Dissertatio inauguralis de cystitide, quam annuente summo numine, ex auctoritate reverendi admodum viri, D. Georgii Baird ... pro gradu doctoris summisque in medicina honoribus ac privilegiis ... [electronic resource]

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UNIVERSIT O PENNSYLVANIA,

IS INSCRIBEDAS THE GENUINE TRIBUTE F

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DEAR SIR,

BD easexto acceptis his imperfectEssanas a mar of the respect whicli Pentertain for our talenis, as a Physician, an for themany obligations and posite attentio conferredon me by your family, urinim residence in this country and e assure it,ill alway beremembered with gratitude and esteem, Byjour assectionate friend,

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INTRODUCTION.

I is proposed in the following pages tota brie vi, of the disserent method whichliave been recommended for reatin wound of the intestines, o describe certain Merimenis, o brute animal Whicli,ere madesto ascertain the method mos likel to prove successsul, and to osse som doubis relative to the commonopinionion his subjeci. io no inten to emter minutet into the generes mode of reatingwound of the intestines, ut o confine mysessentiret to the est anne of stitchin them.

the frequent fatalityi suci injuries, evince thegreat importance of the subjeci. It is ess known

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12to surgeons that the mos trissing puncture madeinto the cavit of the abdomen, is apirio induce ver serious consequences, fio the tendencywhicli the peritonaeum has to inflame, henslirati injured 'o much must the dange beincreased hen an intestine is,ounded, and anopening produced through hicli it contenisma pascinio the cavit of the abdomen mare, hoWever, old by a celebrated author, that there is ver litti tote apprehende Doni his

circumstance, o account of the equille pressure

whicli is alway kepi, in the abdomen by the

viscera Buta hope to prove rom experiment, that his ideas eremo altogether correcti that subjeci. The invaluable wor on hernia, of r. Asile Cooper, ave is to this essay, and the ingenious observation os essrs Coope and Thompson, respecting the disserence et centhe consequences of longitudines and transverse wound of the intestines, induced me to alte particulari to that par of the subjeci.

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wOU S soli intestines may beknown by a passage of blood froni the mouth and anus, as welbas by the discliarge of foeces and faetidaiofroni the externa Wound and they ought ob suspected When nausea, omiting, violent griping, patia throui the abdomen, col Sweala. o Dintings occur after, penetratin Wouncio that cavity. The intestines are ometimes Wounded ithout protrudinithrough the externat ound in such cases it ouldie of very lit- tu Mantage to know, whether the wound was transverse or oblique the method tote pur-sued must be similar to that in simple penetrating und of the abdomen, vig. lood-lettiniandacio diei. Som author recommen dilatin the externat ound and searchiniso the

injure bowel 'ut the anger arisin stom

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14 penetratiniwound in the abdomen, o si sietes, is orareat, that in no instance ought it tole

ed intestine is protruded that the future cante properi applied. The disserent Endsis sutures which have been recommended, have est ad thei advocates oli mos ancient, and that whicli appears o have been mos generali usedis termed the lover future, hici I shali nowtake the liberi os describing. in mining this Suture, a fine mali round needle shouldie used arme&with a sit thread whicli has been previ-oUSty axed. The surgeon bringing the sips of the wOund in contact, perforates both dges a thesam time, and carrying the neem to the sameside at whicli it entered, he must malae a secondstitch, at a mali distance rom therarsi perhapsthe eighth of an inch, and in the fame manner by a prope number of stitches, must log the wOund throughout iis hole extent Thisieingitone, a sufficient tength of threa is est ut at the externat wound for the purpos os drawiniit away, when, suppose the wound of the

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15 intestine to e united whicli is generalty com pleted in sicor seven d . in Withdrawing the ligature care houldie alien to do it very gently least e liould destro the adhesion whichliave tinen place This mode of stitchin awounded intestine, is certaini a very complica- ted process, and shouldie dispensed illi in every instance for a more Simple one. more modern method has been spolieno by Μr Ledran, hicli is terme the oop-ed future Tymae this suture, an assistant talaes

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testine are rawn into pleais, o that the stitcha es hicli,ere distant about a quarteris an ineli are o brough together, and thus the pso the wound are revented rom Separating. The ligatures are tot fastene to the externaldressing, after ard the remaliuntii the wound in the intestineas healed they are then tot un- twisted an es the endicut ossintne si te ter hicli the must be withdrawn lowl and separalely. The same objection may be applied here, in the lover future, his is certaini amore complicated process, and it increases the dan-ger of the operation, by essening the diarieter of the intestine, theret, occasioning dangerous

obstructions.