Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ory shall be made todetermine, if possible, the location of any primary focus of the disease. Theabdomen should be opened in the region of such primary focus, or, if none isfound, a median operation between the pubes and umbilicus should be the ascitic fluid has been removed by sponges, tuberculous foci shouldbe sought. If any organ or region is preponderatingly affected with tuber-culosis and its removal is easily accomplished it should be removed. Thi
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ory shall be made todetermine, if possible, the location of any primary focus of the disease. Theabdomen should be opened in the region of such primary focus, or, if none isfound, a median operation between the pubes and umbilicus should be the ascitic fluid has been removed by sponges, tuberculous foci shouldbe sought. If any organ or region is preponderatingly affected with tuber-culosis and its removal is easily accomplished it should be removed. Thisrule does not apply to any procedure so serious as resection of the intestineunless by the operation all foci can be removed. It applies to such struc-tures as the Fallopian tubes, appendix vermiformis, or ovarian peritoneum. The most effective operation is the simplest. It consists in removal of theascitic fluid. The presence of the fluid in the peritoneum is a natural reactionagainst the disease. As the fluid becomes old, it probably loses its bacteri-cidal power. Withdrawal of the old fluid is followed by the formation of. Fig. 1216.—Subpleural , Incision in diaphragm for exposure of subphrenic abscess. new fluid which has greater antitubercular properties. The abdomen shouldbe closed without drainage. Operation is done only when there is ascites, and ascites is usually presentonly with disseminated disease. An opportunity to perform a resectionof any tuberculous area is rarely offered. There are two exceptions: Whenthe Fallopian tubes or vermiform appendix are involved, they should beremoved, and the opening cauterized and occluded. This is recommendedbecause there is apt to be a tuberculosis of their mucous membrane whichmay continue to reinfect the peritoneum. After exposing all of the diseasedperitoneum to the air, the abdomen is closed without drainage. Operation isbest done after the primary febrile stage has passed, but before the patientbecomes de
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
