History of medical practice in Illinois - Bushnell Historical Society

166 History of Medical Practice in Illinoisalcohol and opium in operations and denied that chloroform had "aneffect to diminish the plasticity of exudations." He also spoke of the localuse of cold for anesthesia, perhaps the first use of refrigeration in Illinois.This he declared must be so used as not to freeze the flesh. He cited Dr. W.S. Edgar, Surgeon to the 32nd Regiment, Illinois Infantry, who stated that"at Vicksburg, it came to be the practice to place ice between the surfacesafter amputations for a short time before the final closure, with the result ofmuch more frequent union by first intention." Since then he (Prince) hadenjoyed the use of a spray of ether on the parts with great satisfaction."It isplain that nothing should be applied upon a wound surface whichcoagulates the albuminous fluids. The application of salts of zinc doesthis, and the treatment is, therefore, of questionable propriety. If thecoagula are not well washed away (probably by draining fluids from thewound) they must serve as foreign substances adverse to union." He referredto Chassaignac introducing rubber drainage tubes to avoid thissituation and continues: "If however, the wound can be so managed thatnothing may be left in it that is certain to putrify, a small amount ofeffusion may be absorbed, as in subcutaneous wounds" (spreading ecchymosis).He quoted Simpson's experiments to determine the comparativetolerance of the tissues for metallic and organic suture threads and ligatures.He used needles to press on wounded blood vessels by insertion into,through or across soft parts.Also at this meeting the Prentiss method of applying dry cold through arubber tube coilfed with ice water was discussed. An antiseptic poulticewas mentioned but it was said to furnish too much moisture for purposesof first intention union.A solution of potassium permanganate, 1dram to each pint, was mentionedas an excellent antiseptic, especially for irrigation, the main objectionbeing its stain. Zinc chloride, glycerine and water were announced asantiseptics and ascoagulators of the albuminous exudate which was desirablefor union by adhesions.A long classification was given of plastic operations with explanationsand illustrative operations done by both foreign and American surgeons.One rule stood out: "A cicatrix should never be touched with a knife."This method was advocated: "Step by step, sound skin may be made totravel in the direction of a cicatrix until it occupies the position of thecicatrix removed." The surgeons of that day also knew that a flap should bebroad enough to allow for shrinkage and it should not be stretched undertension. Illustrative instances of severe cicatrix of the face, mouth andneck were reported. Harelip and exstrophy of the bladder were discussed,and a fair sized bibliography of current articles and books on the subjectwas appended to this long and important paper.