File:Interstate medical journal (1917) (14596966920).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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on of the divided endsand with preservation of the ileocolonic sphincter. Similarly humanileostomy cases, as Lynch and MacFarland7 maintained, do revealinhibitory control in the reduction of and in the solidification ofthe contents discharged from the ileac stoma. These observationsserve to indicate the significance of the iliocecum as an importanttone-relay center. It is unnecessary to refer to the rich lymphatic 12 INTERSTATE MEDICAL JOURNAL connections of the end-ileum which establish it as a vital absorp-tive medium. Functionally, this junction of the small and the.largebowel appears almost indispensable for the welfare of the individual. SURGICAL CONSTIPATION. Surgical constipation implies any obstruction, dynamic or ady-namic, of the terminal small or of the large intestine in which sur-gical intervention is indicated. Due to Lanes enthusiasm, interestis particularly manifested of late years in the obscure adynamicobstruction of the colon. As a result, two schools have arisen—
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Fig. 2.—Diagram illustrating Lardennois method of subcecal colectomy. Noteportion of large intestine preserved (cecum) and portion removed. the mechanists, championed by Lane, who ascribe all stasis toobstructing bands or kinks, and the laboratory clinicians, repre-sented by Keith, Alvarez, and our own laboratory, who are em-phasizing the physiological impairment of the neuromusculature inthese difficult intestinal cases. This latter hypothesis is in accord-ance with what has been said above concerning the ileocecal valve,explains many of the ill results when the valve has been sacri-ficed, and accounts for the pathological findings in many of thecolons resected. INTERSTATE MEDICAL JOURNAL 13 OPERATIVE TREATMENT. Operations of intestinal resection involving the ileocecum may bedivided into three classes as follows: 1. Colectomy, partial or complete, including the sphincter. 2. Colectomy, partial or complete, with the preservation of theileum, sphincter, and cecum. 3. Colectomy, part

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