The citizen. (Frederick City, Md.) 1895-1923, 1895-08-30
TIMELY MEDICAL TOPICS.
A Series of Brief Treatises on
What To Do in Emergencies,
What Not To Do and Other
Hints of Value.
prepared Weekly, Tor the Citizen.)

Burns aud scalds of the larynx and
trachea, are practically never dissociat-
ed from similar injuries to the parts
above, and perhaps to the vesCphagus.
Burns are produced by the Inhalation
of hot steam and superheated air.
Scalds are commonly produced by hot
and caustic fluids. Caustic fluids taken
internally are not always swallowed,
but "often go the wrong way" The
consequence of these injuries is a very
acute laryngitis, which supervenes
at once, with intermescence and
oedema In proportion to the extent
and severity of the lesion will be the
amicult and depth Of the tissue de-
struction." Following the first vio-
lence of the lesion membranous exu-
date is formed, which separates by
sloughing and if the patient survives,
may undergo extensive cicatricial con-
traction. These cases are often compli-
Gated with bronchitis of a most serious
and even fatal character.
The symptoms produced by burns are
immediate and violent; those produced
by caustics may come on more slowly.
Treatments: So far as treatment is
concerned, immediate death by suffO-
cation can easily be averted by trach-
eotomy, though it may not avail to
save the patient from secondary le-
siOns.
Scdlds produced by caustics, acids or
alkales are usually seen too late to adj
NIT of an antidote, or to avert their de-
structive effects.
The symptoms must be averted as
they arise and while the introduction
of a trachea tube may make respiration
easier. The probability is that the at
tendant will have to treat a complicat-
ed case of lesion of the mouth and
larynx, if not to the oesophagus,
which will battle her most persistent
and we'll directed efforts. Iced and
mucilaginous drinks. antiseptic mouth
trashes and gargles and ano-
dynes under the skin or by
the rectum with rectal nourishment,
sum up the principal indications in the
way of treatment.
INJURIES OF THE NECK.
Commissions of the neck may be so vi
olent as to cause insensibility, or even
death. The reputation which a blow
upon the jugular, has among the laity,
is an evidence of the severity of many
of these injuries.
The result of such blows may be the
| fractufe of the hyoid or of the carti-
lagos of the larynX, or rupture of the
mucuous membrane, followed by a
deep *emplupema. *AsphyXia may re-
! peatedly threaten, and for this trach-
eOtonemy may he required. Aside
from these LESSONS, there may be bloody
illusions or acute inflammatory swell
ings, with all their supperative pos
sibilities, while from some abrasion or
eruption of the skin an erysipelas even
of the phlegmonOus may develop.
Open wounds of the neck may be of
all sizes, and may be incised, punctur-
ed or lacerated in character. A wound
by which the deep fascia is divided,
may be called deep wound and will
usually involve blood vessels and
nerves of Importance.
SALvE.
The prescription given below is from
DR.. H. Kylberg. 1t was obtained
from him during his travels in Swe-
den by ali influential friend, upon con-
dition that he would not open it until
he had left the country. The proper
ties ascribed are to extract pus, if any
be present, and to heal any wound by
promoting healthy CARNATIONS:
R.-Lapis Calaminarls Prep...2 ounces.
Venice Turpentine..............2 ounces.
yellow wax ........ ................2 ounces.
GOat'S lailOW ....".".............2 ounces.
Cotton Seed Oil....................1 ounce.
Boil up last four parts in clay pot,
then add the calaminars, aud stir un-
til hardened.
CONSERVATIVE SURGERY IN APPEN-
DICITIS.
Time is the test of action, 1t reveals
more truth than can be acquired by
any other method. Appendicitis at
first appeared among us and was treat
ed in various ways. History shows that
thousands of autopsies and centuries of
time were required to teach mankind
that the trouble in the right lilac fossa
is appendicitis. At first men eXtirpat-
ed the appendix, thinking there was
no other way to cure the patient.
Nearly three years ago DR.. Byron
Robinson began to pursue the method
of leaving the appendix alone. L sim
ply incised and drained. | did not at
tempt to break up old infammatory
adhesions. The barriers of undates
surrounding adhesions and deposits
were left undisturbed. The abscess
around the appendix was simply cut
and drained. The rubber tube was
stitched into the wound and gradually
withdrawn as the days progressed.
am now more inclined to limit the
working or irrigation; simply incise
and Introduce the tube and allow the
| n A g.,
cases may suffice to illustrate the plan.
In 1895 operated on college STU
dent afflicted with appendicitis. He
was rugged, strong man. I cut
down on the parts well to the outside.
!. e., near the crest of the ilium. Soon
came down on cavity filled with
pus.
After its evacuation | found a yery
irregular cavity surrounded with dense
walls of exudate. The walls were very
firm and thick. could not find the
appendix without breaking up all
these adhesiOns, and for the first time
l concluded to let the appendix and ad-
heslons entirely. alone. The surgeon
standing by said that such was bad
surgery and that it would Immediately
recur. But determined to follow the
practice of opening far to the right, so
as not to enter the general peritonal
cavity and to simply drain. The stu
dent made splendid recovery and L
have never heard that he had single
disturbance. The points in the meth
cd are: ld.) Open SO far to the right that
one will be certain not to enter the
peritonal cavity. The incision only
enters the abscess cavity. (b.) TO