A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

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    for Other than caustic purposes are best secured in solution. These are usually simple in character, at most a small quantity of glycerin only being added. The effects of the solutions are in direct ratio with their strengths, and bear an exact relation to the character of the tissues to which they are applied. General Surgery.—Chloride of zinc is a valuable escharotic in the treatment of Cancer. In cases which do not permit of operation Can- quoin's paste may be laid over the exposed surface and allowed to remain from six to twenty-four hours. Haberlin finds a marked amelioration of the condition of the parts in Uterine Cancer upon application of the paste on cotton held against the cervix by a vaginal tampon. E. Van de Warker has revived a method of using chloride of zinc in uterine cancer after amputation of the cervix. The following description is con- densed from Mann's American System of Gynecology: The cervix is removed at the vaginal junction, extending, however, with knife or scissors to the os internum. Hemorrhage is checked by packing the cavity with masses of cotton prepared by immersion in a solution of persulphate of iron in the proportion of one to three of water and squeezed nearly dry. This dressing should be removed on the third day. The canal and uterine cavity are then packed with pledgets (pieces about the size of a chestnut) of absorbent cotton soaked in chloride of zinc solution. Two strengths are in use; one of five drachms to the ounce, and a second of equal parts of the salt and water. The weaker solution is used when the uterine walls are thin, to avoid danger of involvement of the peri- toneum ; the stronger solution is indicated when the walls are of normal thickness. The thickness of the uterine walls can be gauged at the time of operation by introducing the finger into the uterine cavity and a sound into the bladder and rectum. To protect the vagina and the vulva, they should be anointed before the operation with a pomade containing one part of bicarbonate of sodium to three of cosmoline. The pain following the application of the escharotic is often severe, requiring hypodermic injections of morphme. The packing should be removed on the second or third day, when this can be done without force; but when the dressing is firmly cemented, it is better to wait a day or two longer. The slough separates in from five to ten days. If the strong solution has been employed, the slough is thrown off in a single piece. Cicatrization is complete in from two to four weeks, and is followed by marked contraction of the uterine cavity. In a case of cancer of the cervix and body of the uterus, we recently employed the stronger solution. By its action a slough comes away in one piece the shape and size of the interior of the uterus. The complete relief of pain, hemorrhage, and discharge was marked, and continued for many months. The cautery treatment should not take