摘要:

In pursuing the study of this subject it is necessary to divest the mind of all preconceived ideas bearing upon it and to note carefully every individual circumstance, however contrary it may appear to one's expectations and desires. One great difficulty is the unreliability of the patient. Pain of the most excruciating kind leaves in the mind but a very imperfect recollection of its exact site. In all cases the description of the pain prior to examination should be received with great caution, and instructions given to note accurately the exact site during an exacerbation or recurrence. In the latter case trustworthy accounts can generally be received even when the observer is not present.I must confess I have also found it necessary to put a control on my own observations, by having them verified by a colleague. In making my observations I invariably had the most striking and important cases examined independently. Such phenomena as my colleagues could not verify I rejected, for if these sensory symptoms are to be of value they must be capable of being elicited by observers free from bias. And further, cases should not be recorded based upon recollections alone, for it is wonderful how far from the truth memory may wander, when there is a favourite theory to be advanced.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03642.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03643.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

摘要:

Summary1The etiology of post‐traumatic pain states (causalgic syndromes) is reviewed. Evidence favours: (a) The production, by a peripheral focus of injury in a nerve, of sustained discharges from cord neuron pools. These would result in widespread pain, with sensory, motor, sympathetic and trophic disturbances. (b) Fibre interaction between sympathetic or other efferents and the somatic afferent fibres, at the site of injury, feeding the irritable internuncial neuron pool.2Twenty‐one cases of various types of syndrome are described and classified. Aching, as well as burning pains, occurs in both major and minor causalgias and in painful amputation stumps. Transitions from one pain type to another are recorded.3No single Fiurgical approach will afford relief in all cases of causalgia. In thisseries five patients were permanently relieved by local infiltration of procaine into tender areas or the sympathetic chain. The others required neurotomy, sympathectomy or chordotomy. Only two of eight patients in whose treatment sympathectomy was employed had permanent relief.4Causalgia as a complicafion of elective surgical procedures involving nerves or spinal cord was encountered in five ca

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03644.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

摘要:

SummarySome instruments are described for intraabdominal resection and anastomosis of the rectum in the obese patient.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03645.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03646.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03647.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

摘要:

SummaryOn a basis of six cases segmental pulmonary resection is found to be eminently practicable at least as far as the middle lobe, lingula, apical or first dorsal and lower basal segments go. Convalescence on the whole has been good to excellent. In three of the cases post‐operative bronchograms show healthy bronchi in the portions conserved, but no late results are available.The principle of securing bronchus and vessels and then peeling the segment off through an avascular plane has also been applied with success in lobectomy in cases with poor or absent fissure

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03648.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

摘要:

SummaryFrom a study of the lymphatic spread in a series of patients with carcinoma of the rectum who were alive and well five years after abdomino‐perineal, perineo‐abdominal or synchronous combined excision of the rectum, it is concluded that the continued and more frequent use of restorative resections of the rectum is justif

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03649.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03650.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1949.tb03651.x

出版商:Blackwell Publishing Ltd    

年代:1949

数据来源: WILEY