The limitations of surgery : past and present / [Archibald Young].

  • Young, Archibald, 1873-1939.
Date:
1925
Catalogue details

Licence: In copyright

Credit: The limitations of surgery : past and present / [Archibald Young]. Source: Wellcome Collection.

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    largest extent of small bowel that has been removed, without producing death. As much as 12£ feet have been excised,14 and the patient made a good recovery, his health not apparently deteriorating, although analysis of his urine and faeces, after an ordinary diet, showed that his metabolism was distinctly abnormal; there were deficient digestion of meat, fat, and starch, marked indicanuria, and a high urinary ammonia nitrogen, as compared with urea nitrogen. We ought to be able to find out how much small intestine can be removed without disturb¬ ance of metabolism. At present there are such widely divergent views as that of Pirie Watson, who considers 6 ft. 7 in. as the maximum15 and Moynihan’s view that 14 ft. 8 in. may be safely removed. It ought to be possible to find out, with the aid of the physiologists, at what point there comes in a degree of metabolic disturbance such as might be prejudicial to life. These are only a few of the many problems that may be cited in respect of abdominal surgery. There are very many more. The accumulation of facts, the advancement of knowledge, the correlation of observations, clinical and experimental, on these and many kindred subjects, should in time set wider the limits that presently exist. Fractures. May I take another subject, viz., that of fractures ? Here, again, are numerous problems the settling of which should afford a prospect of advance. Few subjects could be more important to the economic future of the worker and the community. And yet how great are the limitations by which the present-day treatment of fractures is beset. Even with the most modern procedures, even with the great enlargement of the field of operative treatment of fractures, we are still far from having reached what can be regarded as a satisfactory position in respect of early and efficient restoration of function
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