Culebra Cut

“ The white-hot iron that seared his flesh, tormenting the agonized ends of nerves that already had borne past the breaking point, was the final, exquisite touch of agony.
Coulter was one of those men who bear pain—even a slight pain—with difficulty. Even the sight of blood made him faint. This was horrible beyond anything he had ever dreamed. The physical racking; the feel of the steel blade cutting through his own flesh and sinew, down to the bone, made him bite his lips till they spurted blood, in the effort to keep from screaming aloud. ”

“ If the cell-tissue under the wound is actually growing at the time, however, a further process is observed when the wound-cork has been formed. The uninjured cells below go on growing outwards more vigorously than ever, the pressure of the overlying tissues taken off by the cut having been removed, and, lifting up the cork-layer as they do so, they rapidly [124] divide into a juicy mass of thin-walled cells which is of a cushion-like nature and is termed a Callus. ”

“ Through awkwardness, a student of anatomy pricks himself with his scalpel in the course of his work; or else, by inadvertence, he has an insignificant scratch on his hand. A cut which one would hardly notice, produced by the point of a pocket knife, a scratch of no account, from a thorn or otherwise, now becomes a mortal wound, if powerful antiseptics do not speedily remedy the ill. ”

“ He has itching sensations in his gums, his mouth burns, and salivation is greatly increased. He feels that he is going to give way to the necessity to bite, and then he flees to the woods, where he bites the trees viciously, tears their bark and discharges his venom. His poisonous saliva mingles with the sap, and, surprising phenomenon, the tree withers and dies!
Woe to the man or animal who happens to be bitten by a Curado de Culebra in a fit of passion. The victim will die as quickly as if he had been bitten by a snake! ”

“ He must cut and cut deep, must go beyond even the visible roots of the disease, slice down into the clear, firm flesh to make sure and doubly sure that he has cut away the last fragment of the tainted tissues. ”

“ A young woman had married a husband of her own age, but having no issue by the union, the humours collecting abundantly about her neck, she had contracted a sore disorder, the glands swelling in a dreadful manner. Admonished in a dream to have the part affected washed by the 226king, she entered the palace, and the king himself fulfilled this labour of love, by rubbing the woman's neck with his fingers dipped in water. Joyous health followed his healing hand; the lurid skin opened, so that worms flowed out with the purulent matter, and the tumour subsided. ”

“ It occasionally becomes necessary in pathologic work to cut tissues directly upon the microtome without freezing or imbedding. This can be done satisfactorily in the case of very firm substances, such as amyloid liver and spleen, etc. The sectioning is done in the wet, using 80 per cent alcohol, as in celloidin cutting. A large celloidin [Pg 239] knife should be used, and the blade should be flooded in alcohol. A large piece of the tissue, or, better, several pieces, are clamped in the object holder with only a small layer of tissue above the holder. ”

“ Surgeons apply the word bubo to inflamed glands from syphilis, wherever they happen to be. The body abounds with absorbents, which are small delicate vessels that form a net-work over the entire surface, and exist also in every structure. Their purpose is to convey the nutriment to the circulation. They form stations, as it were, or points of assemblage; and these are generally situated in the angles of the body—the groin, the armpits, hams, neck, &c.—parts [94] most protected from injury. When skin inflammation is present, to familiarize the meaning, the nearest glands sympathize and swell ”

“ Vivisection was practised to procure an amulet for sore eyes, according to the following prescription: "If a man have a white spot, as cataract, in 182his eye, catch a fox alive, cut his tongue out, let him go, dry his tongue and tie it up in a red rag and hang it round the man's neck." Pliny's way was to "take the tongue of a foxe, and hange the same about his necke, so long it hangeth there his sight shall not wax feeble."
Like was also used to cure like, at least in the following directions: "Take the right eye of a Frogg, lap it in a piece of russet cloth and hang it about the neck ”

“ Would you like to see what becomes of a Cetonia-larva when the organism is wounded in its vital centres at the very beginning? The experiment is an easy one; and I made a point of trying it. A sewing-needle, first softened and flattened into a blade, then retempered and sharpened, gives me a most delicate scalpel. With this instrument I make a fine incision, through which I remove the mass of nerves whose remarkable structure we shall soon have occasion to study. The thing is done: the wound, which does not look serious, has left the creature a corpse, a real corpse. ”

“ And the wise physicians and men of healing came to heal and tend them, and they applied salves made from plants, such as wise men know, to their hurts and gashes, and soothing herbs to their wounds; and of every herb and soothing salve that was applied to the wounds of Cuchulain, he sent an equal portion over the ford to Ferdia, so that no man among the host of Meave should be able to say, if Ferdia fell by him, that it was because Cuchulain had better means of healing than he. ”

“ All the internal organs of the body are, when freshly removed, of much too soft a nature to permit, when in their unprepared condition, of easy or perfect cutting. It is upon bringing them to that critical degree of hardness, which is often so difficult to attain, that the chief secret of successful section-cutting depends; for unless 17the hardening process has been carried up to, but not beyond, a given point, which varies with different tissues, the operator, however dexterous, will fail to obtain satisfactory sections. ”

“ He enjoins us to avoid all kinds of food requiring mastication, also smoke and sternutatories. When the brain projects beyond the bone (a case called hernia cerebri by modern surgeons) , he advises us to sprinkle it with squama æris, and to use cicatrizing applications. A person who has sustained a fracture of the skull is advised to avoid [442] the sun, wind, frequent baths, and the free use of wine until the wound is healed.
Aëtius recommends bleeding and laxative clysters. ”

“ Kugler recites the description of the case of an arrow-wound of the thorax, complicated by frightful dyspnea and blood in the pleural cavity and in the bronchi, with recovery.
Smart extracted a hoop-iron arrow-head, 1 3/4 inches long and 1/2 inch in breadth, from the brain of a private, about a month after its entrance. About a dram of pus followed the exit of the arrow-head. After the operation the right side was observed to be paralyzed, and the man could not remember his name. He continued in a varying condition for a month, but died on May 13, 1866, fifty-two days after the injury. ”

“ Hernia cerebri requires some consideration. Its development, by reason of its usual bacterial agency, must always be regarded as of serious import. The congested brain bulges through the aperture in the skull and presents on the surface as a purple—sometimes black—fungating mass, bleeding freely, and associated with a considerable discharge of cerebro-spinal fluid, serum, and pus. ”

“ But if the Entrails are fasten'd to the Caul, it is requisite to separate 'em by cutting a little of the Caul, rather than to touch the Intestine; which last being reduc'd, a Servant may press the Belly on the side of the Wound; so that if a Mass of Flesh be found in the Caul, which hath been form'd by the sticking of the Caul to the Muscles and Peritonæum, this Fleshy Mass must be entirely loosen'd, and then a Ligature may be made to take it away, with some part of the Caul, as we have already shewn in the Gastroraphy. ”

“ A slight degree of heat is productive only of redness of the surface, with a sharp hot pain, and these symptoms may subside with or without vesication. However, effusion of serum under the cuticle often takes place almost immediately after the contact of the heated body—the cuticle may be destroyed by the intensity of the injury—or the true skin may die, either partially or throughout its whole thickness, and the subjacent parts be at the same time injured to a greater or less depth. ”

“ But when people bleed they die! Are you dying, Othomar? Look, blood on your coat...."
The empress remained sitting straight upright; she glared from Berengar at the bleeding wound of her eldest son....
"Blood, blood, blood!" sang Berengar. "Othomar is dying! Yes, he always gives me so many nice things, does Othomar. I have so many already, many more than all the other children of Liparia put together! And what am I to have now?... Still more?... That nice thing: what is it? I can feel it: it's so heavy ”

“ The entire body may be covered with them, but usually those parts nearer the centre of circulation generally possess the most—such as the chest, neck, shoulders, arms, wrists, hands, and head. As the disease progresses, the scurf on the spots accumulates, falls off, re-forms, getting thicker each time, when upon being detached, for they cling now more closely, a sore and moist state of the skin is observable. ”

“ The cuticle is very thin in most parts of the body, but in some places, as the palms of the hands and the soles of the feet, it is quite thick. This is because these parts of the skin come in contact with objects in such a way as to be liable to injury if not thus protected. The cuticle has no blood-vessels and very few nerves. ”

“ CUPPING. The operation of cupping is one of the methods that have been adopted by surgeons to draw blood from an inflamed part in order to relieve the inflammation. The skin is washed and dried; a glass cup with a rounded edge is then firmly applied, after the air in it has been heated; the cooling of the air causes the formation of a partial vacuum, and the blood is thus drawn from the neighbouring parts to the skin under the cup. ”

“ Smaller octagonal scarificators with four to six blades were sold for cupping parts of the body with limited surface area.
Cupping Procedure
The art of cupping, it was generally agreed, required a high degree of dexterity that could be maintained only by constant practice. Professional cuppers were concerned with avoiding any appearance of clumsiness, else the patient might come to fear an operation essential to his health. In the hands of an inexperienced physician or surgeon, cupping could be highly painful to the patient, and yet fail to produce the requisite amount of blood. ”

“ Thus inflammation and its products on the interior of the skull proceed from “injuries of the scalp alone.” The injury occurring in a subject of a highly impressible and delicate nervous temperament, at a time in which the central organ of the nervous system was exhausted by excessive mental tension for days and nights of severe effort, carried with it impending destruction. The insidious danger of the first injury was now only to be estimated by its threatening consequences at the stage of progress of the case when it arrived at the Mountain. ”

“ But the vital economy seems not to possess the power of reproducing the muscles and true skin, and therefore, when these parts are wounded, the rupture is repaired by a gelatinous substance, which gradually becomes hard, and sometimes assumes something of a fibrous appearance. It so perfectly unites the divided muscle, however, as to restore its functional power. When the cuticle is removed, it is reproduced and no scar remains; but, when the true skin is destroyed, a scar is formed. ”

“ The said Pears boiled with a little honey, help much the oppressed stomach, as all sorts of them do, some more, some less: but the harsher sorts do more cool and bind, serving well to be bound to green wounds, to cool and stay the blood, and heal up the green wound without farther trouble, or inflammation, as Galen saith he hath found by experience. The wild Pears do sooner close up the lips of green wounds than others. ”

“ Friday was usually set apart in this reign as the regular day for healing, but, in addition to this, special portions of the church year were reserved for the exercise of this gift. Very careful examinations were made by the surgeons, and those who were found to be suffering from the evil were presented with a ticket by the surgeon which entitled them to receive the healing touch of the king. If the king's touch were really efficacious, one might think that the disease should have been wholly exterminated during this reign, so great were the 238 number touched. ”

“ It is to be known once for all, that in wounds of the nerves the medicine which cures punctures being of a bitter nature, it is not possible to cure with it the division of the nerve, as the parts cannot endure pungency and inflammation. And neither does the medicine which cures incisions answer with punctures. For its strength does not reach the bottom of it, the incision of the skin being narrow. A spare diet is to be allowed, and a soft couch ”

“ But when many other parts of the head have been struck, as in a fall, and a fissure of the skull takes place without a solution of continuity of the skin, an abscess afterwards forms in it, and being opened, this fissure is discovered, which appears to them to have been occasioned by the blow on the opposite side ”

“ If deeper structure than the skin be involved, the diseased area should be carefully removed even to the limitation of the buccal mucous membrane, the soft parts detached from the mucous membrane to render them mobile, and the wound brought together by suture. Care must be exercised so that the tension of the suture does not create a new deformity, such as blepharal ectropium, distortion of the rima oris or the alæ of the nose. ”