The shoulder : rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa / E.A. Codman.

  • Codman, E. A. (Ernest Amory), 1869-1940.
Date:
1934
Catalogue details

Licence: In copyright

Credit: The shoulder : rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa / E.A. Codman. Source: Wellcome Collection.

    16/608
    Xll Pkki ace ocncv operations, and in one such case 1 as able to make a pre¬ operative diagnosis of perforated duodenal ulcer and to successfully operate on the patient. This took my mind from the shoulder to the duodenum, as it was the first case thus diagnosed and operated on at that hospital. Within a short time afterward, I had several others which were also successful. This led me to study chronic duodenal ulcer, and the shoulder remained displaced behind the duodenum and stomach for the next two years, although my clinical experience with shoulder lesions continued, and unfortunately also, my personal ex¬ perience as a patient with duodenal ulcer. My chief interest during the next few years was in the surgery of the duodenum. I think I was among the first to appreciate its importance, for I wrote a paper in 1909, when the diagnosis was made so seldom, that I was only able to collect fifty proved instances from our surgical, medical and post¬ mortem records. Of these, eleven were my own cases. I have recently reviewed this paper and was agreeably surprised by the accuracy of the statements as shown by the confirmation of my predictions. How¬ ever, although working chiefly on the surgery of the stomach and duodenum during this period, I added a point of importance to our practical knowledge of shoulder lesions, namely the demonstration, by actual successful suture of two cases, that ruptured supraspinatus tendons may be repaired. I also drew attention to the importance of examining the patient in a stooping position as an aid to diagnosis in these cases. in Thus, in the year 1910, at the age of forty, I was deeply interested the surgery of the upper abdomen, still studying lesions of the shoulder, steadfast to my general surgery at the M. G. II., and suc¬ cessful enough to be making a reasonable living in private practice. I hen began the great and still unsuccessful interest of my life, over which I have toiled harder and suppressed more regrets, than over any other star-gazing period of my career. Already in 1900 I had become interested in what I have called the Knd Result Idea, which as merely the common-sense notion that every hospital should follow (i’i’ii/ patient it treats, long enough to determine whether or not the II ea I merit has been successful, and then to inquire “if not, whv not?” with a view to preventing similar failures in future. My chief, l)r. 1 . R. Haiiington, and I had been applying this plan practically to in si i \ u e since 1900. AN e had found that this routine tracing of every case, interesting or uninteresting, had brought to our notice man\ things in Inch our knowledge, our technique, our organization, our own skill or wisdom, and perhaps even our care and our con¬ sciences, needed attention.