Treatment of chronic ulcer of the stomach and duodenum / by Edward L. Kellogg.

  • Kellogg, Edward Leland, 1872-
Date:
1914
Catalogue details

Licence: In copyright

Credit: Treatment of chronic ulcer of the stomach and duodenum / by Edward L. Kellogg. 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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    y :r^ Reprinted from The American Journal of Gastro Enterology, Januar}', 1914 TREATMENT OF CHRONIC ULCER OF THE STOMACH AND DUODENUM By Edward L. Kellogg, M. D. CLINICAL PROFESSOR. DISEASES OF THE DIGESTIVE TRACT, POLYCLINIC MEDICAL SCHOOL. ASSOCIATE attending surgeon, GOUVERNEUR HOSPITAL. The treatment of gastric and duodenal ulcer must be considered both from the medical and surgical viewpoint. Every ulcer, except in cases of perforation, py- loric stenosis with commencing dilatation of the stomach or suspected malignant degeneration, should be given the benefit of medical treatment before being sub- jected to surgery. Under the medical treatment there are several methods which deserve special mention. The Rest and Rectal Feeding Method of Williams and Donken.—The essen tials are rest in bed, no nourishment by mouth for two weeks, and nutrient ene- mata every three hours. To insure suc- cess I use the following technic; The bowels are first washed with warm salt solution or plain water and, after one hour’s rest, a warm nutrient enema at 95° F. is given through a soft tube (prefer- ably the Murray tube) introduced one foot. The funnel is elevated only two feet, in order to provide a gradual flow. The patient lies in the dorsal or left lat- eral position, and is required to rest quietly for an hour. The cleansing enema Foot note—This paper does not refer to malignant, tubercular or syphilitic ulcer. may not be required more than two or three times daily, if absorption is good and the bowel is free from mucus. I have found some difficulty in giving the nutrient enemata every three hours, as recommended by these authors, and when I have succeeded, have usually found it advisable to give a smaller quantity. Pa- tients will retain an enema every four or six hours, when the three-hour interval causes irritation. The addition of a few drops of the tincture of opium will often make it possible to retain an enema that would otherwise be expelled. We may choose from the following formulae:— Ewald’s Enema— - A. Two or three eggs are beaten with cold water, gss. B. Prepared cereal, §ss is dextrinized by heat and boiled with gss of a 20% solution of grape sugar, and to this §ii of claret is added. When lukewarm stir in the beaten eggs and add gr. xv of salt. Boas Enema— Milk, §viii. Yolks of two eggs. Salt, gr. XV. Red wine, §ss. Wheat flour, cooked, ,^ss.