Annual clinical debate / T.W. Parkinson in the chair.

  • Chelsea Clinical Society
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: Annual clinical debate / T.W. Parkinson in the chair. 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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    g*l)cr6ca ^rtuicar gociefp. Mketinu, March UtH, 1911. ANNUAL CLINICAL DEBATE. T. W. Parkinson, M.D., C.M., President, in the Chair. COLITIS: THE MEDICAL ASPECT. By W. HALE WHITE, M.U., F.R.C.P., Senior Physician to Guy’s Hospital. Wlieii face to face with a case of colitis, the first thing to decide is wdiether it is primary or secondary. There are many forms of colitis secondary to other diseases ; this applies to all the three common varieties, acute catarrhal, membranous, and ulcerative. Colitis may be due to injury, to inflammation in a neighbouring part, or to such diseases as bilharzia or to septic diseases, less frequently now, fortunately, than it used to be. Another variety of secondary colitis is very important, the colitis secondary to Bright’s disease. 11 is no uncommon thing for a patient admitted for Bright’s disease to die of acute colitis. This is found in those who have had jalap or other drug likely to produce this condition. Then, again, there is a variety of colitis due to the pneumococcus. The treatment of all these varieties depends, of course, on the primary condition. There is one kind which is especially important, viz.: that behind a malignant growth of the colon. The last variety of .secondary colitis I wish to refer to is that a.ssociated with disea.se of the appendix. We have to make out whether the colitis is secondary to appendicitis, or whether the appendicitis is simply part of a general disease of the colon. The treatment of the two conditions is difterent. If the appendicitis is the cause of the colitis, the latter may disappear if the organ is removed, whereas if the ayipendix is involved in a genei’al colitis, you are not likely to cure the latter by removing the appendix, and, in addition, you are preventing an appendicostomy, which might do the colitis good. I will turn now to primary colitis. Whatever variety it may be (acute membranous or ulcerative), I suggest that the cardinal point is to keep the large bowel empty. To take the simple acute colitis due to
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