A contribution to the surgery of foreign bodies / by W.S. Halsted.

  • William Stewart Halsted
Date:
[1900]
Catalogue details

Licence: In copyright

Credit: A contribution to the surgery of foreign bodies / by W.S. Halsted. 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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    and on attempting to start to work on Monday morning, lie sud- denly vomited. Altogether he vomited twice on Monday, twice on Tuesday, and once on Wednesday morning; the last vomitus was very green. At no time have there been foreign bodies in the vomitus. Loose greenish stools on Sunday, Monday and Tuesday contained none of the ingested bodies. March 14. Patient had a chill yesterday morning followed by fever. He complains to-day of very severe pain in the abdomen, particularly in the epigastrium. At times he rolls himself about in bed in paroxysms of pain. The abdomen is quite flat but very rigid. The respiratory movements are greatly restricted. All of the abdominal muscles are very rigid, but nothing further is made out on palpation. In the skiagraph taken just before the operation, the stomach is sharply defined, as if the viscus was filled with a shadow-casting mass; but gentle palpation, even under ether, did not reveal the outlines of this mass. The reason for this undoubtedly was that the foreign bodies occupying chiefly the deepest part of the fundus of the stomach anchored it in such a position that it could not readily be palpated, and at least could not be distinguished clearly from the vertebral column and the ribs. March 15, at 10 A. M., I saw the patient for the first time. The operation, begun at 10.30 A. M., was not completed until 1.45 P. M., although we worked as rapidly as possible. Under ether, an incision was made through the left rectus muscle; the entire hand of the operator was introduced into the abdomen and the stomach palpated; it was so heavily weighted with the mass of iron that it could not be drawn up into the wound, and I was afraid to prop it up from behind, lest its posterior wall should be perforated, or at least injured, by some of the sharp foreign bodies; so draw- ing gently on the anterior wall of the stomach, I succeeded in bring- ing a small portion of it to the surface. The stomach wall was thick and cedematous. An incision into the cavity of the stomach, large enough to admit two fingers, was made, after the abdominal contents had been very carefully walled off with large quantities of gauze. The first thing extracted was a steel chain resembling a small dog-chain; with it came numerous small pieces of glass and some blackish mucus stained with blood and iron and smelling strongly of iron. For fear that, during our
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