Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves.

  • Treves, Frederick, 1853-1923.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    laparotomy. It has been shown, that in the first five at least of the above-mentioned conditions spontaneous cure, while not absolutely impossible, is yet so exceed- ingly improbable that it cannot be considered when discussing the treatment of the case. In the remain- ing four conditions spontaneous relief of the obstruc- tion is certainly not so improbable, but it must be re- membered that these conditions cannot be diagnosed from the rest, unless in the last-mentioned form a dis- tinct tumour exist, and that even if diagnosed they can be better treated by laparotomy than by any other known means. When once, therefore, the general nature of the case has been diagnosed, laj)arotomy should be performed without delay. It is worse than useless to temporise with aimless enemata, with elec- tricity, with massage, with applications of ice, and the like. The condition of the gut is identical with the condition in strangulated hernia. In a case of stran- gulated hernia no surgeon, after the taxis had failed, would think of delaying kelotomy until he had tried galvanism, enemata of tobacco, metallic mercury, and other measures of like character. Kelotomy is in itself an operation of small magnitude. It is only serious when delayed, and its success depends not so much upon the technical details of the procedure as upon the condition of the gut at the time of operation. The present series of cases are even more urgent than are any cases of strangulated rupture, for no taxis can be applied, and relief can only be expected from oper- ation. Laparotomy, therefore, should be performed at once. It must be remembered tliat the average duration of life in these cases is only six days. Lapar- otomy at present appears to be a very serious measure, but when one comes to examine the fatal cases the seriousness is soon explained. Other things being equal, the success of the measure depends little upon the precise species of obstruction, and still less upon