Medical versus surgical means of diagnosis and treatment of gastrointestinal diseases : the burning question in medicine / by Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
1912
Catalogue details

Licence: In copyright

Credit: Medical versus surgical means of diagnosis and treatment of gastrointestinal diseases : the burning question in medicine / by Anthony Bassler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    positively unpardonable unless there is an intercurrent condition that warrants it to save his life or keep him from added suffering. In 69 of these 387 cases it was a fair clinical conclusion to arrive at that neurasthenic symptoms which were not present before had developed as a direct consequence of the operation. Of the 318 remaining, the individuals had become more distinctly neurasthenic in apparently 205 instances, and the 113 remaining it either was not iso or there was question enough about it not to consider this in a definite way. Some of these had been operated upon as many as six times, and more pitiful was the fact that with many of them they were ready for as many more laporotomies as they would or could fall into the hands to do for them. If you take a thousand cases that come with stomach trouble, you can learn that from diagnostic and therapeutic standpoints they are wholly medical in 95 per cent., and medical and surgical in .5 per cent. Thus, on this subject the internists and stomach specialists cannot be ultra-medical or the surgeons ultra-surgical. Every case should be medical before it is surgical, and the gap between the general practitioner and the surgeon .should be filled by a new type of stomach man who is strong in diagnosis and in- clined medically or surgically as the case may prove itself to be. The mistakes and shortages of the internists and stomach special- ists mostly have been due to lack of work, and those of the sur- geons to overwork. We cannot advance this part of medicine excepting on the basis of pathological diagnosis, which is neither medical nor surgical alone. Both sides must work in conjunction more than they do today, and the internists and stomach specialists must give better and more diagnoses to the surgeons than they now do, or at least say that exploratory incision is indicated, and surgeons should not operate unless there is some strong suggestion or logical reason for doing so. I have tried in this paper to express some of my opinions based upon clinical observations. In the writing of it only the kindliest of motives have moved me although it may appear that some hid- den attack is contained in my words. I cannot feel that any of us are so narrow and self satisfied that we would not place the patient’s interests above our own. Criticisms and suggestions in medicine .should not be born of enmity and antagonism. With a more general sincerity, the medical men-will make a better prog- ress through surgery and the surgeons through medicine, for on this subject we cannot fail to know the right when so much is at stake.