A retrospect of surgery, January 1886-January 1890 / prepared by Francis J. Shepherd.

  • Shepherd, Francis J. (Francis John), 1851-1929.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A retrospect of surgery, January 1886-January 1890 / prepared by Francis J. Shepherd. Source: Wellcome Collection.

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    pylorus. The second case was that of a woman aged 52, who died 30 hours after the operation of suppression of urine. At the post-mortem, the pylorus was found widely dilated, and no rupture of the mucous membrane existed. The stenosis in this cage was caused by a large, old ulcer situated posteriorly, and partially cicatrized. The base of the ulcer was adherent to the pancreas, and the edges were much thickened. The pyloric orifice lay immediately next to the right and upper edge of the ulcer. Excision of Pylorus for Cancer.—This operation was reported to the Surgical Society of New York by Dr. Sands (^Medical News, March 20th, 1886). The patient, a man aged 31, suf- fered from dyspeptic symptoms for the last three years. Tumor felt at pyloric extremity. An incision was made transversely about 3J inches long, directly over pyloric extremity. After separating peritoneum and enclosing the pylorus between two sets of clamps, the stomach was then cut through. The wound was brought together by seven interrupted silk sutures intei'- nally and six Lembert's sutures, four of silk and two of catgut. The operation lasted four hours. Patient gradually sank and died about 36 hours after the operation. Dr. Sands stated that the operation had been performed too late, and was sorry he had not performed Loreta's operation. At the post-mortem, the cancerous infiltration was found to extend beyond the line of section. Tetanus.—The pathology of tetanus is as yet but little un- derstood. Cases of cure of this disease are from time to time reported, they are doubtless quite authentic, and show that the disease is not necessarily fatal. Chloral in large doses is the favorite remedy, and in some cases the results of treatment by this drug are encouraging, whilst in others chloral appears to have not the slightest influence for good on the disease. Till the pathology of the affection is better known, all treatment must be to a greater or less extent empirical. Many observers look upon tetanus as due to the introduction of some virus from with- out, for nearly all the cases follow the receipt of an injury; the cases of so-called idiopathic tetanus being rare, and in some in-