Abstract of cases in which a portion of the cylinder of the intestinal canal, comprising all its coats, has been discharged by stool, without the continuity of the canal being destroyed / [William Thomson].

  • Thomson, William, 1802-1852.
Date:
[1835]
Catalogue details

Licence: Public Domain Mark

Credit: Abstract of cases in which a portion of the cylinder of the intestinal canal, comprising all its coats, has been discharged by stool, without the continuity of the canal being destroyed / [William Thomson]. Source: Wellcome Collection.

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    had from the first been very imperfect, and in which it would appear that only one of the two folds of invaginated intestine had been detached by the process of disjunctive absorption,— the other fold, or a portion of it, having been found adhering to the inner surface of the intestinal canal,—an aperture and rent was found in the very narrow tube by which the two portions of intestine were connected. In this very singular case, the aper¬ ture of communication in the lower portion of intestine was at the angle formed by the invaginated and the containing portion of intestine. In the next place, we have to consider the state of the abdo¬ minal viscera in other parts. In one case (23) almost the whole of the small intestines had coalesced along with the omentum into one mass. In another (27) the folds of the intestines and omentum were all glued together by a fatty curdy matter. In one (26) an adhesion of the omentum prevented the escape of feces into the cavity of the abdomen through an opening existing in the colon. In one case (21) the abdomen was filled with fetid purulent serum, and unfortunately this was the only circumstance connected with the state of the parts which was ascertained. In another case (32) the omentum was inflamed, firmer in consistence than natural, and very thick. The cavity of the abdomen, par¬ ticularly the pelvis, contained a considerable quantity of grayish puriform fluid. In several cases there were found marks of gangrene in the course of the intestinal tube at a greater or less distance from the place at which the disjunction of the discharged portion had occurred. In one (22) many different parts had a livid and almost gangrenous appearance, yet admitted of being distended with air. In a second (24) the intestines were gangrenous at different points at a considerable distance from the place of union. In another (28) besides the united extremities having been disjoined by gangrene, all the adjacent parts were gan¬ grenous, and the middle part of the mesentery very black. 12. Circumstances deserving of attention, relative to the jjersons who experienced a recovery of some duration.—A very singular feature in the history of many of the cases that have been related is the rapidity with which the patients have been restored to apparent health. In many of them, as has been seen, a very short space of time has elapsed between the dis¬ charge of the portion of bowel and the return of the individual to active exercise. The appetite, too, seems in many instances to have been very keen during the progress of recovery, and in some of those which ultimately proved fatal, as has been already remarked, death seems to have been occasioned by its too free indulgence, and particularly by the employment of unsuitable diet. The knowledge of these facts suggests important cautions as to the measures which ought to be enforced even in the cases of this kind in which there seems least room for apprehension.
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