Cholecystotomy : with a report of two new cases, a table of all the hitherto reported cases, and remarks / by J.H. Musser and W.W. Keen.
- John Herr Musser
- Date:
- [1884]
Licence: Public Domain Mark
Credit: Cholecystotomy : with a report of two new cases, a table of all the hitherto reported cases, and remarks / by J.H. Musser and W.W. Keen. 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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![of surg'ical treatment shown by the tables, the con- viction is forced upon one that the duty of the medical man is to observe with extreme minuteness the course of the affection, so as to be able to make a clear diagnosis, and above all not to postpone any attempts at surgical relief until pathological changes have taken place in the liver which are beyond repair. Many cases undoubtedly are lost by this fatal delay, our own among the number. SuRGMCAL Remarks by Dr. Keen. Diagnosis.— The diagnosis from the medical point of view is fully discussed by Dr. Musser. The diagnosis by surgical means is made by 1, aspiration with or without exploration by a probe ; and 2, by acupuncture. 1. Simple aspiration is not a wholly harmless method, as was proved by the first case I operated upon, in which considerable local peritonitis was lighted up (]S'o. 8), and not a little hemorrhage was caused even by a hypodermic needle. But it is one of the slighter risks incident to the disease, and ought in our opinion always to precede any more serious operation, such as opening the abdomen. The light it throws upon the physical facts is too valuable to be neglected. Combined with aspiration we may use a probe passed through the canula. Petit as early as 1733 {Maladies-Cliir., i. 282) proposed paracentesis and exploration by a sound, but his proposal was appa- rently forgotten till Bartholow, in 1876, actually used this method successfully. Brown {Brit. Med. Jour., 1878, ii. 916) also apparently put it in practice. It should certainly be tried when an aspiration is done, but that it will not always give information to be](https://iiif.wellcomecollection.org/image/b2229546x_0050.jp2/full/800%2C/0/default.jpg)
