The collegian of 1666 and the collegians of 1885, or, What is recognised treatment? / [by Hugh Owen Thomas].

  • Hugh Owen Thomas
Date:
[1888]
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Licence: Public Domain Mark

Credit: The collegian of 1666 and the collegians of 1885, or, What is recognised treatment? / [by Hugh Owen Thomas]. Source: Wellcome Collection.

    134/166 (page 128)
    I 28 rule, that there should be no time wasted in the useless attempt to divine the mode of strangulation; to operate because an intussusception has failed to be relieved by treatment is, I think, sound advice; but of what use is this advice if the full signs of the failure of other treatments is not even alluded to anywhere in the lecture ? Mr. Bryant gives us many instances of failure of treatment. How did it happen that those in attendance did not notice that the treatment was abortive? This rule is not interesting to me without being informed of all the signs of urgency. The second rule is an excellent one, and well worthy of being acted upon during a search in the abdomen, and to Mr. Bryant is due the merit of first giving us this useful hint. The third rule is also an excellent one. In the fourth rule enterotomy, as suggested by me some years ago, is accepted. The fifth rule is also an excellent one, so long as we cling to the “ treatment by opium, inflation, or purgatives, which has hitherto been in vogue.” But, unfortunately, the performance of laparotomy does not end all the difficulties in connection with the lesion, treatment, to which Mr. Bryant alludes with curt courtesy, is generally resumed after operation, but though not under such disadvantages as before. In this lecture the post operation medical treatment is not brought up to date, if we accept Mr. Banks’s teaching “now.” “Moreover, now that purging and other violent remedies have been given up, and treatment is directed toward ensuring repose of the bowel by opium, with the view of letting nature overcome the obstruction, such recoveries are decidedly on the increase,”