The surgical treatment of wounds and obstruction of the intestines / by Edward Martin and H.A. Hare.

  • Martin, Edward, 1859-1938.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The surgical treatment of wounds and obstruction of the intestines / by Edward Martin and H.A. Hare. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    55/186 (page 57)
    INTESTII^AL PARALYSIS. Certaijst cases of intestinal obstruction occur and frequently run on to a fatal issue, yet, at the autopsy no sufficient cause can be found for the symptoms observed during life. These cases are classed by Henrot under the name Pseudo-strangulation, and are classified as follows :— 1. Cases dependent upon paralysis of the muscular coat of the bowel, due to pathological changes. 2. Cases in which the muscular coat is intact, the symptoms depending upon reflex action. 3. Cases in which there is paresis or paralysis dependent uj^on a general condition of the nervous system. The symptoms dependent upon conditions under Henrot's second and third heading are usually evanescent in character and threaten danger to life or cause difficulty in diagnosis only for a very brief period. Inflammation of the abdominal parietes, severe injury to the testicle, operations about the rectum, or general hysteria have all been accompanied by symptoms of acute intestinal obstruction wdiich were promptly relieved by attention to the condition which had excited the reflex. After abdominal wounds, however, tedious laparotomies, or severe contusions in the abdominal region, there may be developed a condition of intestinal paralysis which quickly leads to obstruc- tion, to great distention, and to death from either septic absorp- tion, exhaustion, or peritonitis; it is to this condition far more than to well-developed inflammation that the ovariotomist of the past can trace many of the deaths following operation. We have fre- quently examined post mortem the abdominal cavities of these cases, perishing a few days after operation and presenting the charac- teristic symptoms of obstruction, and have found nothing beyond enormous distention of the gut with kinking, moderate injection, and a slight sero-sanguinolent effusion.