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October 17, 1914

ANOCI-ASSOCIATION IN RELATION TO OPERATIONS ON THE GALL BLADDER AND STOMACH

JAMA. 1914;LXIII(16):1335-1337. doi:10.1001/jama.1914.02570160001001
Abstract

In reviewing the records of 893 operations on the biliary tract and 331 operations on the stomach performed by my associates, Dr. Bunts and Dr. Lower, and myself, together with those performed by other surgeons at the Lakeside Hospital, we find that the clinical course of certain patients after gastric resections and after common-duct operations is similar in many respects. At the time of operation pulse and temperature are normal, but the patient is emaciated and sallow in appearance; his vitality is much reduced; his demeanor is melancholic and he is alternately possessed by hope and despair. After the operation his downward course and exit strikingly resemble the sinking and disappearance of the unwary traveler who has been trapped by quicksand.

Statistics show that no clinic has ever reduced the mortality rate of any considerable series of resections of the stomach below 10 per cent., and the mortality rate of

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