Contributions to practical medicine and surgery / by James Arnott.

  • Arnott, James, 1794-1885.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical medicine and surgery / by James Arnott. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    tual mode of making internal incision, which differs essentially from every other mode in use, farther than to say, that if the cutting part of the instrument be very sharp, its only motion mu,st be eccentric; but if it has purposely been made blunt (and it is this variety that I have always employed) it must, in the act of cutting, be slightly retracted; and, whether sharp or blunt, its edge must be made to press strongly against the part which is to be divided. The instrument is very simple—consisting merely of two or three flat rods, one of which is sharpened towards the end, and a flat silver or steel tube, terminating in a grooved director, along which the sharpened rod is passed, and from which it is afterwards raised by pushing another rod under it.* The introduction by Mr. Syme of the external incision of stricture upon the grooved director, borrowed from lithotomy, constitutes a remarkable epoch in this department of surgery. The circumstance of so bold and manifestly hazardous a measure being proposed by a surgeon of eminence, roused attention to the fact, that something else was required than bougies and sounds as a remedy in the more dangerous form of the disease. In thus dispelling a very general delusion, the introduction of this method was of the greatest service; but it was natural that an inquiry should soon be instituted whether there were not other measures equally effectual but * The instrument is described in my Argenteuil Prize Essay, and in the Medical Times and Gazette for 14th September and 2nd November, 1861. M. Maisonneuve, of the II6tel-Dieu in Paris, adopted the prin- ciple of this instrument about four years after the first of these publica- tions. He informs us, iu a paper read before the French Academy of Medicine, that all that was wanted to render an urethrotome which he had devised complete, was merely to blunt the edge of the cutting part — emousser aimpUment la partit saillante. Merely to blunt! The blunting of the urethrotome was as great a change in principle as was effected by Hawkins when he merely sharpened the edge of the gorget in lithotomy.