Vicious circles in disease / by Jamieson B. Hurry.

  • Jamieson Boyd Hurry
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Vicious circles in disease / by Jamieson B. Hurry. Source: Wellcome Collection.

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    The iridectomy lowers the intra-ocular pressure which would otherwise end in blindness. Laparotomy. Intestinal obstruction may be complicated by various Circles which the surgeon breaks by laparotomy. One of them is thus described by Nothnagel : “ Paresis and paralysis of the bowel may appear very early in the course of peritonitis, especially in perforative peri¬ tonitis, where it is most probably due to reflex inhibition of intestinal peristalsis. Paresis gives rise to meteorism, since gas continues to collect and accumulate in the bowel as it is not driven onward. ... As soon, however, as a con¬ siderable quantity of gas accumulates in the intestine, the Vicious Circle is completed, for gaseous distention of the' intestine leads to further impairment of its muscular powers and eventually to over-distention and paresis, or to definite paralysis.” 1 These few examples will suffice to illustrate the principle of breaking the Circle by attacking the locum minor is resistentice. TREATMENT OF SEVERAL FACTORS At other times it may be impossible to ascertain the weakest link in the chain. The wisest course is then to attack each of the factors concerned, at any rate in such complex conditions as Amand Routh describes : “ We have frequently to deal with a Vicious Circle, with local and constitutional states so interacting, that no real improvement is possible until both the general and local states receive their due share of attention.’’2 1 Diseases of the Intestines and Peritoneum, p. 773. 2 Allbutt, Playfair and Eden, Gynaecology, p. 737.