Further improvements in the treatment of malignant stricture of the oesophagus / by Charters J. Symonds.

  • Symonds, Charters James, 1852-1932.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Further improvements in the treatment of malignant stricture of the oesophagus / by Charters J. Symonds. 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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    sinks under the operation, even thouj^h feeding be com- menced at once. This applies with greater force to those coses which liave not been obtaining nourishment )>y tubage previously. A very slight shock is sufficient to overturn the balance and terminate the life. Even too energetic and prolonged attempts at tubage in such cases are unwise, Itetter tt) give enemata, enjoin rest, and keep the patient warm for a few days l>efore repeating attempts at tubage or undertaking any operation. I do not at all wish to appear to hold that gastnwtoiny is an unsafe procedure. •Mr. llowse has placed this operation on a sound and successful basis so far as method is concerned ; but all the.se precautions have not atliled much to the suc- cess in malignant cases, so far as life is concerned ; the majority succumb. Next we come to the nse of the long feeding tul>e per- manently retaine<l. I mentioned in the j^aper referre<l to in the British Medical Journal that I had found the hard tul»e used by Krishaljer and others cause ulceration of the mucous membrane over the back of the cricoid. I have since found the same etlect. I also gave my adhesion to the use of rubber tubing, as suggested by Mr. Iterry.® In one case I tried his method of introduction, and succeeded after great trouble. I think the plan suggested below will be found more easy of application. Np:w LoN(i Tube.—After many suggestions and experi- ments 1 had maile a rubl>er tube of the same pattern as the thick-walled stomach tube used for feeding only, and not for retaining. This has a closed catheter end and a large eye. It was pas.sed in one case by the whale- bone introducer and succeeded perfectly. A simple device then occurred to me, by which anyone can make a tube in a few minutes. Take a piece of retl rubber drainage tube with a thin wall and a wide bore, and about eighteen inches long; cut one end obliquely and sew it up, thus obtaining * St. Hiirthiiliiiuow'.'* llospiUil Report.s,
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