The student's handbook of the surgery of the alimentary canal, being an abridged and amended edition of the author's treatise on the same subject / by A. Ernerst Maylard.

  • Maylard, Alfred Ernest, -1947.
Date:
1900
Catalogue details

Licence: In copyright

Credit: The student's handbook of the surgery of the alimentary canal, being an abridged and amended edition of the author's treatise on the same subject / by A. Ernerst Maylard. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    have hit upon the same plan, which is illustrated by a drawing. Gersuny ^ records two successful results by an ingenious method of torsion. After removal of the diseased portion, the upper segment is pulled down, and by two pairs of forceps placed on opposite sides the bowel is twisted until the finger feels some resistance when introduced and pushed up. It is then stitched to the skin margin. In both the cases so treated there was power to retain faeces. If no attempt is to be made to obtain any sphincter action, then the bowel must be either left in position with the intro- duction of a tube from the lowest part of the wound into it, or it must be secured to the skin of the wound at such a point as allows of little or no tension ; in other words, a sacral anus must be formed. In either of these methods the wound cavity must be loosely stuffed with iodoform gauze and left freely open. After treatment.—Every effort must be made to keep the bowels confined for a few days, by the administration of opium, and a milk diet. When the metal button is used, it is advised by Murphy that an early and free use of laxatives be employed, so that the button may not become dammed up with solid faeces. When a wound has been stuffed, the tissue should be re- moved after forty-eight hours, and earlier if there is any fear of fecal leakage, or any symptoms of sepsis. It may be restuffed, or freely and frequently irrigated, according to cir- cumstances. When once the wound is freely granulating, and there is no indication of inflammation, the patient may be allowed to rise, and sit or even walk. The earlier this freedom can be permitted, the better. In cases of sacral anus, Hochenegg has devised a pad which is secured by a hinge to a belly band. It is kept firmly applied to the orifice by a strap passing from the front down between the legs, across the perineum and up behind. Accord- ing to Thorndike,^ who figures the apparatus, it does its work efficiently and with comfort to the patients. Vaginal proctectomy.—Little has been done with regard to ' Ceniralblatt filr Chirurgic, 1893, vol. xx. p. 553. Boston ]\[cd. and Svr.j. Journ. 1891, vol. cxxiv. p, ■l.'^C.