The rectum and anus : their diseases and treatment.

  • Charles Bent Ball
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: The rectum and anus : their diseases and treatment. 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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    above preventable complications ; and the more fully we appreciate the advantages of thorough drainage and continuous iiiigation, frequent washings with anti- septic solutions, or dusting with iodoform, the more likely are we to still further reduce the death-rate. Yolkmann states that amongst his early cases he lost a great number from se])tic inflammation, but since he has adopted better methods of wound treatment his results laave been very much better. He advocates continuous irrigation of the wound with an antiseptic fluid, such as solution of salicylic acid, or carbolic acid, until granulation is established. Billroth, between the years 1860 and 1876, lost 13 out of 33 cases, and all the cases died of septic periproctitis and peritonitis.* Crippsf gives twenty-three cases within his own experi- ence, of which four died. The statistics given by Heuck | of the 2)ractice of Professor Czerny for a period of six years appear to be the best hitherto recorded. Of twenty-five patients operated on, only one died as a direct result of operation. In many respects the history of rectal extirpation resembles the early history of ovariotomy ; and it is highly probable that with increased care in wound treatment and operative detail the rate of mortality will be matei-ially lessened. It is, therefore, at present premature to be guided too much by statistics. Let us now consider what are the probabilities of complete cure; or, if recurrence takes place, how long will it be delayed? Billroth, in 1881, had only two CRses in whicli the patients lived two years after the operation; and Allingham speaks with great caution, apparently not considering that life is even })rolonged by the operation; on the other hand, C'ripps found, that out of twenty-three cases, in nine * Clinical Surgery, New Sydenham Society, 1881. i Loc. cit.,\^.'6\)l. X Archiv fin- kJinische Chiriirgie, Banil xxix. Heft 3.