Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner.

  • Corner, Edred M. (Edred Moss), 1872-
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    III. THE CLINICAL IMPORTANCE OF ACUTE INFEC- TIVE NECROSIS IN ACUTE ABDOMINAL CAS] TiiM deaf li or gangrem of part of the alimentary trad forma one of the most important fields which, by reason of the recent rapid advances, abdominal surgery has taken within its scope. The resulting catastrophes, such as appendieit is, perforations of ulcers, etc., have long been known, as well as the enormous mortality which accompanies them. With increase of our knowledge of the pathology of these oaf and improvements in operative technique, the death-rate has of later years been very considerably lowered. Tnfor- tunately the clinical signs, by means of which we must try to recognize the internal progress of the pathological process, are, by their very nature, relatively coarse, late and inexad means of gaining that urgently required information, the diagnosis, the possession of which is of vital importance to the patient. The manifestations of an acute abdominal disease are, unfortunately, often very obscure as to their origin. And much valuable time is lost before the decision is made as to whether the abdomen must be opened or not. The tremendous change in the mortality made by such delay is not even yet quite fully appreciated. All acute abdominal crises begin similarly, with shock, collapse, vomiting, etc., which symptoms have been called by Sir Frederick Treves, peritonism. This may be termed the first stage. Later, in the second stage, the diffuseness of the manifestations ceases, and localizing signs and symp- toms appear. But it must be remembered that though the outward appearances become more local, the inward infection may be spreading. At this period a diagnosis may be made. Later, as the infection becomes more and more diffuse, the