Some Points in Practical Surgery Suggested by the Study of the Life and Work of John Hunter: Being the Hunterian Lecture Delivered Before the ... London, February 26, 1902 (Classic Reprint) - Softcover

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Excerpt from Some Points in Practical Surgery Suggested by the Study of the Life and Work of John Hunter: Being the Hunterian Lecture Delivered Before the Hunterian Society of London, February 26, 1902

Upon the subject of hydrocele Hunter writes: I believe I am the first who has taught that the radical cure is performed by inflammation, suppuration, and granulation. The most simple mode recommended for obliterating the cavity consists in making a small opening into the sac, and introducing an extraneous body to pre vent union by the first intention. Hunter does not refer to the injecting of fluids in this place, such as alcohol or other stimulants, but to the introduction and retention of what he speaks of as a tent, which gives the alarm to the whole cavity, and thus secures healing by granulation.

Tapping and injecting with a strong solution of iodine, like the Edinburgh tincture, has advantages, but it is extremely painful, and often sets up an inordinate and prolonged inflammatory tension, which in some instances, I believe, is detrimental to the testicle, as happens occasion ally in acute orchitis. Thus the gland may be rendered sterile, as the late Mr. Henry Smith pointed out some years ago.

Again, injection with iodine occasionally fails to effect a radical cure by reason of the extreme thickness of the sac, or the latter may be so capacious as to render it unsafe to excite an acute inflammation in this way in a confined area. Double hydroceles are not very common. Where a single hydrocele is tapped and injected, though the inflammation resulting may be very intense and damaging to the testicle, yet by reason of the opposite organ the power of procreation is not likely to be interfered with.

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