SURGERY. 
tin-bed state of these organs arising from 
various causes will either give origin to va- 
rious obstinate local complaints, or very 
much increase the difficulty of their cure. 
Many observations connected with this 
subject are scattered in the works of sur- 
gical writers ; but the public are indebted 
for a general, scientific, and original view of 
the whole subject to Mr. Abernethy ; to 
whose surgical observations we must refer 
the reader. 
The symptoms of disordered digestive 
organs, whether induced by the irritation 
of local disease, or by other causes, as se- 
dentary life, impure air, anxiety, and too 
great exertion of mind or body, are, dimi- 
nution of the appetite and digestion, flatu- 
lence, and unnatural colour and fetor of the 
excretions, which are generally deticient in 
quantity. The tongue is dry, whitish, and 
furred, particularly at the ba'ck part, and 
this symptom is most apparent in the 
morning. As the disease advances, a ten- 
derness is felt on pressing tiie epigastric 
region, and the urine is frequently turbid. 
Mr. Abernethy considers this affection to 
be a general disorder of all the organs con- 
cerned in the assimilation of our food ; and 
that it consists in a weakness and irritability 
of the affected parts, accompanied by a de- 
ficiency or depravity of the fluids secret- 
ed by them ; upon the healthy qualities of 
which the right performance of their func- 
tions seems to depend. The duration of 
the affection without fatal consequences, or 
indeed without any changes of structure in 
the parts, shows that it is only a disorder 
of functions. 
When it is considered that this derange- 
ment of the chylopoietic viscera may bring 
on various diseases, and that local affections, 
occurring during its existence will become 
peculiar in their nature and progress, and 
difficult of cure, the importance of the sub- 
ject will be readily allowed. A particular 
attention to diet is a point of primary im- 
portance in the treatment and connected 
with this, the practice of taking five grains 
of powdered rhubarb an hour before dinner 
is very beneficial. A correction of any ob- 
vious irregularity in the intestines, and a re- 
gular diurnal evacuation of them are the 
next points to which we must attend. 
Purging is by no means advisable in the 
weakened state of thqse' orgaPs. The ad- 
ministration of small doses of mercury every 
night or every other night has a powerful 
effect in correcting disorders of the biliary 
secretion, and coii»er|uently in bringing the 
stools to their natural colour. Vegetable 
diet-drinks, as the decoct, sarsaparill. comp, 
have been advantageously combined with 
these means. The cause of the disorder 
may be more completely relieved by good 
air, exercise, and mental tranquillity, while 
the medical assistance above-mentioned 
counteracts the effects. By such simple 
treatment as we have just mentioned, ob- 
stinate and extensive local diseases of 
the most opposite classes, which have re- 
sisted all the ordinary methods, will often 
be either entirely cured, or very signally 
relieved. 
Tetanus, or locked jaw, is one of the most 
alarming consequences of local injui-y. It 
is most frequent in warm climates, in the 
male sex, and in the robust and vigorous. It 
does not appear till many days after the 
accident, and frequently when the wound 
is quite healed. Injuries of the fingers and 
toes are its most frequent causes, 
Sytnptoms. The muscles of the lower 
jaw first become stiff, and then rigidly con- 
tracted, so that the mouth cannot be open- 
ed. Those of the neck, back, and whole 
body, are successively affected in the same 
manner. The spasm, however, is not con- 
stant, as violent and most painful convulsions 
occasionally agitate the whole frame. The 
progress is various ; when rapid, the patient 
scarcely ever recovers; but if fie survive 
the fourth day, the prognostic is much more 
favourable. The vital functions are but 
little affected. 
Treatment. When the symptoms have 
come on, there seems to be no connection 
between them and the original local cause; 
so that no assistance can be derived from 
this source. Opium in very large doses, as 
a grain in two hours, and then gradually in- 
creased ; and the same remedy by the way of 
clystei', and in frictions seems to have af- 
forded the most relief. The warm bath, 
camphor, volatile alkali, and musk, accord- 
ing to circumstances. Large quantities of 
wine have been recommended ; and in some 
cases the cold bath during the spasm has 
relieved. Salivation is useless. 
Inflammation, in some of its states or va- 
rieties, is presented to our view in almost 
every surgical disease, and consequently 
particularly demands the attention of the 
surgeon. It occurs as a natural means of 
cure in many species of accidental injury; 
and here it is considered as healthy : it may 
also be regarded in the same light where it 
follows any local irritation in a healthy con- 
stitution and part. In other cases it is com- 
U S! 
