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.

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    In conclusion, I would claim for this method of treat- ment—that it is applicable to nearly every case of malignant strictare, and probably to all if seen early enough ; that it affords the patient far more comfort than the long feeding tube ; tliat it is superior to gastrostomy in the comfort it secures and in the freedom from danger; that life is pro- longed in every case, and as long as after the most successful gastrostomy ; that the tube does not give rise to any irri- tation, being tolerateii by the most irritable patient; that, insteati of favouring growth, it checks it, by allowing unhealthy Huids to pass from the <esophagus into the stomach ; that the ti.se of the short tube—and, when cough on deglutition arises, of the soft rubber tube—anil enable us to treat all caaes without resttrting to gastrostomy. Note.—Since writing the above, I have had the pleasure, while on a visit to Berlin in February of the present year, of seeing the tubes usetl by l>r. Uenvers in I’ntf. I.eyden’8 wards. Dr. Kenver* tells me he has now employed the method in seventeen cases, sutd retainotl a hard mhber tube for six months in one instance. These hanl tubes are one inch and a half long and open at the lower end, and are suitable for short hard strictures. I have not myself eniployetl this form, being satisficil with the tnlie I have described here. Moreover, the plan originally suggested jKissesses the great a<ivantage of simplicity, for an intrtslucer can lie constructed by anyone out of a piece of wire ami a No. 12 catheter. In a sulwequent paper I ho|>e to give a descrip- tii>n of the modiheations after 1 have made a trial of them. Dr. Kenvers showetl me a patient suffering from a cicatricial stricture caused by swallowing a corrxwiive, whom he has successfully tubed. This is tlie first case, so far as I know, that has lieen treated by a short tul>e. While I was attending Professor Krause's clinic, a [latient came with malignant stricture of the awophagns, anil was at once relieved by a short tube, which was in- serteil by Professor Krause iiimself. As to the general applicability of the method, there may Ite some difference