The Corpuscle. . rdiac end of the stomach. With careful manip-ulation I was enabled to pass the smallest-sized olive-pointed bougieinto the stomach. There were apparently two points of stenosisabout an inch apart. The bougie would become engaged in theupper one, then become free, and finally pass through the lowerone into the stomach. After exploration there was no bleedingwhatever; nor did the patient ever have any hemorrhage. Thediagnosis was conclusive of carcinoma of the cardiac end of thestomach, especially with the aid of the clinical history. I sug-gested gastrostomy as a palliative mea
The Corpuscle. . rdiac end of the stomach. With careful manip-ulation I was enabled to pass the smallest-sized olive-pointed bougieinto the stomach. There were apparently two points of stenosisabout an inch apart. The bougie would become engaged in theupper one, then become free, and finally pass through the lowerone into the stomach. After exploration there was no bleedingwhatever; nor did the patient ever have any hemorrhage. Thediagnosis was conclusive of carcinoma of the cardiac end of thestomach, especially with the aid of the clinical history. I sug-gested gastrostomy as a palliative measure, and after consultationwith his family and friends an operation was agreed upon and thepatient sent to St. Josephs Hospital. The man was so weak, thepulse being only 46, that an operation at this time would mostcertainly have been fatal. He was given 1-30 grain of strychninhypodermically every three hours and enemata of milk, beateneggs and whisky, until August 31, at which time he became some-what Fig. 4.—Inversion of stomach above constriction and sutured with Lernbert sutures,forming a circular valve. Operation: Before taken to the operating room patient wasgiven an enema of black coffee, also a hypodermic of 1-30 grain ofstrychnin. Pulse 56. Anesthetic, ether, which was sparingly givenand was administered with great care by Dr. Homer Thomas. Fengers incision was made. The abdominal wall was unusu-ally thin. Immediately after opening the abdomen the stomachpresented itself, which I found very much contracted. I passedmy hand along the great curvature up to the cardiac end, whereI felt a hard nodulated mass, which confirmed the diagnosis. Thepoint selected for the gastrostomy was at the greater curvature,and as near the cardiac end as possible without putting tensionon the organ. The first stage of the operation was completed 112 Gastrostomy by a Circular Valve Method: Senn. in the manner I described before. During the operation, whichtook twenty minutes, th
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectrushmed, bookyear1896
