Acute intestinal obstruction / by Monroe A. McIver.

  • McIver, Monroe A. (Monroe Anderson), 1840-
Date:
1934
Catalogue details

Licence: Public Domain Mark

Credit: Acute intestinal obstruction / by Monroe A. McIver. Source: Wellcome Collection.

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    otomy*); and it remained for Nelaton,25 whose name was usually given to the operation, in about the middle of the last century, to establish this as an accepted surgical procedure carefully thought out and executed. The value of enterostomy was soon realized and it is in use today, modified in technique and choice of location but not in principle. Obviously, however, this procedure could usually relieve only cases of simple blockage of the bowel and did little or nothing to relieve the more frequent cases where in addition to the occlusion of the lumen there was interference with the mesenteric circulation to the involved segment. Almost simultaneously with the employment of these indirect operations, direct attempts were made to relieve the condition by opening the abdomen and removing the obstruc¬ tion. Before the days of asepsis and anesthesia, these proce¬ dures were indeed desperate adventures and of course few in number. The first reasonably authentic report was made in 1679 by Bonetus,26 and describes an intussusception success¬ fully reduced by a young surgeon who “had long followed the camps.” About two hundred years later (1874), Ashhurst27 was able to collect only 74 cases, in 14 of which the operation was carried out for obstruction from intussusception and in the remaining 56 for causes “other than intussusception/’f Four¬ teen years later, however, the number of recorded cases had risen to 328;28 and after that time, with the growth of abdom¬ inal surgery, the number of direct operations became legion. About thirty years ago, the last edition of Treves’ classical contribution, “Intestinal Obstruction,” appeared. In addition to giving Treves’ own contribution to the subject, this volume summarizes the work of Brinton, Leichtenstern, and others, and thus may be taken as the foundation for any further treatment of the subject; the descriptions of the anatomical * Travers,24 in 1812, stressed the value of the establishment of an intestinal fistula in cases of strangulated external hernia. f Ashhurst’s4,27 articles carried a comprehensive and interesting account of the early history of operations for intestinal obstruction, furnishing a total list of the early cases, and a number of abstracts of the histories.