REVIEWS AND BOOK NOTICES.
Modern Surgical Therapeutics: A Compendium of Current Formulæ, Approved Dressings, and Specific Methods for the Treatment of Surgical Diseases and Injuries. By George H. Napheys, A. M., M. D., etc. Sixth Edition. Revised to the most recent date. Philadelphia: D. G. Brinton, 115 South Seventh Street. 1879. Pp. 605. Price $4.00, in cloth.
This is a companion volume to Napheys’ Medical Therapeutics which we noticed in our January issue.
The design of this work is to give a careful digest of surgical therapeutics up to the latest date, and the author has succeeded in carrying it out. As a work of ready reference it may be compared favorably with any of a similar character. Discrimination in selections, however, does not seem to be the aim of the author, but rather to bring all matters under their heads, leaving the reader to select those best suited to his needs.
In divesting surgery of its operative procedures, it leaves a comparatively indifferent number of resources, but the therapeutical branch is by no means at a stand still.
We are pleased to see that under the head of anæsthetics, chloroform has been allowed its proper place at the head of the list.
Chloroform “is the most potent of all anæsthetics,” he says, “and its use is still advocated by many eminent surgeons. Only the alleged dangers attending it, prevent its exclusive employment. Many of these arise from its ignorant or heedless administration.” The directions for its use are given, as also the means of combatting dangers arising from it. Dr. Napheys might have added with a great deal of truth, that chloroform should not be administered by any surgeon who is not habitually on his guard as to the dangers of the anæsthetic state.
The dressing of wounds after the new processes of antiseptic practice receives a great deal of attention. To one familiar with the dressings during our civil war, on examination of the present multitudinous plans to exclude “germs” would bring back the days of our grand-fathers in surgery with their balms and balsams and salves; and some of the dressing is not more rational. According to Esmarch (p. 151 and 152) the dressing of gun-shot wounds should be purely antiseptic. “Do not examine the wound at all, rather than examine it with unclean fingers—and everything is unclean, in the strict sense that is not antiseptic.
“* * * * To avoid pernicious putrefactive influences the wounds must not be touched by the hands, but closed rapidly by antiseptic plugs, in order to preserve them from the contact of putrefactive agents until they can undergo the Lister treatment in the hospitals if necessary. He proposes that every soldier should carry in the lining of his uniform two balls of salicylated jute wrapped in gauze.”
We make this particular quotation to show to what old-maidish precision the antiseptic idea is leading good surgeons. This ever-present inextinguishable “germ” is the evil spirit hovering over every wound. Nets of gauze are set to protect it; strong odors from the witches cauldron are summoned to stifle and destroy the malicious fiend.