A New Method of Approach in Gastric Surgery

Abstract

by the injections is all that is required, buit I thtink that physiological rest for the parts for somiie dtays is neceissary, and can best be obtained by induced temporary paralysis or abolition of toniicitv by stretchlinog t1e sphliiicter ai1i. For the cuire *of sim)Ile non-complicated fissures thlis Ilmalw" be all thlat is req1uired. Frequiently 1 h-ave performed a dilatationl opelration at a niursing homiie ill the molrnitiO, tlhe patient ret-trning to his own homne the sanme eventing, with-iouit complaining of paine, and, c-lieii A 5 c.crn. syringe with a very fine needle 2 inches long is used.The skin at the point of injection is anaesthetized by injecting a few drops subcutaneously, and, by pushing the needle along unde-the skiin, the points for further deep injectioiis aic awiaesthetized so tlhat only the initial needle-prick is felt. At a point on the skin half an inch from the anal opening, the needle is inserted downwards aiid slightly inwards throuigh the sphincter to a depthl of 1D in., care being taken not to penetrate the bowel-wall anid iniject 2anaesthetic into the rectum. A gloved finiger in the bowel should obviate this by guiiding the needle to its destination.Having reaclhed the tissues underlying the haemorrhoid the solution is injected slowly drop by drop as -the needle is gradually witlhdrawn. After tlhree to five minutes anaesthesia will be complete. I lhave never folund it necessary to apply the solution to the sirface of the liaemorrlioid nor to inject the anaesthetic into the body of tde pile. Qui-nine and urea, whilst excellent for deep inifiltratioln, slhouild not be employed to anaesthetize the skin, as it canses tlhickeninig and induratioin of the cut edg,e. Abouit 2 c.

A British Medical Association Lecture on CARCINOMA OF THE STOMACH

“…Thiey are small in mLniber, but ar e of value, in that ever-v case hlas been proved by operation, siiupIpoitefl eitloer bv micirosopic examination or bv ca, rfrle obser-ation of the after-p0-ogress of tle patienit. The figures (see Clhart 1) to chronic ulces, for witlh chroniic peptic ulcers the incidence in males'is even imiore marked. There weore, for instance, in miiy owvn series of 1,141 chlronlic ulcers, 850 males.…”