Huber, 436; Cleft-Palate and Hare Dermatology - Wolff, 729; Diagnosis - LeFevre, 435; Diagnostic Meth- ods Sahli, 371; Dietetics - Pat- tee, 116; Digest - Abbott, 491; Dis- secting Manual - Cunningham, 22; Eczema - Brown, 494; Eye-De- Food Hutchinson, 239; Williams, Gall-Stones Moynihan, 118; Gen- Histology - Bailey, 673; Hygiene — Jurisprudence - Reese and Leffmann, Man and His Poisons-Abrams, 115; Materia Medica - Butler, 239; Cul- breth, 171; Groff, 62; Kiepe, 119; Morris, 120; Osborne, 435; Potter, 553; Mental Diseases - Barr, 375; Church and Peterson, 118; Nurse's Hand-Book Henry, 492; Nursing - орк 10-7-41 1-2 PHILLIPS' * THE BEST RE-CONSTRUCTIVE PHOSPHO-MURIATE of QUININE Registered in U. S. Patent Office, Oct. 17th, 1905. COMPOUND (Soluble Phosphates with Muriate of Quinine, Iron and Strychnia) Permanent.-Will not disappoint. PHILLIPS' Only, is Genuine. THE CHAS. H. PHILLIPS CHEMICAL CO., New York and London. THE SOUTHERN PRACTITIONER AN INDEPENDENT MONTHLY JOURNAL DEVOTED TO MEDICINE AND SURGERY SUBSCRIPTION PRICE, ONE DOLLAR PER YEAR DEERING J. ROBERTS, M.D. EDITOR AND PROPRIETOR Vol. XXVIII. NASHVILLE, JANUARY, 1906. No. 1 Original Communications. THE PRESENT STATUS OF THE SURGERY OF THE BY WILLIAM D. HAGGARD, M. D., OF NASHVILLE, TENN. THE triumphs which surgery has achieved over certain diseases of the stomach comprise one of the most useful and gratifying experiences which have crowned the efforts of our profession in the last decade. It has demonstrated anew, that, as the hand-maid of medicine, surgery is ever widening the limits of its helpfulness, and adding new lustre to its already brilliant achievements. The modern surgery of the stomach is not more than four or five years old, and in its more perfected aspect it is only half that old. Abstract of the Address on Surgery before the Mississippi Valley Medical Association at Indianopolis, October 16, 17, 18, 1905. Its results, judged by statistics before that time, are not comparable to its present accomplishments, and the oft-repeated reference to its "frightful mortality" should give place to the recognition of its present surprisingly low death-rate. Improved technique, low mortality, and satisfactory end results will inevitably do away with the empirical treatment of occult intractable stomach troubles. Operating-room demonstration of pathology in vivo is impressing the easy mechanical relief of these lesions. A closer intimacy with living pathology will instill the lesson which we have learned so well in other portions of the body, where the golden opportunity is no longer permitted to slip away. The typical indication for operative interference is obstruction of the pylorus from an open or cicatrized ulcer causing dilatation of the stomach with stasis of food. The short-circuiting operation of gastro-enteric anastomosis finds its ideal indication here, and has given most beneficent results. The complications of ulcer requiring operation are: 1. Perforation. 2. Hematemesis of chronic ulcer. Hemorrhage from an acute ulcer is rarely fatal, and is usually amenable to dietetic treatment. Operation is advised in repeated acute hemorrhage or in constantly recurring small hemorrhages. Other indications are found in the following groups of cases: 3. Obscure and persistent stomach symptoms, with a long history of dyspepsia culminating in hemorrhage after it has been controlled by medical means and the patient put in the proper condition for operation (Cabot). 4. Cases of chronic intractable dyspepsia, even without dilatation, which fail to yield to proper medical treatment and are not due to general visceral ptosis. Waterhouse says that unless definite improvement manifests itself after three months of medical treatment of chronic ulcer, or all serious symptoms have not disappeared after six months |