A surgical study : gastrotomy and gastrostomy / by J.H. Pooley.

  • Pooley, J. H. (James Henry), 1839-1897.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A surgical study : gastrotomy and gastrostomy / by J.H. Pooley. 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.

    28/33
    seen, sixteen of the eighteen cases recorded were for cancer- ous disease, and of these ten are described as epithelial, a form of malignant disease which is the slowest of all to af- fect the general system, and which, unless it involves some organ essential to life, admits sometimes of almost indefinite prolongation of existence; here we are reduced to the miser- able alternative of watching the horrible sufferings and death of a ]>atient, not directly from the disease, but from sheer starvation, with the certainty that, could nourishment be supplied, life, for a considerable time at least, is still possible. At the same time, as the eflbrts to swallow become more diflicult and painful, they become also more irritating and aggravating to the disease that makes them necessary, and constantly increase it; while, on the other hand, could a gastric fistula be safely established, there is no doubt that in many instances the rest afforded to the (esophagus would en- able it, after a time, to resume to some extent its functions. In a case of syphilitic stricture, the respite obtained by the operation might give time for a complete cure to result; while in the case of a stricture from the results of corrosive jMjison, most likely to occur in a child, though if complete very little hope of the restoration of the canal could be en- tertained, almost any thing would seem better than to see the miserable little sufferer die of starvation, and it might l)e possible to prolong life for many years. In this connection, there is one very curious fact that de- serves a passing mention. Bardeleben found that though life was easily maintained in dogs that simply had a gastric fistule, but took food in the natural way, that in a dog in which he had obliterated the ce.sophagus, after the successful establishment of such a fistula, he was ijnable, with all pos- sible care, to prolong life more than a year. This observa- tion being a solitary one, is therefore of little practical value, but curious and interesting. It only remains, in conclusion, to speak of the operation