The surgical treatment of wounds and obstruction of the intestines / by Edward Martin and H.A. Hare.

  • Edward Martin
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The surgical treatment of wounds and obstruction of the intestines / by Edward Martin and H.A. Hare. 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.

    51/186 (page 53)
    the possibility of a body passing tiie entire length of the alimentary canal, the chances being largely in favor of a s])()ntaneoos discharge of whatever has passed into the stomach through the cardiac valve. Charles II. of England (Bonet) placed a razor and two knives in the mouth of a professional sword swallower; they were s\vallowed, and discharged per annm on the third day. On the antliority of Longius it is stated that a sharp pair of scissors swallowed by an epileptic were evacuated on the 9th day. Bonchet' quotes Gosse- lin's observation of a sailor, who having swallowed a pipe suffered for ten days with colic, nausea, and vomiting, when a natural dis- charge of the offending body produced instant relief. The pipe could be felt through the abdominal walls and its progress from day to day distinctly outlined. In contrast with these cases Denovilliers notes an autopsy which showed that death had resulted from the obstruction caused by a single cherry-stone occluding a strictured part of the gut. The foreign bodies may be:— 1. Large, but regular or rounded in outline. Here there is every prospect of spontaneous discharge without damage to the intestine; coins, marbles, pebbles, etc., would be classed under this category. 2. Large, irregular and angular in outline; edged or pointed. Although the probability is, even in these cases, that spontaneous discharge will take place, serious complications are likely to arise. Injury to the mucous membrane of the bowel, perforation of all its coats, lodgement and blocking of its lumen may occur. False teeth, knives, spoons, scissors, nails, etc., are classed under this heading. 3. Small in size, of regular shape, single or numerous. A single body of this nature can only by the rarest exception, as in the case cited above, produce obstructive symptoms. Masses of such bodies are the commonest cause of the form of obstruction under consid- eration. Cherry-stones, date-stones, prune-stones, grape-seeds are the representatives of this class of foreign bodies. 4. Small in size, sharp or pointed, single or numerous. Here the danger to life is slight. Perforation and migration of the for- eign bodies frequently takes place but rarely causes serious symp-