. American practice of surgery ; a complete system of the science and art of surgery . ournal of the American Medical Association, October,1906.) THE DIAPHRAGM. AND SUBPHRENIC ABSCESS. 475 Another mode of traversing the chest, in order to reach the diaphragm, isthat first used by Walther in 1892. According to this plan the same coiii-se ispiii-siied as that which is adopted in all cases where intentionally we traversethe pleura to reach the liver, that is, by stitching the diaphragm to the parietesof the thorax, a method that will be further described under SubdiaphragmaticAbscess. The plan ha
. American practice of surgery ; a complete system of the science and art of surgery . ournal of the American Medical Association, October,1906.) THE DIAPHRAGM. AND SUBPHRENIC ABSCESS. 475 Another mode of traversing the chest, in order to reach the diaphragm, isthat first used by Walther in 1892. According to this plan the same coiii-se ispiii-siied as that which is adopted in all cases where intentionally we traversethe pleura to reach the liver, that is, by stitching the diaphragm to the parietesof the thorax, a method that will be further described under SubdiaphragmaticAbscess. The plan has been followed by von Frey, Amante, Henii Girard,Zeidler. and Grekow. Lenormant has had no personal experience with themethod, but, from my cases, the other plan has seemed so simple of execution,and has given such perfect results—to others as well as to myself—^that I seeno reason for abandoning the latter, Unless infection be present this coursecertainly seems imnecessary. As in the case of hernias in other parts of thebody, protruded omentum had Costal arch everted aph rogm. better be amputated, especialhso if the mass is of considerablebulk. Other points of techniquewill be found in the sections ofthis article which relate to thetreatment of wounds and of sub-diaphragmatic abscess. The conclusions given abovein regard to the policy of oper-ating remain true and reliablewhether there are or are not ac-companying wounds of \dscera;upon the latter depends largelythe gra\ity of the the other hand, if these con-clusions prove tiiie in chronicdiaphragmatic hernia, in cases inwhich we have reason to suspectthe existence of hernia, do they also hold true for the interval between anaccident and the appearance oi strangulation? Should an operation of elec-tion be undertaken for the radical cure of a diaphragmatic hernia? The onlycase of this kind which we are able to report is Llobets,* in which by meansof an extensive plastic operation on the side of the chest, an
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