Download PDF by Jonathan Reinarz and Kevin Siena (eds): A Medical History of Skin: Scratching the Surface

By Jonathan Reinarz and Kevin Siena (eds)

Illnesses affecting the outside have tended to impress a reaction of specific horror in society. With noticeable and occasionally repellant outward indicators of illness, they have been frequently gave the impression to be hugely contagious, in addition to synonymous with immorality. Such connotations could have stemmed from the tell-tale buboes of syphilis, however the social stigma of disfigurement is anything that also exists this day. This choice of essays makes use of case reviews to chart the scientific historical past of epidermis from the eighteenth to the 20th century.

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46 Getting patients to submit to 24 A Medical History of Skin the knife was difficult and often impossible. 48 He did, however, encourage the use of caustics if the patient refused the knife. In his notes from Pott’s lecture on ‘Cancer of the Breast’ (1767), Heaviside reports Pott claiming: I cannot see a reason why the Surgeons should be afraid to do it by Caustic as well as the Quacks. 49 To complicate matters, Pott was a pioneer in using caustics on children with paralysis of the limbs, most likely from tuberculosis spondylitis of the skeleton, which caused massive deformities and contractures.

Second, patients were difficult creatures and frequently refused to submit to the knife, even if they died from the consequences of this decision. 54 The debate of caustic versus knife also raises the issue of pain and its mitigation in the treatment of skin wounds. Knives might be much quicker, but caustics could be mixed with opium, as Clare indicated and as Pott administered to patients with paralysed legs. Essentially, little evidence appears to survive in eighteenth-century records of how pain was measured qualitatively or quantitatively by patient or surgeon.

Most agreed it was best to keep wounds open to allow material to rise to the surface and be discarded, but air was seen as a potential poison that could cause blood to corrupt and mortify. Alternative and competitive exit routes on the skin were carefully dug with fingers and knives, and peas, beans and cannula inserted in order to allow pus to flow from the primary and covered wound. 73 Skin was a complex and challenging theoretical and 30 A Medical History of Skin practical substance, one that surgeons wrestled with daily.

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A Medical History of Skin: Scratching the Surface by Jonathan Reinarz and Kevin Siena (eds)

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