The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
[1906]
Catalogue details

Licence: In copyright

Credit: The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power. 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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    A man, agod (JH, was adiiiitlod into the liosi)Ual un August l.otli. 1902 willi a history that lie had sulTereil severely from dyspepsia for the past live years and that for the last two years he had jiain after his food and vomiting. During the six or seven months preceding his admission to the hospital there had been occasional streaks of hlood in the material vomited. The attacks of vomiting usually took place once in two days and he would then bring up as much as two pints at a ti- me. For the last two months he had ra[)idlv lost flesh. It was noted on admission that he was a thin and wasted man with a flaccid abdomen, which moved freely during respiration. The stomach was greatly dilated as the lesser curvature lay about three inches below the costal margin and the viscus occupied the greater part of the epigastric, all the umbilical, a great ]>art of the hypogastric and some of the iliac regions of the abdomen. A succussion splash was very distinct and a hard rounded tumour about the size of a Tangerine orange could he felt in the middle line, sometimes above and sometimes below the umbilicus. The liver was not enlarged. A test meal showed the presence of free hydrochloric, lactic and bu- tyric acids with albumoses.' The patient was kept under observation and was dieted carefully until Au- gust I9th. when I performed a gastro-jejunostomy upon him as he was getting worse instead of better and I felt sure that he had a cancer of the stomach. When the peritoneum was opened, the pylorus was found to be thickened but the swell- ing which had been felt through the abdominal walls was a mass of adhesions sur- rounding the duodenum and attaching the whole of the first part to the neighbour- ing tissues. The patient slept badly after the operation and was re[ieatedly sick suffering much pain until he left the hospital on September 19th. From the hospital he went to a nursing home at Reading and afterwards to Devonshire where he is still living. lie wrote to me under the date October 28th. lflO.3 — fourteen months after the operation; «I hardly know where to begin, so presume I had better start from our first interview which was on .Inly 23rd. 1902. Went into Bart’s August 1st. Ope- ration performed on me .August 19th., left September 19lh. at my own request; went direct to a home at Reading: left there .\ovember 1st. tor Ilfracombe direct: bore the journey well. Out in a bathchair November .nth. for an bour and so every day when fine until December 11th. when the chair was dismissed and I walked. 1 can eat and digest my food. 1 occasionally take a glass of mild ale — no spirits or wine. 1 retire to bed about lU o’clock, previously eating an apple. I rise at 6; make my- self a cup of cocoa - half milk — and after washing, smoke a pine and read till 8.30; then breakfast,— my best meal: —lunch at 1 0 generally cold meatandsoup: tea at 5.0. Dinner or supper at 7..30, seldom gel meat then, usually bread and but- ter, cheese, salad and plenty of onion. Can walk five or six miles without feeling tired; I am out of doors as much as possible». To this satisfactory account of him- self he adds that his weight went uji gradually from S) stones four Ihs. to 12 stones 0 lbs. and he concludes bis letter by saving: 1 have not weighed so much for 13 or 14 years but remendiering that 1 am 71 years old 1 cant expect to kee[i this weight up altlK)ugh I (lout fe(d mv age.« I saw this jiatient again in the early part of .lune 1904, twenty-two months after the ojieration. He was in good health, maintained his weight atul was passing through London to visit some grandchildren in Canada. The trip was successful for he writes to me acain from Devonshire in October 1904. <>I have just returned