Earth as a topical application in surgery : being a full exposition of its use in all the cases requiring topical applications admitted in the men's and women's surgical wards of the Pennsylvania Hospital during a period of six months in 1869

Front matter

V

Boston Medical Library in the Francis A. Countway Library of Medicine -Boston

EARTH

Contents

PAGE

Preface, vii

Introduction, xi

Preface

The following pages contain the results of clinical work done nearly three years ago, which have been delayed in their publication until now for the double purpose of weighing thein by subsequent experience, and of interpreting their meaning by a careful study of the various subjects which they involve.

In order to accomplish the latter purpose I have not hesitated to quote extensively from various authorities, at the risk of reproducing much that is well known, and even perhaps of taxing the reader's patience.

By discussing these subjects from a strictly chemical point of view, and in reference chiefly to the part taken by oxygen in producing them, I would have no other inference drawn than that as this furnishes, in my opinion, a satisfactory explanation of the phenomena, the discussion of the subjects from other standpoints is unnecessary here. The disposition of the most recent observers to give a more prominent place, than was formerly accorded, to the chemical relations of the elements involved in nature's varied processes, has not only rendered my task in this respect easier than it would formerly have been, but brightens the prospect of the dissipation of those objections to the use of earth in surgery which are founded on old ideas.

In this connection I cannot refrain from making some comment on the fact, discovered as I am going to press with this volume, that the article on the Process of Inflammation in volume first of the original edition of Holmes's System of Surgery, written by Mr. J. Simon, and from which I have freehy quoted, has been suppressed in the second edition of that volume, for the reason that "all previous doctrines on the subject are just

Vlll PREFACE.

now in the very crisis of a reconsideration," and the intention is there made known of devoting a separate paper to the subject before the close of the work, so as to secure the latest views concerning it. The paper so promised has just appeared, and is from the pen of Dr. Burdon-Sanderson, well known for his zealous pursuit of such studies. It gives us a most admirable resume of the subject, but does not make it necessary for me to abandon what I have quoted from Mr. Simon's article, for the substance of what I have quoted is retained by Dr. Sanderson, and, as I before intimated, my purpose has been not to discuss the subject in eoctenso, but only so far as it might facilitate the interpretation of the results of my cases.

Since it became very generally known that I was engaged in these investigations, a large amount of matter relating to the past history and the recent uses of earth for surgical purposes has been sent me from various parts of the world, from points as remote even as South America and Australia. This was the result chiefly of the publicity given to my earliest researches at the hospital, by an account in the " Xew York Post " of February 24th, 1869, in which Colonel George E. Waring published, without my knowledge of his intention, an interesting and faithful description of what he had seen in my wards a few days previous. Much of the information which I have thus received would, I am confident, be both interesting and instructive to the reader, and my intention to incorporate it in the first publication I should make on the subject has been frustrated only by the bulk of my own material. I have, indeed, from this very circumstance, been compelled to confine myself on the present occasion to an exposition of my first six months' experience only. I have not done this, however, without some satisfaction, for my inferences of those times have not only been thoroughly confirmed hy more recent experiences, but there were numerous and constant witnesses of the cases, and by giving the details of all of them, I avoid the suspicion of suppressing anything which could have then led me to other conclusions, and they furnish the fairest means of judging of the correctness of the views which I now hold. I hope, therefore, that all who have favored me with communications on the subject will accept my thanks for the same, and be assured that

PEEFACE. IX

they have been a means of stimulating iny investigations. Furthermore, I would take this opportunity to urge them, and all who are in the possession of facts and experience as to such uses of earth, to publish some account of them at as early a date as possible, and so freely disseminate their knowledge concerning the matter.

The illustrations, four in number, which I have introduced, for the purpose of giving a demonstration as strong as possible of my successes, have been made by the American Photo- Eelief Printing Company, and are from photographs reproduced by a method that would seem to leave nothing to be desired as to permanency, as weir as faithfulness and accuracy of representation. This method consists in taking from a negative a positive on a sheet of gelatine, impregnated with bichromate of potash, by exposing such a sheet to the sunlight under the negative, as in the ordinary way of photograph printing. The effect of the bichromate is, that wherever the light acts, the gelatine is rendered more or less insoluble in water, whilst, wherever the light does not act, it remains perfectly soluble ; so that after a proper amount of such exposure, and then placing it in hot water, those parts of the sheet which have been acted on remain more or less of the original thickness, whilst those which have not been are washed away. In this manner the sheet is converted into a print of raised and sunken parts. This is next placed on a steel plate, and upon it a plate of type metal is laid, and the whole is submitted to heavy pressure in a hydraulic press. Thus a t3^pe-metal plate is produced with raised and sunken parts, corresponding to the sunken and raised parts of the gelatine print, and all the lights and shadows of the object are faithfully reproduced, and with as much definition as they were represented in the original negative ; the lights by reliefs and the shadows by hollows. From this plate pictures are finally made in a printing press, in pigment, without the agency of light, and are as unchangeable as the printed text of a book. This invention, which has been pronounced by high authority (the editor of the " Photographic Art Journal" of London), as the greatest of all advances made in photography since the introduction of the collodion process ; and by another authority (Thomas Sut-

X PREFACE.

ton, B.A., Cantab.), as one of the most remarkable achievements of modern chemistiy and mechanics, is, like most such inventions, the work of many minds and hands, but the result of the combinative genius of one individual, Mr. Walter Wooclbuiy, of England. The truthfulness and accuracy with which this process reproduces the representations of photography can be well judged of b^y the pictures in this volume, for in some of them there are artistic defects evidently from the negatives, and which were unavoidable. This is particularly noticeable in that of Case XI, the face of which is dark; the negative in that instance, however, was taken in the ward of the hospital, where the light could not be made suitable for the purpose ; whereas the picture of Case XLYIII is from a negative taken under the most favorable circumstances, and will bear the closest scrutiny. All four of the illustrations, however, exhibit most perfectly the effects of the dressings for which they are introduced, and hence need no apology from me.

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