The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1883-09-19


brother, of East ST. Louis. on "Phlebil1s," In
which the subject was ably discussed and was
received with marked attention.
VARIOUS PAPERS READ.
In paper on "The treatment of compound
fractures" DR.. Ap. Morgan Vance, of Louis
vile, said that he had always been astonished
by the Numerically opposing opinion held by
different surgical authorities as to what is the
best thing to do in cases of compound fracture.
One makes a rule that all cases should be treated
as open wounds. Another, that all should be
closed and the attempt made to bring about the
condition of simple fracture A third, that the
first should be supplemented by through drain
age. If we could know that every compound
fracture that we put up would be converted
with simple fracture there would be no
foundation for the ''open dressing" and Through
drainage" theories but we can never know alb
sOlutely when the formation of pus will or Will
not occur, or what course each special fracture
may take. DR.. Vance said that 1t Is his practice
to dress compound fractures as he would simple
fractures in the same location, using the hXed
dressing plaster of Paris-entirely, and trust
ing to the thermometer to tell if the case VIII
go through a simple or compound fracture.
He SAID that he used no auti-sept1c dressing, as
| he expected the blood TO seal and protect the
wound better than anything else Some absorb
ent substance should be used about the wound
-eakum, or, what Is now better, absorbent cot
/ ton. Some hemOrrhage will almost always oc-
| cur when reaction is established rms
purges the wound, and it heals under
| the scab. cotton and blood. Fever of
| 10l leo to l02l9o that cannot be otherwise
accounted for, indicates Investigation, but there
! should not be too much haste in opening the
dressing, especially if the rise of temperature
occurs within the first forty-eght hours. In
| this case, mercurIal should be given, followed
| by quina. Should it occur suddenly during the
! latter part of the third day and up to the NTH
| or sixth day, open the dressing and give good
| draiLage to the pus. In very hot weather, when
| the wound is large, the use of iee-bags or ice
w Ia nj n
| cases where the bone has made the compound,
! greater success may be expected, as the opening
| is almost necessarily valvular. rhe discussion
| OF the subject closed the morning Q :SsiOn.
| At the afternoon season., DIR, H. j. B. Wright,
| OF Olney, Ill, read report on the therapeutic
| value of nerve stretching, giving conclusions
| from data collected by writing 200 letters TO
| physicians asking for their experience on nerve
stretching In sciatica, nerve stretching was
| productive of good results. Eight cases were
reported, and OF these five were cured; two died
| OF cancer. DIR. Wright operated on laborer
| aged forty-eight years. who had been treated by
| intelligent physicians with the usual methods
| drugs and electricity. he was on crutches, and
| was first subjected TO full line of treatment
| which apparently completely cured him. The
| trouble returned; the nerve was stretched pus
| formed the Inflammation was eXcessive FROM
the time OF the stretching TO the present-eleven
mOnths-the patient has been completely cured
OF sclatica, and IS now a vigorous laDorlng man.
Dr. W. A. Byrd, of Quincy, Ill.,, reported "a case
| OF nerve-stretchlng cuttlng Just WneIe the
nerve energies from the seiatic notch with result
| of perfect cure. Dr. II. HOughton, of IndianapO
| lis, discussed the pathology OF nerve-stre tch-
/ ing, holding that the molecular condition of the
nerve-trunk was interfered with DIR. Myers, of
Fort Wayne, held that the nature of pain is the
basis from which theories of cure by nerve
stretching are developed. DIR. Wright closed
the discussion, looking upon nerve-stretching as
an empirical method of cure, but as long as it
was safe procedure for cure of sciatica, and
usually successful, the profession was justified
In resorting TO it. He did not agree with The
theories proposed in the discussion to the
cause of sciatican, and said: THE operation was
teen acute cases. The nerves of the upper
extremities were stretched in the acute cases,
and of the lower extremites in the chronic. The
procedure had no effect on a of dyraSes-
thesa OF fourteen years standing, this being the
only one of eight chronic cases in which the
operation was a complete failure. The result in
the of sciatica following spinal meningitis
Is set down as only slight Improvement. Five
chronic cases cured were of sclatca. No I'M
pleasant effects are reported as following the
operation, except that performed by ourselves.
This is reassuring and takes away from the
operation the phantom OF danger that has
caused anxious physicians to withhold the
knife, allowing their patient to suffer through
months and even years. 1t adds another just
fable recourse to the way with which we have
been fighting neuralgias, especially of the sciatic
nerves."
RECoUNTING EXPERIENCES.
Suggestions as to the pathology and treat
ment of pneumonia" the title of paper
written by DR.. E. F. Wells, of Minister, o., and,
in the absence OF the author, il was read by Dr.
writer stated was a common disease-a conges-
ton Of the lungs, The tendency is to recovery,
but many patients die who, with proper treat
ment, would get we'll. DR.. Fields found that the
paper was at faulr, because it threw no light on
either the pathology or therapeutics of the dis
ease
Dr. W. g. Haymond, of INDIANAPOLIS, presented
removing portions of the frontal bone which had
been fractured eighteen years before. The two
oh nf rod Hon
and the bones liberated nearly through to the
brain. The decayed portions of the skull were
removed, aud the patient rapidly recovered.
This was regarded as very rare ana successful
operation, as it relieved the patient from torture
of eighteen years duration. - 'f
Following the remarks of Dr. Raymond,
number of the members of the association de-
tailed their experiences in cases of some SINH
larity and the discussion turned upon the effects
of trepannlng In epilepsy, which it was believed
would, IN most cases, be productive OF good re-
suits. ,- r.. jan.
DR.. Fletcher, superintendent of the State In
sane Hospital, invited the society to hold
SION at the hospital which was accepted for
Thursday afternoon.
A paper which aroused as much interest as any
read during the afternoon session was one by
DR.. ]. Z. Link of Terre Haute, on ''The use of
the roller bandaee" as treatment to repress
assesses and eryspelas, and especially for the
dressing of sGumps after amDutation. DIR. Link
used only several layers of old sheeting wrap
ped successfully about the stump, which was
left open for ample drainage. In 200 amputa-
tions by the Doctor, commencing as an army sur
geon In the late war, not a patient had died
from the amputation had suffered pain after
the operation. He need no antiseptics, pms
never formed in the stumps, and there were no
after pains. DR.. Link presented young man
whose arm he had amputated on Sept. 3. and
who is now nearly well. He said he had suffered
pain since the operation. Other patients
were presented and the Doctors method of
bandaging was closely observed. The bandage,
he said, is not to be removed until the wound is
healed. New bandages are put on over the old
ones each day as the muscles shrink DR.. Gross,
of Philadelphia, speaks highly of Or. Links
method, which has proved painless. efficient
aud original.