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History of medical practice in Illinois - Bushnell Historical Society

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1 80 <strong>History</strong> <strong>of</strong> Medical Practice <strong>in</strong> Ill<strong>in</strong>oislisted for overcom<strong>in</strong>g shorten<strong>in</strong>g: " (1) All shorten<strong>in</strong>g must be overcomeat once; don't wait to treat muscles by stretch<strong>in</strong>g. (2) All fractures <strong>of</strong> thefemur must be dressed <strong>in</strong> a flexed position. (3) A fixed and immovableposition <strong>of</strong> the pelvis is essential for the best results. (4) All lateral supportsexercis<strong>in</strong>g pressure are pernicious; they disturb the action <strong>of</strong> nerves andpressure on <strong>in</strong>jured tissues causes pa<strong>in</strong> and vesication." He advised, therefore,"the use <strong>of</strong> a triple <strong>in</strong>cl<strong>in</strong>ed plane" and described a fracture bed withplanes built <strong>in</strong>to it,the body at 45 degrees with the bed frame and theleg at 90 degrees with the thigh.Additional discussion on fracture treatment concerned the time whena fracture should be reduced. The majority <strong>of</strong> speakers believed it shouldbe done as soon as possible. Extension and counter-extension (traction)were advised, and Buck's extension was discussed. Some used plaster <strong>of</strong>paris spl<strong>in</strong>ts. Silicate <strong>of</strong> soda was used by Dr. Gross.1880The Report on Surgery was given by Dr. William Hill <strong>of</strong> Bloom<strong>in</strong>gton,who described a method <strong>of</strong> urethrotomy by cutt<strong>in</strong>g through the prostategland. There was also discussion <strong>of</strong> the hazardous operation <strong>of</strong> cutt<strong>in</strong>g<strong>in</strong>to the abdom<strong>in</strong>al cavity for strangulated <strong>in</strong>gu<strong>in</strong>al hernia, thereby wound<strong>in</strong>gthe peritoneum and endanger<strong>in</strong>g the life <strong>of</strong> the patient from peritonitis.Many surgeons testified that they preferred the <strong>practice</strong> <strong>of</strong> forc<strong>in</strong>g the abdom<strong>in</strong>al<strong>in</strong>teguments on the end <strong>of</strong> the thumb up <strong>in</strong>to the abdom<strong>in</strong>al r<strong>in</strong>gand so dilat<strong>in</strong>g it to permit a return <strong>of</strong> the protrud<strong>in</strong>g <strong>in</strong>test<strong>in</strong>e back <strong>in</strong>tothe abdom<strong>in</strong>al cavity. (It seems unfortunate that at that time their antisepticprecautions could not have assured clean wounds. The surgeons hadadequate anatomical knowledge and a fair idea <strong>of</strong> the pathology, but lackedcl<strong>in</strong>ical experience which was to be obta<strong>in</strong>ed <strong>in</strong> later years under the advantages<strong>of</strong> asepsis.)Antisepsis and Lister's teach<strong>in</strong>gs were aired aga<strong>in</strong>. "Putrefaction <strong>in</strong>wounds and abscesses is analogous to the fermentation <strong>of</strong> a sacchar<strong>in</strong>esolution under the <strong>in</strong>fluence <strong>of</strong> the yeast plant and it is due to exist<strong>in</strong>gdevelopment <strong>of</strong> m<strong>in</strong>ute organisms." They believed that the problem <strong>of</strong> themoment was to exclude air (oxygen) accord<strong>in</strong>g to the old ideas, but todress wounds with an agent capable <strong>of</strong> destroy<strong>in</strong>g all organisms without<strong>in</strong>jur<strong>in</strong>g open wounds or liv<strong>in</strong>g tissue. The antiseptic plan <strong>of</strong> treatmenthad been proven <strong>of</strong> practical utility <strong>in</strong> the treatment <strong>of</strong> compound fracture.The speakers all approved <strong>of</strong> carbolic acid. They used it <strong>in</strong> amputations,employ<strong>in</strong>g a spray and carbolized ligatures and sutures. They also closedflaps and got primary union. Thymol was also used.Excision <strong>of</strong> the float<strong>in</strong>g kidney was described as reported by Dr. Cripps <strong>of</strong>England. Two <strong>in</strong>stances <strong>of</strong> excision <strong>of</strong> carc<strong>in</strong>oma <strong>of</strong> the rectum were re-

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