Lectures upon diseases of the rectum and the surgery of the lower bowel : delivered at the Bellevue Hospital Medical College / by W.H. Van Bruen.

  • Van Buren, W. H. (William Holme), 1819-1883.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures upon diseases of the rectum and the surgery of the lower bowel : delivered at the Bellevue Hospital Medical College / by W.H. Van Bruen. Source: Wellcome Collection.

    146/460 (page 134)
    An overworked practitioner was summoned to the country to a case of stone; he was driven from the station five or six miles to the patient's house in a very hard-seated wagon, in the cold, and severely jolted. Within ten days an abscess developed near the anus, the opening of which was long delayed, and it resulted in a grave and complicated fistula requir- ing for its cure an operation of unusual extent and severity. A very busily employed executive officer in a heavy financial institution, sitting all day, and living a little too well at home, was a victim of one of the most extensive abscesses of this sort I ever saw. His health had always been excellent, and he was in the prime of life, but the abscess, which formed in mid- winter, proved to be the cause of his death. Its for- mation and progress were insidious and slow, and its opening was long deferred, and then not made suffi- ciently free, and, when I saw him in consultation, there was an extensive cavity extending nearly around the circumference of the bowel, and he was suffering from hectic fever, which, as you know, is good evidence that the vital powers of a patient are unequal to the repair of his disease. We succeeded, however, in im- proving his condition by means Avhich I will detail later, so that he could have undertaken a sea voyage with a good prospect of ultimate cure; but he refused to abandon his business, and died, exhausted, during the subsequent midsummer heats. I do not think that these cases will give you an exaggerated idea of the gravity of ischio-rectal abscess, especially when it is the result of vitiated blood and consequent de- pression of the vital powers.