The diseases of the stomach / by Dr. C.A. Ewald.

  • Carl Anton Ewald
Date:
1900, ©1897
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Licence: Public Domain Mark

Credit: The diseases of the stomach / by Dr. C.A. Ewald. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    cancer and ulcer, where bleeding may readily occur. Kegurgitation of food is a very unpleasant complication, as it may even lead to suffocation, aspiration-pneumonia, etc.* This may be guarded against by the local or internal use of cocaine in very nervous pa- tients. The choking sensation is much less marked after the test breakfast {vide infra), since its intensity is manifestly regulated by the amount of the ingesta, and the masses raised are smaller and much less offensive. It ceases, as a rule, after pouring some water into the stomach, since the irritation of the mucous membrane by the tube is thus removed. In most cases, however, the cause is not any irritation of the gastric mucosa, but hypersesthesia of the pharynx, which gives rise to retching and vomiting, and which may readily be lessened by the local use of cocaine. Finally, when the tube is removed it should be withdrawn as rapidly as possible. If the tube is pinched between the thumb and index finger of the right hand nothing can escape during its withdrawal. In this way we may prevent any aspiration of the stomach contents into the bronchi, and at the same time the physician soils neither himself nor the patient. [Another important reason for pinching the tube during its withdrawal is that we thus obtained an additional few cubic centimetres of stomach contents. Indeed, it not infrequently happens that when we have been unable to siphon any stomach contents, enough may be obtained in this way to make a superficial analysis.] I personally have never met with any serious accidents — neither large haemorrhages nor any other mishap—and can agree with Leube's statement that, taken all in all, the passage of the tube into the stomach is to be considered an operation without risk; f but I would modify it by substituting for taken all in all the expression if the necessary care be taken. Another advantage of the flexible tubes is that, in introducing them, it is absolutely unnecessary to introduce the finger into the patient's mouth, thereby sparing him the always unpleasant gagging, and obviating the danger of the physician having his finger bitten. * Emminghaus. Einiges uber Diagnostik und Therapie mit der Schlundsonde. Deutsch. Archiv fiir klin. Med,, Bd. ii, p, 304. f Leube, loc. cit., p. 40.