On chronic disease of the uterine appendages : with a table containing short notes of thirty consecutive cases treated by abdominal section / by William Duncan.

  • Duncan, William Archdeckne, 1857-1917.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: On chronic disease of the uterine appendages : with a table containing short notes of thirty consecutive cases treated by abdominal section / by William Duncan. 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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    it a routine practice to have a soft indiarubber tube passed into the rectum for several inches at least twice a day, and find it gives relief. In a case of Porro’s operation which I performed at the Middlesex Hospital (and reported in the Lancet, vol. i. 1889, p. 16) there was enormous flatulent distension a few days after the operation, giving rise to all the signs of acute peritonitis, but on passing a long stiff tube into the colon a tremendous escape of flatus put an end to the unfavourable symptoms. In slight cases a teaspoonful of brandy in half an ounce of hot water gives much relief. My patients suffer little from flatulence since I have discarded the use of ice. Peritonitis is the only other complication about which I shall speak. It may, of course, have existed before the operation, or it may be due to the escape, at the time of operation, of some pus or irritating fluid into the abdominal cavity; but when it sets in after a straightforward case of abdominal section I cannot help thinking that the operator has to reproach himself that the measures he adopted to ensure strict cleanliness were wanting in completeness. Although when once it has set in it need not necessarily be fatal, I believe the best chance is given to the patient by reopening the wound without delay and irrigating the cavity thoroughly with the boracic acid solution and inserting a drainage-tube. The only case in which I did this for acute peritonitis coming on two days after I had performed abdominal section recovered completely, and is now, three years after, perfectly well. Mr. Lawson Tait recommended the use of saline aperients, but I cannot help thinking that even such an experienced and able observer as he may have mistaken flatulent distension and vomiting for peritonitis. In conclu^on, I would remark that simple cases of abdominal \ section seem to recover equally well if put back immediately after operation into the general ward as when isolated in a special ward for several days.
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