장음표시 사용
51쪽
the experimenis,hiclid performed P und thattreating the intestine in this manner a no sutificienti secure se preventing the Reces Dona es capiti into the abdominat cavity. The following suture has also been proposed in a complete division of the intestine. It was last recommended by r. Ramdlior in cases of hernia, here a portio of the intestine had been
destroyed by mortification....In these cases, he has adrisexto extirpare the diseased para, and to introduce theippe portionis the ound intestine Mihin the lower, for about an incli, an to confinei therei sewiniit once o twice round witha sine eessi and thread; ut besides the dissiculi of knowing whicli is the uppe or lower portion in mound of the intestines. 4nd thati neve canae performe on the living subjeci, as,ill appea by the ninth experiment, forcina mediatet upon aking the sectio of the intestine, the dividediaris hecame so much invertia, as to rende the introductionis one,ithin theother ulteri impossibie. The method whicli
pears to promis mos success, is that recom.
52쪽
18men dedi Μr Asile Cooper, in his Wor onhernia, in that pari hereinae reata particulari os mortificationis the intestine. He direcis, that the injured part shouldie removed, and the
divided portions rought into contaci, and secured by seu stitches, ne einiat oriea themesentery, and the other aliquat distances Dom
This method is certainly the mos fas and simple of any that has et been spolienis, and willno doubi in timete generali adopted. Perhaps seu or sive stilines illi found sufficient in
mos instances of a complete division of the intestine. ut eriliould e carem no to se more hancire reatly necessary for it has been observed that puncturing the intestine frequently increases the dange of the operation
In orde to decide etween these disserent methods, I determinexto institute a series of experiment upo dog by oundinithei intestines, an unitin them illi the various su-
tures above stated. I amoware that it is noteas to determine,illi recision the reaiment
53쪽
19 proper for the human species by inferences derive froni the dog; ut the analog in thepresent instanc appear to me ery Strong. shali in the nex place commence, by relating my
ASSISTED by ni friend r. lapp, an incision was made into the abdomen o a dog, and ne of the smal intestine. havin been brought into vie , a transverse Section was madeint ii, and the wound secured by seu stitches,one at the mesentery, and the ther three at eques distances froni achither, the thread weretheicut osseat he knois, and the externat ound closed by the interrupted future. The animal di notoppea to have sussere materialty Domthe operation, o in twenty four liourche tookDod, and after thetars da exhibited ii sympionis of indisposition the both, he was kilb
The interrupte future as used in very instance, forsen ing the extemia Nound utiles particulari memione .
54쪽
20led the wound of the intestine a mund comopletet heales the place at hicli the intestinelia been divided appeared fomewha thichened, considerable adhesion were observe among thesmal intestines Three of the ligature had dis-appeared, the the was stili remaining ooselyattache to the internat coat, and probabj Would have been discliarged in the fame manne aitheothers, ad the dog been permittest live a fewd s longer.
ment at the intestine, eremo testiui a theexternat wound in casest shouldie necessar towithdra them. In consequence of the restie88-nes of the animal during the operation, considerable violence a done to the paris, e re
55쪽
it a thought prope to remove the ligatures after his heiappeared belle and oo nourishment the 19th, he was killed pon' in open the abdomen the effect o inflammation were stili obvious. The omentum a found adhering to the parietes of the abdomen, and ver much indurated. Preternatura adhesions had talae place monita the viscera, ut more particularly in the mali intestines, hicli ere otted and wiste together in an astonishingmanner The intestine at the place here thev ound had been made was notrivit united.
SEVERAI of my friend honoured me with thei attendance, hiis the fossowiniexperiments were performe the abdomen o adsiliavin been operied, and the smali intestines brough into viem, a longitudina incision of out an inclitand a hal was ad parasset,iththe mesente , whicli as secured by seu stitches, and the intermediate spaces sewn with a sine thread to prevent the faeces froni escapiniint the
56쪽
22 cavit of the abdomen ' the thread were cutissa the intestine. The animal died in about hirtysi houra. On dissection the marks of inflammation ere found much less than might have been
The wound in the intestine a completelytoria pen, Sceptinia one Stitch.
57쪽
23 ternat ound bein considet abi indurate i. Themesenteri gland were enlarged. The wound in the intestine was no completet usited, w of
the ligatures ad disappeared. The the twostili remained the wounde gutina adhered tothe mesenter ansadjoining portio os intestine.
ON a fuit grown arrier, I repeate theforme experiment Wishing to See, hethera longitudina incision could no by great carean attention, e so managed a to O Way the opinio oscit hein universali fatal. Toeffect hicli, a very smali pening was madethrough the parietes of the abdomen, an a portioni intestine, bein brouit into Heu , t was divided longitudinas for bout two inches, and te ard secured by si stitches hicli erecut ora theanois The paris having been rereturned the ps of the externat ound werebrough together and secured by adhaesive plaister. The animal didio appea to have suffer-
For it Was observed that the ligatur usexsor securing the externa Nound increased the inflammatio ver much.
58쪽
24ed in ille leas from the operation, for in essthan tu ent seu hour herio , Dod an has
PLEASED with my succes in the re cedin experiment. I obtained another dogandipened his abdomen, in one of the mali intestines. made a longitudines Woundior about three inches, and reale it in ver respect simi-Ia to that relate above. his animal appearedio hau sussered ver litti more than the other, considering the extent of the wound for in about twenty eight hour heseat an continue cloings untii the tentii Jay after the operation, whenti refuse nourishment. Two Jay after hedied on examination, it a found that thewound had heale completely, but directly above the wound a bone hal an incli long an nearlyas road, lis discovere to have perforated the
59쪽
60쪽
26liealtis, Whicli continiae I ithout interruptioni inti Alayi, whenae,as Essed The divide lportions os intestine were found united, and thelligature had been ali discliarged.
HAVIN operied th abdomen o apointer pup three inches of intestine ere ex Used the arteries belli secured the intestine in ther respects was reate a the last adbeen In twent minutes after the operation,