Remarks of the management of cases of abdominal section / by John D. Malcolm.

  • Malcolm, John David.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Remarks of the management of cases of abdominal section / by John D. Malcolm. 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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    fCj Remarks on the Management of Cases of Abdominal Section.1 By John D. Malcolm, M.B. C.M., F.R.C.S.Ed. In the management of every case of surgery, the operator has to consider four points:— 1. The greater or less certainty of his diagnosis. 2. The manipulations required for the cure or relief of the abnormal condition. 3. The measures required to ensure the healing of the wound. 4. The precautions by which all unnecessary interference with the functions of the parts concerned may be avoided. I do not propose on the present occasion to deal with the two first of these points. Their consideration, even in a most superficial way, would open up a field of inquiry far beyond the limits of a short paper. Neither shall I advert to the measures that should be adopted to ensure the healing of a wound, except to remark that I use antiseptics carefully, and that I do not believe it possible to secure the safety of the patient by any other method. I regard this as more important in abdominal surgery than in the surgery of many parts of the body, because a septic flesh wound may be recovered from, whereas a septic general peritonitis is nearly always fatal. I have so much faith in antiseptics (used with proper care), that if a patient during convalescence from any fairly simple abdominal section exhibits unfavourable symptoms, I feel absolutely confident that the mischief is not due to septic peritonitis; and it is a great advantage to be able to eliminate this source of danger in directing the subsequent treatment. I have never seen a death from suppurative peritonitis when anti- 1 Lead before the South-West London Medical Society, 11th November 1896.