File:Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value (1910) (14594538788).jpg

Identifier: bismuthpasteinch00beck (find matches)
Title: Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value
Year: 1910 (1910s)
Authors: Beck, Emil G., 1866-1932
Subjects: Bismuth
Publisher: St. Louis, C. V. Mosby company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ons. Thereafter patient spent ayear of perfect health in Colorado. Upon her return to Chicago shedeveloped a large abdominal exudate and lost considerably in weight;ophthalmo reaction was positive. Exploratory laparotomy was per-formed by Dr. Carl Beck (my brother). The abdomen was studdedwith thousands of tubercles, and both Fallopian tubes were thick andtuberculous. He removed both tubes and closed the abdomen; pri-mary union took place. Six weeks later the scar reopened and dis-charged a quantity of cheesy material and pus. The sinuses showedno tendency to closure, and the bismuth injections were then instituted. 116 BISMUTH PASTE IN CHRONIC SUPPURATIONS. In the radiograph (Fig. 45) we can plainly trace the path of the sinusto the original focus in the region of the tubes. After one monthstreatment with paste injections the sinus closed, and patient is now ingood health. Although the final result in these last two cases is verysatisfactory, I advise the most extreme conservatism in
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Pig. 45. Sinus following tuberculous peritonitis after removal of the adnexa. the use of the paste in this class of cases, and would limitits use to those cases in which a fistula remains after aradical operation, barring the hopeless cases, such as Ihave cited in the beginning of this chapter. SINUSES FOLLOWING CERTAIN OPERATIONS. 117 Post-Operative Abdominal Fistula of Pyogenic Origin. Nine cases of this variety were treated with bismuthpaste. This series does not include post-operative fecalfistulae, which are considered separately in another chap-ter. The sinuses in the above nine cases were of fromtwo months to three years duration, all resulting fromdrainage following abdominal operations. In eight ofthese nine cases the treatment was effective, requiringfrom one to thirty injections for their closure; in the re-maining case the bismuth treatment produced no effect. The usual technic was applied in their treatment. Ishall cite the case in which the treatment failed, becausewe ca

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