The homeopathic practice of surgery, together with operative surgery, illustrated by two hundred and forty engravings. By B.L. Hill, M.D., and Jas. G. Hunt, M.D. / Title Contents
The homeopathic practice of surgery, together with operative surgery, illustrated by two hundred and forty engravings. By B.L. Hill, M.D., and Jas. G. Hunt, M.D.
Hill, B. L. (Benjamin L.)
Cleveland, O.: J.B. Cobb and company, 1855.
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Illustrated by Two Hundred and Forty Engravings.
B. L. HILL, M. D.,
PROFESSOR OF OBSTETRICS AND DISEASES OF FEMALES, AND LATE PROFESSOR OF
SURGERY IN THE WESTERN HOMEOPATHIC COLLEGE.
JAS. G. HUNT, M. D.,
PROFESSOR OF SURGERY IN THE WESTERN HOMEOPATHIC COLLEGE.
J. B. COBB AND COMPANY.
Entered according to Act of Congress, in the year 1855,
BY B. L. HILL, M. D., & JAS. J. HUNT, M. D.,
In the Clerk's Office of the District Court of the United States for the Northern
District of Ohio.
Stereotyped and Printed by the Hudson Book Company.
To those who have been desiring the speedy publication of this work
the first on Homeopathic Surgery —some explanation of its tardy
appearance is due.
The reasons may be summed up as follows: —The desire to make the
work as perfect as possible, embracing both that knowledge already
written and that evolved in the clinical experience of the Homeopathic
profession; the difficulty and time consumed in obtaining and condensing
communications from our physicians; the severe labor necessary
The work is designed as a text book for students, and an aid to practitioners
Inasmuch as practical experience in our Science dates back but a short time
in this country, it can not be supposed that any one man would have sufficient experience in "Surgical diseases" (a considerable portion of which are of rare occurrence), to enable him alone to furnish the proper material for such a work.
We are well aware that in all our attempts at produci
with the promise of the desired contributions; which from time to time
were received. To those who thus responded we tender our sincere thanks,
particularly to that veteran in Homeopathy, Doctor C. Neidhard, of
Philadelphia, for the number and completeness of his communications.
Had each old experienced practitioner done as well, we have no doubt that
the profession would have had much valuable matter- now lost to them.
In the preparation of this work, in
INFLAMMATION IN ITS GENERAL ASPECTS.
Inflammation- Inflammation not a disease, nor "the reparative principle"Etymology - Heat and other vital manifestations - Excess of, vascular or nervous? - Simplistic questions and varied researches - Acceleration or Retardation? — Chemical and Microscopical results- Inflammation not indispensable
to recovery from local injury -Its stages up to "mortification," and particularly of suppuration.
"INFLAMMATION," says the celebrated surgical p
Modern chemistry would accept the definition, with the addition
of "too fast." Liebig has a complete " Theory of Disease,"
founded on and confirming this simple idea. The slow combination with oxygen throughout the body, as well as in the lungs, is
made not only to explain the problem of animal heat, but of the
common morbid increase of temperature. The degeneration of
the diseased parts, and the subsequent decomposition, of the
whole, are accounted for on
IN ITS GENERAL ASPECTS. 3
responding maxim, " Kings or sovereign bodies can do no wrong"
is to common sense untrue, absurd, and practically mischievous.
As the political doctrine alluded to, the divine right of kings, led
to the servile corollary of "passive obedience," so the divine infallibility of nature points consistently to non-interference, and
letting nature take her course in all cases. Strange as it may
appear, this practical reductio ad absurdum has not daunted some
and makes great use of this distinction, speaks also in perfect
consistency of " too much health," or, " health above par." These
expressions would be regarded by most as involving absurdity;
and perhaps " healthy inflammation," though it is hardly possible
to avoid its use, may come to be considered a contradiction in
Increase of other vital properties, besides that of heat, is so
obvious in inflammation, that the fact has for a long time been
IN ITS GENERAL ASPECTS. 5
would more frequently hold than "pain," if by that be meant
spontaneous sense of suffering, without any external cause.
A change of action tending to, if not, also, resulting from a
change of structure, may be regarded essential to our modern
idea of inflammation. Placing this characteristic tendency first,
as more important than the sensible appearances, Druitt suggests
the following definition as an amendment of one given in a French
a prior, but almost synchronous change in its innervation, from
the ganglionic system of nerves. An active determination of
blood to the brain (for instance) may be for a while quite distinct
from cerebritis, but is very apt to lead to some form of it. A
cupping glass, producing all the external "signs" of inflammation, would actually cause that state, if not removed. Over-stimulation of a part by blood, even in its healthy state and flow, is
IN ITS GENERAL ASPECTS.
fashionable, and still too prevalent, confidence in "starvation;"
and at one period, not many generations back in the dark ages,
patients, with certain fevers or inflammations, were absolutely refused fresh air! As to the great internal stimulus, the living
fluid, or fluid life itself, it is unnecessary to point out to those who
have witnessed the abuse of blood-letting, and wish to learn something better, —how destructive has been the consequence of a
partial and supe
phizing, is no doubt much safer than such hypothetical theorizing,
yet it is in vain to protest against hypothesis and theory. All
men theorize to the extent of their leisure and ability. The only
question is between good theorizing and bad, reasoning with facts
or without, or with few or many. It is speculation that stimulates observation and directs experiment. Hypothesis anticipates
experience, and is only injurious when mistaken for it. Ideas are
IN ITS GENERAL ASPECTS. 9
flammation." One satisfactory test of the one-sidedness of such
views is suggested by this author- that of availability in practice. Could the morbid state in question be really accounted for
on either hypothesis, or any other " simple idea which fancy might
fix upon," such state, so easily understood, could be as easily
treated. If the question could be settled or arranged as the old
kindred one in nosology, between diseases of increased or decrease
In the investigation as to the nature of inflammation, the advocate
of both sides of "the question" have found it necessary to vary
and modify their enquiry, and make many limitations and discriminations not before thought of.
The subject has not been allowed to remain as a merely curious and limited physiological or pathological question. Comparative Physiology and even Pathology have been brought to bear
upon it. The enquiry has not been restricted to what
IN ITS GENERAL ASPECTS. 11
fashion, appears really to be the result, not perhaps of inflammatory blood, but of a modification of the blood accompanying inflammation. There is found, on actual analysis, to be nearly as
much as one per cent, more fibrin in the circulating fluid in some
cases of inflammation than in health, and less than the average
proportion in certain typhoid or non-inflammatory diseases. Fibrin appears to be the material of nutrition and of the reparative
said by Carpenter to be " always conjoined with a depressed vitality of the tissues of some part of the body, which indisposes
them to the performance of their regular nutritive operations;
and this part may undergo a variety of changes, according to the
degree in which it is affected." This "depressed vitality" is
shown to involve a languor in the movement of the blood, with
which the capillaries are distended. There is nevertheless a determination of blo
IN ITS GENERAL ASPECTS. 18
scopic, or what may be called, from analogy to chemistry, atomic
anatomy, the colorless corpuscle or molecule of fibrin, becomes a
"primordial cell" or cytoblast. " Corpuscles" seems a correct
name for these organic atoms, for they appear to have their own
independent vitality, even anterior to being organized, or assimilated to already formed structures. The serous part of the blood
or lymph is the first nutriment of these cell-germs, and hence
from structural injury to the solids, that "contused wounds" are
so troublesome. In "lacerated wounds," the careful surgeon always removes clots of blood, and sponges out all he can that is
yet fluid, as if still living, it must, in that situation, soon die and
become a source of irritation.
When the direct injury causing the inflammation has been
greater, when the "depression of vitality" amounted more nearly
to extinction, or when the inflammatory proce
IN ITS GENERAL ASPECTS. 15
scesses, though limited by the effused and organizing fibrin,
become ulcers, the pus "eating" its way out.
If the original injury or the subsequent inflammation itself
be so great as to cause the disorganization of a sensible amount
of the solid structures, we have what is called sloughing. The
difference between this result and that of mere suppuration being
that the solid matter is not so easily converted into pus as the devitalized fluids. In thi
cases," that of caustics, by the fact of their destroying these
peculiar cells and the adjacent matter partially affected by them;
and thus to draw another argument for the necessity for inflammation. He speaks of the inflammatory action beneath the surface killed by the caustic, as the only possible mode by which
"fibrin can be effused and preparation made for filling up the
breach of substance." The treatment he appeals to, is undoubtedly the best in ma
IN ITS GENERAL ASPECTS. 17
The slight exaltation of vital action that seems necessary to
the recuperative process, is but that process in operation, the performance of overwork and the making up of lost time, in the
more active resumption of functions that have been impeded.
When the amount of the injury, or the want of steady healthpreservative power in the constitution, is such that this resumption
of increased business on the part of nature cannot be got through
18 INFLAMMATION CONTINUED
foe the portion of society that can best be spared, to preserve the
rest from destruction. Here, too, the analogy with inflammation
holds strictly. The preservative process or means often turn out
destructive to friends, more than to foes. The arming of society
is often found an "inflammatory" and disorganizing business,a fatal necessity.
INFLAMMATION CONTINUED UNDER ITS MOST PRACTICAL ASPECTS.
" The four Signs" -Constitutional Symptoms- Ch
UNDER ITS MOST PRACTICAL ASPECTS. 19
The pain may exist in or be referred to parts distant from the
seat of the inflammation. In the hip disease the first complaint
of the patient is often "pain in the knee."
The character of the pain, as well as the amount, differs in
the different structures and tissues. Throbbing is the characteristic of proper phlegmon or circumscribed inflammation in the
cellular structure: and a dull heavy sensation that of the substance of most of the inte
20 INFLAMMATION CONTINUED
of temperature was discoverable. Hunter sometimes failed, after
exciting artificial inflammation in animals, to ascertain any definite increase of heat. It has been generally allowed, however,
that in the lower extremities, and other parts distant from the
center of circulation, the inflammatory state raised the temperature a few degrees, -up to that of the heart or lungs; and this
slight change was attributed wholly to the increased quantity, and
UNDER. ITS MOST PRACTICAL ASPECTS. 21
and not in " single file." As the inflammation advances new vessels may also be formed, thus adding to the degree of redness.
This varies with the structure of the part, the kind of inflammation, its amount, stage, &c. It is greater, for instance, on
mucous membranes than on the skin. There is said to be " uniform redness" in Erysipelas, "capilliform" when only some of
the capillaries are rendered visible, as in conjunctivitis. There
22 INFLAMMATION CONTINUED
below their average of functional power. The secretion proper
to the part is always modified or checked at the commencement
of inflammation, but subsequently it is often greatly increased and
mingled with the products of diseased action. Structural change
becomes chiefly manifest in chronic inflammation, the acute ending in complete destruction or more or less incomplete restoration.
Increase of weight is often a marked symptom or sensation of the
UNDER ITS MOST PRACTICAL ASPECTS. 23
result of a dyscrasia, predisposing the individual to inflammation,
or to an unfavorable modification of it, when produced from ordinary causes. Thus, scrofulous swellings or other inflammations in
scrofulous patients, are easily excited, but difficult to reduce.
Their progress is tedious; and a thin fluid, with curdy matter,
takes the place of serum and healthy fibrin, or of consistent
"healthy pus." After these explanations, it is hardly nec
24 INFLAMMATION CONTINUED
often sufficiently distinct. Hence the kind, as well as degree of
danger, is different in the two cases.
Such expressions as "Adhesive Inflammation, Suppurative,
Ulcerative or Gangrenous Inflammation," must be understood as
descriptive, as denoting degrees, stages or accidental tendencies
of the same action, rather than distinct kinds of diseased action.
All these peculiarities may depend on the state of the patient's
constitution, the part affected, an
UNDER ITS MOST PRACTICAL ASPECTS. 25
vigor and freedom from aberration of " the restorative principle,"
i. e., by recovery from local injury without, or with little, inflammation. It is a familiar observation, that " some people's flesh
will not heal like others." Some are in danger of bleeding to
death from the smallest wound, and are hence said to be of a
hemorrhagic diathesis. Others, it might be also said, have a suppurative or gangrenous or at least inflammatory diathesis. "A
26 INFLAMMATION CONTINUED
posed cutis is liable to suffer from cold air; from which, however,
it is protected, if not artificially, by a thickening of the matter
effused into what is called a scab. Small and distinct elevations
of the cuticle are called " vesicles." If they contain pus instead
of serum, they are distinguished as "pustules," and the process
of their formation "pustulation." Pimples, rashes, &c., might
perhaps be mentioned as peculiar results of cutaneous inflamma
UNDER ITS MOST PRACTICAL ASPECTS. 27
ened and indurated. Their liability to ulceration and gangrene
has been disputed.
Tendons and Ligaments are both described by Sir Astley
Cooper as "not very susceptible of inflammation," at least in
healthy persons. The pain, however, produced by injuries of
the former, particularly punctures, is more than a set-off for this
exemption, oftener producing tetanus than in any other part.
The synovial membranes connected with the ligaments, are ve
28 INFLAMMATION CONTINUED
of the joint or bone with which it is connected. All the usual
phenomena of inflammation take place in the BONES; their gangrene and mortification, however, are usually spoken of under
distinct names, as " caries and necrosis." The result of their
suppuration is often diagnostic, "bone-pus" being so rarely
healthy, that it is synonymous with ichor, generally foetid, and
often quite dark.
CAUSES. - Of the "proximate cause" of Inflammation enough
UNDER ITS MOST PRACTICAL ASPECTS. 29
membranes, appearing to divert the excessive activity or "force"
then generated. This is one reason why it is often spoken of as
a termination. The pain attending this process is "thrilling,"
SUPPURATION it is dull and throbbing, with a peculiar sensation of uneasiness in the part. When the suppurating tumor is
near the surface, the formation of matter is preceded by flush on
the skin above, and followed by the tumor rising and becoming
30 INFLAMMATION CONTINUED
taken back into the blood, and thrown by it on internal parts, are
Abscess, as a result of suppuration, has been before explained.
The pus is confined by the inflammatory effusion itself. The abscesses produced by acute inflammation generally run their course,
including the necessary ulceration for the discharge of matter, in
less than three weeks. The situation of the matter has, however,
much to do with the period, as well as the amount o
UNDER ITS MOST PRACTICAL ASPECTS. 31
of the new structure. These are red in color, and generally-protected by a covering of pus. They rise in successive layers, as
the fibrin is thrown out, and the vessels from the parts beneath
elongate and branch through them. After the cavity is completely filled up, and closed over with skin, "the granulative
structure is absorbed and a contracted cicatrix is left." When
divided parts, or the walls of emptied abscesses are not brought
32 TREATMENT OF INFLAMMATION,
class of physicians in question, bleeding is now the exception in
cases where it was once the rule. Its direction by the authors is
accompanied with so many conditions and qualifications, that a.
cautious beginner can never be sure when he is warranted in resorting to this once never-failing expedient. Still it is the remedy
of the books, and sufficiently relied on for other better means to
be habitually neglected, even when that also is omitted. A l
TREATMENT OF INFLAMMATION. 33
secured "resolution;" if not, suppuration or sloughing must
Now blood-letting, by merely lessening the general amount
of the circulating fluid, can certainly have no direct tendency to
bring about this desirable result. The amount removed is drawn
in at least equal proportion from all other parts, which then have
an inadequate instead of a superabundant supply. The inequilibrium must therefore be increased instead of lessened. Th
84 TREATMENT OF INFLAMMATION.
the brain. It is a cold, clammy death-sweat. In the natural
action of this function, the whole surface of the body is in the
active condition, warm and red, and the pulse full and soft.
Experience confirms physiology in showing that blood-letting
cannot effect the object for which it is practiced. It is now, indeed, sometimes said that the bleeding is rather a preventive than
a curative measure; that it is chiefly useful as a means of gaining tim
TREATMENT OF INFLAMMATION. 35
for inflammation are now so many, that they will no doubt become
the rule, even among Allopaths. It is well known that Homeopathists have always proscribed blood-letting.
is a very different measure from venesection, but this is liable to
many of the same objections,. The same quantity of blood, taken
just seen, from their systems not knowing when to give the fainting sign of "hold,
enough!" but the fat and some of the f
36 TREATMENT OF INFLAMMATION.
slowly and gradually from the small vessels of the part, will not
produce the same immediately dangerous effects. There is no
shock produced upon the general system, the vessels having time
to contract so as to reduce their calibre to the amount of fluid
contained. Still, if much blood be taken, even in this way, evil
consequences must ensue.
But the great objection to local bleeding is, that the necessary
applications cannot be made directly to
TREATMENT OF INFLAMMATION. 37
rounding ones nearly exhausted also, it is confessed that little or
no good can be done.
LEECHES are, in some countries, and by some practitioners in
this country, the most approved means of local depletion. But
of these agencies in surgery it may be said, as of blood-letting in
general, that the cautions necessary to be observed in their use,
nearly amount to a prohibition.* Besides, they must not be applied directly to the part inflamed;
38 TREATMENT OF INFLAMMATION.
Dismissing the subject of abstracting blood, together with cathartics, &c., as measures not only unnecessary, but highly injurious, since healthy organs are attacked in order to relieve
diseased, the vital force is impaired, and the means employed
have no special adaptation to the end proposed,-we will speak
briefly of the
SPECIFIC OR HOMEOPATHIC TREATMENT.
Its simplicity, its harmlessness, is in as strong contrast to
other modes, as it is superior in
TREATMENT OF INFLAMMATION. 39
superior to the depleting means usually employed, will be needed,
and in some cases, Belladonna, Bryonia, Cantharis, Mere, &c.,
are useful. (For the particular indications for each remedy, see
WOUNDS, ABSCESS, DISLOCATIONS and FRACTURES.)
The local applications will be spoken of in connection with
the different classes of injuries, but we would state here the general rule for their use. Immediately upon the occurrence of an
injury, and until consider
40 THE DIFFERENT KINDS OF WOUNDS, &C.
THE DIFFERENT KINDS OF WOUNDS, ERYSIPELAS, TETANUS, AND
DEFINITIONS - Simple, &c. - Cuts, Bruises, &c. - their respective importance,
pain, bleeding and danger - TREATMENT - Incised Wounds and HemorrhageCompression, Styptics and Ligatures -Punctured and Penetrating Wounds -
Suppuration - Lacerated and Contused - Irritation, Gangrene, &c. - Gunshot Wounds - their varieties and peculiarities - Probing, &c. - Calendula
THE DIFFERENT KINDS OF WOUNDS, &C. 41
— the incised; the punctured and penetrating (distinguished by
their depth); the contused and lacerated (often connected); those
occasioned in any way by explosion of gun-powder, and called
for convenience "gun-shot wounds;" and lastly, those that, besides the mechanical injury, are the means of introducing into
the body some poisonous substance.
1. An Incised Wound is, in plainer English, "a cut" — more
precisely defined as a "solution of contin
42 HEMORRHAGE, PAIN AND DANGER.
a ball, may inflict severe injury. The stratum of air impelled before the ball, or contained between the ball and the skin, is doubtless sufficiently condensed to impart a decided impulse to the
surface that is grazed.
The subject of cannon balls will be found more curious than
practically important, except to surgeons in the navy or army.
The rifle or pistol balls, with which the surgeon is more likely
to be concerned, generally make at once a punctu