Case of removal of the entire stomach for carcinoma : successful esophago-duodenostomy recovery / by Charles Brooks Brigham.

  • Brigham, Charles Brooks, 1845-1903.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Case of removal of the entire stomach for carcinoma : successful esophago-duodenostomy recovery / by Charles Brooks Brigham. Source: Wellcome Collection.

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    abscess discharging a drachm of pus. The patient feeling remarkably well, sat up in bed and was photographed. The amount of liquid taken by the mouth in the last twenty-four hours was a little more than a pint; this did not include two eggs ; there were also five nutritive enemata given. Urine voided, one pint. Evening pulse 104, tem¬ perature 101.2°. Midnight pulse 100, temperature 100°. March 6th. Pulse 102, temperature 100.6°. During the day the patient had four semi-solid movements. All the sutures were removed from the abdominal incision. The tongue is moist and clear. Since the operation there has not been the least fetor of the breath, nor has there been any vomiting except the mucus vomited soon after the operation. To-day the patient took a drachm of sweet oil with a view of facilitating the downward passage of the Murphy button. This was regurgitated soon after, the patient declaring that it was not Italian oil. As there was a burning sensation in the lower abdomen soon after the enemata were given, the brandy was omitted. Evening pulse 110, temperature 100.2°. Midnight pulse 106, tem¬ perature 99.6°. March 8th. Pulse 100, temperature 99.8°. There is to day a distress after swallowing and a pain in the upper part of the abdomen. Evening pulse 104, temperature 99.6°. Midnight pulse 98, temperature 99.4°. March 9th. Pulse 100, temperature 99.4°. There is still a burning pain in swallowing, and a disinclination to drink on that account. During the morning about two ounces of pure bile were vomited, the bile having a distinct smell of urine. Two hours later, after a sleep of three- quarters of an hour, the patient awoke, and found she could swallow easily. There was no longer an obstruction to the passage of food, and she said she did not know where the food went to, so easily did it pass along. Evi¬ dently the Murphy button had left the position which it had occupied for thirteen days. The amount of nourish¬ ment now given each time was three ounces and more. Evening pulse 100, temperature 99.8°. Midnight pulse 98, temperature 99.6°. The nutritive enemata were dis¬ continued. March 10th. Pulse 102, temperature 99.4°. The amount of liquid taken in the last twenty-four hours was 37 ounces ; amount of urine voided, 27 ounces. The sup¬ posed stitch-hole abscess had been discharging but slightly ; and as the opening was too minute to admit of anything larger than a probe, chloroform was given and the opening dilated. A shred of necrosed tissue was removed with the forceps, the wound washed out with a hot normal salt solu-