Further improvements in the treatment of malignant stricture of the oesophagus / by Charters J. Symonds.

  • Symonds, Charters James, 1852-1932.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Further improvements in the treatment of malignant stricture of the oesophagus / by Charters J. Symonds. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    28/32 (page 28)
    ( ) now of twenty-two cases, and tliis was not due to any injury inflicted on the stricture, but to a {>erforation of the pharynx Jiigh up. liesides tliese twenty-two cases, all under prolonged treatment and under various hands, we have treate<i quite ten other cases by bougies without accident. It may be said, therefore, that there is no danger in passing bougies ; a great deal too much stress has l»een laid upon this jwjint of danger. I have pa.ssed tubes and Imugies in all comlitions, and so have my dressers, without, so far, any accident save the one mentioned, and that occurred to myself, and might have been avoide<l, and now, with the new introducer, certainly will be in future. The improvement in the patients is remarkable : one man, as stated, gained 19 lb. in ten days, but he was nearly dea«l before treatment; while others have gained flesh less markedly, all have been benefited. The delight of a man at being able to swallow again is u’ell worth seeing. It seems almost a miracle to him. We last saw under treatment a postman who came unable U> swallow. He was a<Imiited for one night and treated as described above. A No. 7 was passed, and he returned to his duties daily. During Christmas week he was swallowing freely, as a larger tube had been pa.ssed. From a perusal of the cases it will be seen that all were able to move al»out, and some to follow their usual occupation; when this is not laborious it may be carried on till the strength be reduced by the progreas of the iliseasc. Ditu/nosis.—This diseeise is so frequently overlooked and so often mistaken for disease of the stomach, on account of the vomiting, that it may l>e well to add that, in a man over thirty-nine, dysphagia without symptoms of intra- thoracic pressure, accom[)anied by the rejection of foo<l soon after swallowing, attended with wasting and in some cases the constant expectoration of saliva, is almost sure to be due to a malignant growth in the (esophagus. When blood and a foul cnlour are found on the Inrugie, the case is rapid and ulcerating. Auscultation is interesting, but the rushing sound is often absent.