The National tribune., 1889-12-05
CHAPTER Xiv.
wouNpg AND rRAcruREs.

| exempt from ulSeASe. oaVaReS, VINO ENJOY an
almost complete immunity from lung affections
and digestive disorders are far more liable to
external injuries (if not to their malignant
after eIects) than the children of civilization,
and the first physicians were surgeons, pre-
scribng medicine chiefly in the form of salve
"What drugs won't heal the knife will whore
the knife fails use fire." is an old medical
maxim that could have been suggested only by
the experience of a wound healer.
Modern hygiene, however, has somewhat en-
larged that formula, and tho remedial efficacy
o. fire, knives aud drugs is often surpassed by
| the healing powers of nature.
THE LET-ALoNR PLAN
One by one the barbarous methods of meds,-
| val surgery arc going out of fashion, and m
everincreasinR number and variety of external
injuries have been found to be durable by trust
| ing tho trouble to the selfregulating tendency
of the organism, and merely assisting nature
| by securing the conditions Of cleanliness and
! rest There was time when in1ammations,
| as a consequence of wounds, were supposed to
| require bloodshed as the very first condition OF
| n successful treatment. The patient was BLEED
| to the verge Of a fanting fit, cups or leeehes
were applied directly to tho swollen parts-so
invariably, indeed, that "leech" became q
| synonym for surgeon, and was for centuries
used in that sense, like the Spanish nickname
"sangrado"-a veiu-cutter. As in hundreds
| OF other cases. tho suppression of the symptoms
| was taken for the removal of the cause; but
/ the result too often proved the dangers of that
! fallacy. BY the utter exhaustion of the vital
| resources the inflammation, indeed, could be
| temporarily reduced but the enforced mac
| tivity OF the system frequently avenged itself
| by desperate complications. Tho patient be-
came -deirious, and died In the crisis of pu-
/ trid fever.
| In vonnda fnvolvin1 Tho doaf ructjnc nj ~
| tensve tissues, tho swelling of the surrounding
| part serves the double purpose of fastening the
process of reproduction Thy an accelerated pulse
| aud temporary increase Of heat) and of enforc-
| ing rest with an emphasis OF request proper
toned to the seriousness of tho emergency.
In fractures and deepy-eontused wounds the
| lacerated parts often become sensitive that
nero attempt mt movement of the rest requr-
| ing muscles produces an agony of pain but, nc
| the same time, the patient will be able to rest
with comfort in n certain position-the very
| position most favorable 10 the reunion of the
disrupted parts.
REST AS A REMEDY.
In many such cases II might, indeed, be ques-
toned IL the value of perfect rest can be- equaed
by all other remedial agencies taken together.
Wounded animals retire 20 an out. of the. way
hiding place and By absolute quetude and
heroic iasts contrve TO recover from wounds
which in an old plan hospital would not have
given man one chance of survival in thou
sand. One OF the most vivid recollections Of
my boyhoo years Is n scene in riding school
OF my native town, where / was often bothered
by the antics OF little ratterrier that insisted
on following me in spite of all protests aud had
an unlucky way of getting between the horses
| logs aud making himself "A nuisance generally.
One frosty afternoon ia November the little
| plague put In an appearance just when the rid
ing master ordered his class To mount, and SEQ
| ing other way TO avoid trouble hailed n
| stRble-b0y and asked him 10 take the dog 10
| tho hayloft OF tho building. Tho building was
so high that tho barking of the terrier in the
| top story could hardly be noticed In tho base
| ment. aud had almost forgotten my dog, when,
| two hours after, on starting for home, heard
| him whine somewhere near the top Of tho rid
| ing-hail. aud looking up | saw him stand, or
rather hang, on the edge of an open louvre used
| for hosting Ia bales OF hay and straw. Finding
| himself locked in, the dog had made his way
| 10 that louvre on hearing my voice down be-
/ Low, and in tho next moment lost his foothoid
| on the slippery sill and down he came. turning
| over and over ia his descent from sheer hight
Of at least go feet. The hostler of the establish
ment was something Of veterinary surgeon,
! and after examining the dog. that lay gasping
| and half-stunned on the rough cobblestones. he
| At once pronounced tho case hopeless. Broke
two Of his legs and nearly all of his ribs this
| side. and will be dead before shutdown. No use
| bothering with dead creature, sir. Better
| give the stable-hoy shilling aud he will bury
/ him for you somewhere in the gullies.' That
| seemed really the best plan, aud after pocket.
Ing his sexton fees tho boy collared the hapless
| heap OF broken bones and promised to put it
| out Of the way.
| About 10 days after was talking 10 a friend
Mt the entrance of tho riding-school. when /
| was startled 20 hear the same whine of my lit
tie rat-ierrier. apparently from the same louvre
that had lured him TO that fatal leap. at once
| entered the building and made my way to the
| hayioit, where-not the ghost but the unmis-
| takably animated body of my little dog emerged
| from pile Of loose straw that seemed TO have
| formed his sick bed since that cold afternoon
| week aud half before One OF his hindlegs
| was still little. stiff but no managed TO skip
| about ut lively rate, and evinced symptoms
| of appetite that made mo decide 10 take him
| homo and attempt the completion of his cure.
| The hostler seemed unable to explain tho re-
| suscitation Of the corpse, but on being cross
| examined the stable boy admitted that he had
not buried the dog at all, but just put him out
| OF the way till the frozen ground should thaw,
| and had then forgotten all about ID. 1t seemed
| horrible idea that the poor cripple had passed
10 days without food and drink but IL seemed
| that he must have effected a survival with
| the aid of little deposit of drft-snow ON top
| OF the hay-pile and that after his partial re-
| c0very he had paid professional attention to
| the rats that abounded ia every Granny of the
1 olu lOII NJ AIl events no nhu WohbHGfel tho
storm, and at last recovered completely from q
| complication Of injuries that would have defed
| all the resources Of an international convention
of medieval sangrados.
THE ExPEoTANT TREATMENT.
"The expectant method of treatment" is a
term which the manager Of the Edinburg
City Hospital applied TO his plan of dealing with
acute cases of alcoholism ldelirium tremens),
and which often might, with great advantage,
be followed in the case of refractory wounds
Altogether the necessity for surgical interfer-
cnee by means Of drug. fire and knife, has
been greatly oyerrated. There il u class of
infiammatory wounds which, on the let.alone
plan, could BIO managed as easily a common
brnise, but which. under the irritating influence
of lancet cuts assume an alarming malignancy.
One iavorite excuse for such Interference was
the alleged necessity for promoting suppura-
ton" Many of our ablest modern pathologists.
however, incline 10 the opinion that the same end
can be attained by u little patience. or by such
simple means as the use of warm water, applied
directly TO the infiamed tissues. j have known
! cases where the latter plan urgently recon-
| mended by the superintendent of the Battle
Creek Michigan Model Sanitarium and by DIR.
Frank Hamilton, of the New York Bellevue Hos
| pital.) has made the use OF the surgeons knife
| altogether superfluous under tho very circum.
| stances which formerly would have been ao-
| cepted AS indisputable evidence for the need Of
| lancet operation. Hard, throbbing swellnga
L Until sEfatI.I - r.. IL A. -As