Report upon the treatment of chronic colitis / by D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Report upon the treatment of chronic colitis / by D'Arcy Power. 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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    3 Method of examination. It may be easy or it may be impossible to discover the exact cause o a chronic inflammation of the large intestine, but in every case a dili- gent search should be made by every means known to modern medical science for upon the discovery of the cause will in large measure depend the treatment. r The examination, therefore, must be methodical and thorough. It is rarely possible to arrive at a correct diagnosis by such a simple examin- ation as is possible in the out-patient room of a hospital or in the consulting room of a surgeon. It is better that the patient should be put o bed for a day or two before the examination is made and should be in the charge of a competent nurse. The bowels must be emptied and cleansed by simple enemata and subsequent irrigation with unirritating lotions. When this has been done thoroughly, digital examination follow- ed by the careful use of a sigmoidoscope will often reveal the cause when the inflammation is limited to the rectum or to the lower part of the sigmoid flexure. Abdominal palpation may give a clue when the cause is situated in the colon at a greater distance from the anus. Causes. Mr. J P. Lockhart Mummery (1) gave an account of 36 cases of colitis which had come under his observation for surgical treatment. In six cases he was unable to find a cause. In seven « the colitis was due to a tumour within the bowel. In each of these cases there was considerable doubt about the diagnosis previously to the discovery of the tumour, and several of the patients had already been under treatment for colitis » « In looking through my cases of cancer of the rectum, he says, I find t at there are several in which the symptoms were those of colitis rather t an of cancer, but I have not included them because there was at no time any doubt about the real diagnosis as a clinical examination reveal- ed the true slate of affairs. » Care is needed to arrive at a correct diagnosis even in those cases where a gross lesion is found on examin- ation for Mr. Mummery says of a case : « The patient was a gentleman, aged So, who had been passing large quantities of blood and mucus for many months in his stools. An examination was made with the sigmoido- scope which revealed the presence of numerous small follicular u cers scattered about on the mucous membrane of the rectum and sig-
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