File:A new manual of surgery, civil and military (1917) (14579983780).jpg

Identifier: newmanualofsurge00ochs (find matches)
Title: A new manual of surgery, civil and military
Year: 1917 (1910s)
Authors: Ochsner, Albert J. (Albert John), 1858-1925 Percy, Nelson M. (Nelson Mortimer), b. 1875
Subjects: Surgery
Publisher: Chicago, Cleveland Press
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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>- M\ 1 V j- Ptlorectomt with Partial Gastrectomt. Showing ligation of lesser and greater omentum, also application of clamps to duodenumand to stomach. Also circular and end-sutures of duodenum in place.(From original drawings by Dr. W. J. Mayo.) to sixty ounces a day, usually twenty to thirty ounces every twelve hours,for two days previous to the operation. This is continued for several daysfollowing operation if necessary. In these dehydrated patients it is almostimpossible to get sufficient fluids into them in any other manner. For sub-cutaneous infusions we prefer the ordinary Davidson syringe, to which Iattach an aspirating needle. The hand bulb enables nice regulation of the 496 SURGERY OF THE ESOPHAGUS AND STOMACH inflow. The whole can be boiled and the infusion given by a nurse as easilyas an enema. In debilitated patients very little anesthetic is used, justenough to enable the surgeon to open and close the abdomen. All of the
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Pylorectomy with Partial Gastrectomy for Carcinoma of Pylorus. Showing manner of closing end of pylorus and stomach, also ligation of all vessels.(From Dr. W. J. Mayos original drawing.) visceral work can be done without pain. The previous exhibition of morphiakeeps the patient from becoming nervous. An enema of six ounces of coffee is given as soon as the patient is put tobed. If necessary morphia, strychnine and so forth are exhibited. The after-treatment is simple, the head and shoulders of the patient are SURGERY OF THE ESOPHAGUS AND STOMACH 497 raised by four or five pillows, rectal alimentation is instituted, hot water bymouth, after twelve hours, in tablespoon doses, increased to an ounce everyhour. After thirty-six hours the usual experimentation with liquid foods isbegun. To recapitulate, there are six important stages to the operation as out-lined :

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