Case of communication with the stomach, through the abdominal parietes, produced by ulceration from external pressure : with observations on the cases of gastro-cutaneous fistulæ already recorded / by Charles Murchison, M.D.

  • Murchison, Charles, 1830-1879.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Case of communication with the stomach, through the abdominal parietes, produced by ulceration from external pressure : with observations on the cases of gastro-cutaneous fistulæ already recorded / by Charles Murchison, M.D. Source: Wellcome Collection.

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

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    the gradually increased compressiou of a circular bandage, while at the same time the patient was nourished chiefly per rectum} In none of the cases does any cutting or paring of the edges of the wound appear to have been attempted. Dr. Keith seems to consider such a procedure practicable in the case of Catherine E-oss, provided that she herself would throw no obstacle in the way. It is much to be fearedj however, that in any such operation the contact of the gastric juice and the distention of the stomach by food would very much interfere with union by the first intention, while, at the same time, there would be a risk of exciting dangerous inflammation of the stomach. G. General health of persons with Gastro-cutaneous Fistulce. It is astonishing to observe how Kttle influence the existence of a gastro-cutaneous fistula has upon the general health. In most of the cases resulting from wound or simple rdcer the patients are stated to have enjoyed excellent health. This was particularly remarkable in Wencher's case of a woman, who lived for twenty-seven years with sxach a fistula, following her ordinary avocations; and is still more so in the case of Alexis St. Martin, who, during the last thirty-five years that the fistula has existed, has married and become the father of several children, earning a livelihood for his family by a laborious occupation. In Catherine Ross the state of general debility is more to be attributed to a general derangement of the entire nervous system than to the efiects of the fistula. The principal abnormal symptoms which have been observed as dependent tipon the fistula are, great thirst, increased appetite, obstinate constipation, deficient secretion of urine, and amenorrhoea. The most of these symptoms are directly traceable to the constant escape of the ingesta ' For a fuller account of the treatment iu this case, see South's ed. of Chelius's ' Surgery,' vol. i, p. 477.