OHIO STATEWIDE FILES - Lindsay Journal #1, PART 3 *************************************************************************** OHGENWEB NOTICE: All distribution rights to this electronic data are reserved by the submitter. Reproduction or re-presentation of copyrighted material will require the permission of the copyright owner. *************************************************************************** File contributed for use in USGenWeb Archives by Helen Silvey Helen_Silvey@macnexus.org http://jpaul.gwdi.com/silvey/ January 8, 1999 *************************************************************************** Continued Hydrocele case 4th. Aug. 9, 1831, was called to see son of a Mr. Fouts 15 years old, laboring under scrotal celular Hydrocele. The patient had been brot from a distance to the neighborhood of Richmond to receive my professional attentions. As regards the history of his case dont now recollect what his affection was traced to. The boy was a german by birth, had been of healthy constitution, and accustomed to labor on his father's farm. His lower extremities were some what Edematous, which in some degree was general of the whole surface of the body. On my first visit made a puncture into the scrotum & drew off a considerable quantity of water. 4 or 5 days afterwards, water had agian collected in the scrotum, which I again drew off by puncture. The lower extremities continuing still to exhibit evident symptons of cellular infiltration, next resorted to cupping the inside of each leg above the ancle which gave exit to a considerable quantity of water, being tinged by a small quantity of sanguineous fluid no doubt from the cuticular vascular system only. I would here mention that my patient, was, when I first saw him, of yellow, Puffy, Cachetic, & exsanguinated countenance. and had regular exacerbations of fever every 24 hours. with some thing like an appyrexial period of 18 hours duration. Believing that there was considerable Hepatic derangement in this case, after my first operation, administered calomel & Jalep as a cathartic, & continued to keep the bowels open, which were inclined to torpidity,with Jalap & crem Tart. during the first 4 or 5 days. at the end of which time his exacerbation of fever had nearly subsided about this time put him on a preparation of Carb. Ferri, in hard cider, The water continued to drean off or drip more or less for about 24 hours from the punctures on the legs. made on cupping. & having introduced a small pledget of Lint, on puncturing the scrotum the 2d. time, kept it open 3 or 4 days; & until a slight degree of inflamation had taken place in the part. At this stage of the treatment there appeared to be some amendment. the Febrile Paroxysms having entirely subsided. The Edematous symptoms were much less evident. The Chalybeate was still continued. By the 10th. or 12th. day. the appetite which from the first had been better than might have been expected, now had improved. the expression of countenance had changed from the bloated cachectic, to that of returning health; the lips, the cheeks, & the skin, generally, put on a more healthful hue, & the eye had parted with its dulness, for that of expression & animation. At the end of about 18 days my Patient was taken home. The only change which had been made in the treatment. was when the prepartion of cider before mentioned bacame disagreeable to the stomach, the sub. carb. Ferri was given in substence in 5 or 6 gr. doses 3 or 4 times a day -- and when his stomach and appetite began to come up, directed Mustard seed ground & Horseradish grated, to be used freely in good vinegar, as a condiment, or rather for seasoning, on his meat, & Beef steak. My Patient, so far as I have known any thing of him, has enjoyed since good health. It was something like a year afterwards his Father called on me to pay the Bill, his son up to this time had enjoyed excellent health, and expressed much gratitude for my servises rendered in the case. I forgot to mention that as an external application and Rubifacient during the coninuence of scrotal & cellular infiltration, I prescribed the volatile Linament, with the addition of sprs. or the ol. Terrebint. to be bathed pretty generally over the whole surface two or three times a day. which as an adjuvant have reason to believe had an excellent effect. I would here observe that this & the foregoing case had, in some degree, similar symptons; particularly in the scrotal infiltration. with regard to the general symptons. the latter case was evidently more of the cachectic character than the former. The latter case I should have mentioned in the history of it, that the patient had been laboring under this disease some 2 or 3 weeks before he was brot to my neighborhood, for the purpose of being put under my care. what the previous treatment had been, dont now recollect what my information was on the subject, more than this, that when the scrotal enlargement had taken place, which I think came on suddenly, the Physicians of his neighborhood, professed to be at a loss as to its diagnosis, or real character, & recommeneded that he should be put under my care. The operation of puncturing the scrotum, I feel confident, had an excellent effect in both cases. the infiltration & distention in both was so great, that nothing else, in my opinion, could have carried off the water, indeed was it so great in the former case, that the skin must have given way in a few days, had the operation not been performed, could the patient have survived so long. -- As it regards the cupping in the latter case, am well satisfyed as to the good effects of this also. And altho' these operations are deemed hazardous by some of our writers on the subject, so far as my experience goes, must say that there is little danger in majority of cellular infiltration. I have performed the operations of punturing, scarification, & cupping on many patients during my 14 or 15 years practice, and in no instance has gangrene, or any other untoward symptom resulted. The reasons advanced, as every medical man knows, are, that when cellular dropsy or infiltration takes place there is so much debility, or want of tonicity on the furface & within the cellular tissue that the healing process may not be sustained & that there is danger of gangrene & mortification, direct, or the result of inflamation. That such may have been the result, in some few cases of dropsy of the cellular structure have no doubt. but where such results have taken place I should presume the operation must have been delayed too long. Under great prostration of the powers of life. & almost within the Articulo Mortis, when Death was shaking his fist under the nose of the Patient, and under circumstances when any treatment would have been unavilaling. -- I once had a patient which (who) had been laboring a long time under acites, or Abdominal Dropsey, attended, when I was called, by general infiltration of the cellular membrane. even the head, (&?) scalp, participated in this affection producing much distortion, & enlargement of the head & face. the eyes nearly, or quite closed in consequences. her legs almost as large as her body should have been. & her bodys corrisponding with the lower extremities. & the other members, in this awful sight of human wretchedness. This was a Female 13 or 14 years of age. during some months attentions on her, I taped the Abdomen several times, drawing off some 2 or 3 gallons at a time, The legs were also taped or sarifyed with the lancet at different times. & ran water like a sugar tree. much to her relief for the time being. which in some instances continued discharging for a day or two, in no instances was there any untoward or unpleasant symptoms attending the healing of the puntures & scarifications. And would just add, altho' foreign to the subject under discussion, that at one time this patient had become so much better after the water had been drawn off. Under the exhibition of chalybeate medicine, (Sub. Carb. Ferri) in conjunction with the squill and Digitalis, that strong hopes were entertained of her recovery. She had gained so much strength as to be able to walk to a neighbour's house. If I mistake not several times, her countenance had much improved, her cheeks had began to put on the bloom of health, & her before distorted frame, began to resume its once gracefulness, and symetry. but on returning from a pedestrian excursion in which she visited a near neighbor was caught in a shower of rain, and was immidiately taken worse, seemed to have taken cold, & in a few days afterwards, died suddenly. If there be any danger attending the operation of puncturing the legs, or any part of the surface of a dropsical patient, as deep as the cellular tissue, it could only be in crouded hospitals, surrounded by a putrid or tainted atmosphere. & during a very unhelthy season of the year. Dec. 12, 1836 Wm. Lindsay Hydrocele, case 5. Sept. 20, 1831. was called to operate on Benj. G. Moore 45 or 50 years of age for Hydrocele of one side. Having invited my friend Dr. W. Mount then of Eaton. to whom I acknowledge myself under peculiar obligations. proceeded to examine the case. which being a well marked one of simply Hydrocele. made an explanation to the patient of the various methods which had been practiced by authors on the subject, our patient consented that any operaton we migh prefer, should on his part be submited to, but seemed rather to prefer that of simply drawing off the water with the Trochar, & the injection of such fluid as we might prefer. We proceeded immidiately to the operaton, & succeeded with out any difficulty in drawing off the water, which we followed by the injection of the tepid fluid (dont now recollect which was made use of, wine & water, or Brandy & water,) keeping it within the scrotum until considerable pain, & some sickness, were induced. This was the first time I had operated, or witnessed an operation in this way. & was induced from the good authority on the subject, to hope it would have been successful. and for a period of something like 4 or 5 years was of the impression such was the fact. but some 2 years ago am informed that water had again collected, & was drawn off by a Physician of his immediate neighborhood what was the success of the 2d operation, or what is the present state of the case, am not informed. As I have not had an interview with the Patient or Physician on the subject. but am compelled from the result of this case. & some others which have since presented, that, the operation in this way is much less certain of producing a permanent cure of Hydrocele than of the operation of laying the Tunica vaginalis, or the sac containing the water, freely open with the knife. In another place, at the close of these cases, coming within my practice. I design giving my views, on the suject of operating for the radical cure of Hydrocele, more in extenso. Richmond Ia Dec. 17. 1836 W. Lindsay Case 6th Hydrocele ________________Reynolds, Aged 65 or 70, by profession an Indian Doctor having sometime previous consulted me concerning his case pronounced it Hydrocele. He informed me on the 1st interview that he had been laboring under this disease many years. Supposed it was of Syphalytic origin had consulted, as he informed me with several Physicians who had given various opinions with regard to what might be his disease. & himself was quite at a loss to det(e)rmine what was its true character, but by some was supposed that his case was Rupture. My Diagnosis was soon made out, considering it a case of, simply, Hydrocele, & that well marked. the patient resided 25 or 30 miles distent fro me. On the the date above I was called to a case of Surgery in his neighborhood, where Reynolds met me, & requsted me to call on him on the next day before I left for home. which I accordingly did. As the man was so far distent from my residence operated by simply drawing, off the water, haveing no syringe or necessary preperations for injecteing fluid as recommended, by our Authors on the Subject. This was on the 14th Sept. 1832 Some time during the following winter my Patient called to see me at Richmond, my residence, Hydrocele having again returned. I now opreated on him in my own office by drawing off the water, & throwing up whiskey, it being an article of which he had some fondness, or prepossessions for, when administered in a diferent manner. My patient in a half hour after being operated on, set out on foot, as I afterwards learned, designedly, for his residence, as before stated 25 or 30 miles distent. but on the road, about 3 miles from Town, haveing called on an acquaintence, the pain from the operation was such, that, he was compelled to take up lodging, & was under the necessity of remaining a week or ten Days. being very busily engaged myself at that time in attending to other cases of practice did not again see him during the period that the inflamation contined but the next day after the operation, on learning his situation, sent out an experienced nurse to stay with him, who was instructed, gave me daily information how his case was progressing. In his case the inflamation appears to have run about the necessary height, to produce an obliteration of the sack containing the fluid viz the Tunica vaginalis Testis. I think him radically cured. as it regards what may have induced the disease with him, presume that cause which he himself suggested since his cure, viz. that of syphalis is a matter of doubt. That he had once been laboring under this latter disease is quite probable, having many years ago lived with the cherokee or Creek Indians & since my acquaintence with him, among the negroes, having a blackey for a wife. The fact is among the many cases which have come under my notice, have generally been unable to trace Hydrocele to any particular case. with absolute certainty. Dec. 17. 1836 Richard Ia. W. Lindsay To be continued Helen, Sacramento ***********************************************************************