demonstrated to me before and since that time. ** Cases V and VII show the hazard of leaving a raw surface, as the stump, after castration in women, unprotected. It would be better to paint this raw surface over with the iron spoken of, touch it with a hot iron, or a hood of peritoneum from some neighboring tissue may be used. Cases II, VI and VIII show the influence tubular and ovarian ■ diseases may have upon the appendix. Case XVII. I think it is not too much to say of this, my only fatal case, that he would probably have recovered if the opera- tion had been done in a well-appointed modern hospital. Lastly, a few words about the operation. I make a clean cut straight down on the most prominent part of the swelling, if there is any, or over the supposed site of the appendix, if there is no swelling. I begin near the anterior superior spinous pro- cess, and cut inwards and slightly downwards towards the inner border of the rectus. In fact, the incision is almost transverse. The more nearly transverse it can be made, the better the union afterwards, and the less the danger of subsequent hernia. I am afraid of the plan of separating the fibres of the different planes of muscles with retractors and two assistants. The muscles must be injured, repair of bruised parts slower, hernia more common, and drainage, if needed, less perfect. The incision is