. American practice of surgery ; a complete system of the science and art of surgery . oughly attached to the abdominal wall, during which time the patient re-ceives an abundance of nourishing food. The dilatation is now begun in the following manner:—By means of the SURGICAL DISEASES OF STOMACH AND (ESOPHAGUS. 433 continuous double cord another cord is carried through the stomach into theoesophagus and out through the mouth. This cord should again be double, sothat a rubber drainage tube may be looped into it and drawn through thestricture, as shown in Fig. 176. In this diagram, however, the
. American practice of surgery ; a complete system of the science and art of surgery . oughly attached to the abdominal wall, during which time the patient re-ceives an abundance of nourishing food. The dilatation is now begun in the following manner:—By means of the SURGICAL DISEASES OF STOMACH AND (ESOPHAGUS. 433 continuous double cord another cord is carried through the stomach into theoesophagus and out through the mouth. This cord should again be double, sothat a rubber drainage tube may be looped into it and drawn through thestricture, as shown in Fig. 176. In this diagram, however, the rubber tube islooped directly upon the original silk cord, which is not a safe practice, because,if the cord should break, it might be difficult to replace it, while there is nodanger of its breaking in simply carrying through another cord. The rubberwill stretch out into a thin body when drawn through a tight stricture, but whenrelaxed it will act as a powerful dilator. The size of the rubber tube may beincreased, or any desired number of tubes may be drawn through the stricture. Fig. 177.—Dilatation of a Stricture of the CEsophagus. In this diagram a large double tube isrepresented as having been drawn into the stricture, in which position it is left for a time in order thatit may exert a dilating influence. at the same time, as the calibre of the latter increases. (See Fig. 177.) Therubber tubes may be drawn back and forth. The first one is drawn through themouth and out of the opening in the stomach by means of the silk cord. Thedilatation can now be carried on by looping a larger rubber tube through theloop of the other tube. By means of the latter, draw the larger tube up throughand out of the mouth, and then repeat this until as large a tube as desired maybe drawn through the stricture. This, however, requires a large opening in thestomach, which is not necessary if the tubes are simply looped into the silk cord;and by alternating the direction of the pull, the tube
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
