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CONGRESS OF THE INTERNATIONAL SOCIETY OF SURGERY.
778
registered on the roll of midwives. In these conditions naturally a number of untrained and ignorant women are practising in various parts of the country as certificated midwives. As time goes on the number of these women will gradually diminish and their places will be taken by properly trained women who have passed the examinations of the Central Midwives Board. It is difficult to see how any other solution of the problem could have been arrived at without a grave injustice being done to certain competent midwives and without depriving the public of a form of necessary assistance. The Board has, of course, the power necessary to take off the roll the name of anyone who is found to be unfitted or who is convicted of negligence, and no doubt will do so in the case of the midwife in this instance if it finds the views of the coroner and his jury just.
stomach. Mr. MayoRobson will deal with the subjects’ of simple ulcer, haemorrhage, adhesions of the stomach to adjoining organs or to the abdominal parietes, perforation, hour-glass contraction, tetany of gastric origin,
dilatation,
gastroptosis,
acute
phlegmonous
gastritis,
stenosis of the pylorus, injury of the stomach, hyperchlorhydria, and persistent gastralgia. Dr. Rotgans will confine himself entirely to gastric ulcer and its complications. He recommends operative treatment when the movements of the stomach are interfered with by conditions such as excessive peristalsis, vomiting, hypertrophy of the wall of the stomach, and retention of its contents. In such cases the cause is usually mechanical-namely, stricture of some part of the stomach or the existence of adhesions. The cause may also consist in troubles dynamo-moteurs, conditions in which the above-mentioned mechanical defects do not exist and gastroptosis is the only anatomical coraTHE BATHS AT HARROGATE. plication. He would also operate in cases of severe pain, AN important addition to the bathing facilities attumours, hæmorrhage, perforation, and emaciation. Dr. Harrogate has recently been completed by the installationMattoli will discuss the surgical treatment of gastroptosis, of the necessary appliances for the carrying out of the pyloric stenosis, circular perforating ulcer, and several other treatment which has hitherto been almost entirely asso- gastric abnormalities. The official languages of the Congress Inare English, French, German, and Italian. During the ciated with the French spa, Plombieres-les-Bains. THE LANCET of April 30th, 1904, p: 1186, we published proceedings a general meeting will be held to appoint the International Committee, to fix the next place of meeting, a paper by Dr. de Langenhagen on the Treatment of and to elect a president. We understand that the Belgian Muco-membranous Colitis in which the methods adopted Rectal irriga-committee will send invitations to fetes in honour of foreign at Plombieres are set forth in detail. tions when properly carried out are without doubt verymembers of the society on hearing from them. Intimations valuable in the condition described by Dr. de Langen-should be sent direct without delay to the general secretary, and also in other diseases of the intestinal Dr. Depage, 75, Avenue Louise, Brussels.
hagen
as catarrhal enteritis and intestinal lithiasis. The treatment has also been recommended for appenTHE SURGEON’S RESPONSIBILITY FOR THE dicitis and in cases of doubtful diagnosis a " hydroDETAILS OF AN OPERATION. mineral cure" may often be tried with advantage. Dr. de A MODERN surgical operation in many instances demands Langenhagen is of opinion that the "intestinal bathing"on the part of the surgeon not only a high degree of should be considered as a real internal dressing"of the manipulative dexterity but also in a considerable measure mucous membrane, and he therefore claims that rectalthe power of organisation. The details of the preparation irrigation is suitable not only in cases of colitis with of the patient, of the dressings, instruments, ligatures, and constipation but also in those cases in which there are so on, take up a good deal of time and require special knowalternations of constipation and of diarrhoea or in cases of ledge, and it may be impossible for the really busy surgeon chronic diarrhoea. Many patients who cannot from financial to attend personally to all these matters. It is true that of or private circumstances proceed to a continental spa can recent years with the gradual replacement of antisepsis by and will go to one in England. This latest addition, then, asepsis these details have been a good deal simplified, but to the baths of Harrogate is likely to prove a most useful the danger to the patient where asepsis is practised is all one and the corporation of Harrogate may be congratulated the greater if by chance any of the procedure is not carried on the enterprise which has just been completed. out with scrupulous accuracy. Whether the surgeon looks after these things himself or is compelled from the pressure CONGRESS OF THE INTERNATIONAL of work to intrust them to others there can be no question OF SURGERY. but that he must be held responsible in the case of any AT the first Congress of the International Society ofaccident occurring. If he has any doubt as to the capability his nurses then it is his duty to see that their work is < Surgery, which will be held in Brussels from Sept. 18th to of 23rd, one of the subjects for discussion will be the Surgical properly supervised and checked. If he does not give clear ] Treatment of Non-Cancerous Affections of the Stomach. Theand definite instructions—and whenever it is possible these discussion will be opened by Dr. A. Monprofit, professorsshould be written-then he is alone to blame if his orders are of clinical surgery in the Medical School of Angers in not executed in their entirety. In hospital practice it is France ; Mr. A. W. Mayo Robson, Vice-President of the (obvious that much must be left to resident officers and Royal College of Surgeons of England ; Dr. J. Rotgans of nurses, but even here it is the duty of the surgeon to inquire Amsterdam ; and Dr. A. Mattoli of Rome. From abstractsfrom time to time into the manner in which these duties of the forthcoming addresses, published by the secretary ofare performed. There is always a tendency on the part of the Congress, it appears that Dr. Monprofit will include in 1the most conscientious man or woman, although inspired his remarks the operations of puncture of the stomach ,with the best intentions, to become a little careless in the through the abdominal wall, paragastric exploratory performance of duties which are of the nature of a routine 1 be carried on quite without superv i,ion. It would seem laparotomy, extragastric and intragastric dilatation of to the pylorus, pyloroplasty, exploratory gastrotomy, gastror- hardly necessary to call attention to such an obvious truth, 1 from time time instances occur in which a surgeon, rhaphy, curetting and cauterisation of gastric ulcers, gastro- but J human fallibility, has trusted too much to others stomy, partial gastrectomy in various situations, gastro- forgetting plasty, gastropexy, gastro-anastomosis, anagastrostomosis,and has neglected to overlook properly their subordinate total gastrectomy, and gastro-enterostomy. This last is work, with disastrous results to the patient. A great the operation which he considers to be the most ]responsibility rests upon every surgeon with regard to all, applicable in the majority of these diseases of theeven the minutest, details of an operative procedure, no
tract, such
SOCIETY
to
registered on the roll of midwives. In these conditions naturally a number of untrained and ignorant women are practising in various parts of the country as certificated midwives. As time goes on the number of these women will gradually diminish and their places will be taken by properly trained women who have passed the examinations of the Central Midwives Board. It is difficult to see how any other solution of the problem could have been arrived at without a grave injustice being done to certain competent midwives and without depriving the public of a form of necessary assistance. The Board has, of course, the power necessary to take off the roll the name of anyone who is found to be unfitted or who is convicted of negligence, and no doubt will do so in the case of the midwife in this instance if it finds the views of the coroner and his jury just.
stomach. Mr. MayoRobson will deal with the subjects’ of simple ulcer, haemorrhage, adhesions of the stomach to adjoining organs or to the abdominal parietes, perforation, hour-glass contraction, tetany of gastric origin,
dilatation,
gastroptosis,
acute
phlegmonous
gastritis,
stenosis of the pylorus, injury of the stomach, hyperchlorhydria, and persistent gastralgia. Dr. Rotgans will confine himself entirely to gastric ulcer and its complications. He recommends operative treatment when the movements of the stomach are interfered with by conditions such as excessive peristalsis, vomiting, hypertrophy of the wall of the stomach, and retention of its contents. In such cases the cause is usually mechanical-namely, stricture of some part of the stomach or the existence of adhesions. The cause may also consist in troubles dynamo-moteurs, conditions in which the above-mentioned mechanical defects do not exist and gastroptosis is the only anatomical coraTHE BATHS AT HARROGATE. plication. He would also operate in cases of severe pain, AN important addition to the bathing facilities attumours, hæmorrhage, perforation, and emaciation. Dr. Harrogate has recently been completed by the installationMattoli will discuss the surgical treatment of gastroptosis, of the necessary appliances for the carrying out of the pyloric stenosis, circular perforating ulcer, and several other treatment which has hitherto been almost entirely asso- gastric abnormalities. The official languages of the Congress Inare English, French, German, and Italian. During the ciated with the French spa, Plombieres-les-Bains. THE LANCET of April 30th, 1904, p: 1186, we published proceedings a general meeting will be held to appoint the International Committee, to fix the next place of meeting, a paper by Dr. de Langenhagen on the Treatment of and to elect a president. We understand that the Belgian Muco-membranous Colitis in which the methods adopted Rectal irriga-committee will send invitations to fetes in honour of foreign at Plombieres are set forth in detail. tions when properly carried out are without doubt verymembers of the society on hearing from them. Intimations valuable in the condition described by Dr. de Langen-should be sent direct without delay to the general secretary, and also in other diseases of the intestinal Dr. Depage, 75, Avenue Louise, Brussels.
hagen
as catarrhal enteritis and intestinal lithiasis. The treatment has also been recommended for appenTHE SURGEON’S RESPONSIBILITY FOR THE dicitis and in cases of doubtful diagnosis a " hydroDETAILS OF AN OPERATION. mineral cure" may often be tried with advantage. Dr. de A MODERN surgical operation in many instances demands Langenhagen is of opinion that the "intestinal bathing"on the part of the surgeon not only a high degree of should be considered as a real internal dressing"of the manipulative dexterity but also in a considerable measure mucous membrane, and he therefore claims that rectalthe power of organisation. The details of the preparation irrigation is suitable not only in cases of colitis with of the patient, of the dressings, instruments, ligatures, and constipation but also in those cases in which there are so on, take up a good deal of time and require special knowalternations of constipation and of diarrhoea or in cases of ledge, and it may be impossible for the really busy surgeon chronic diarrhoea. Many patients who cannot from financial to attend personally to all these matters. It is true that of or private circumstances proceed to a continental spa can recent years with the gradual replacement of antisepsis by and will go to one in England. This latest addition, then, asepsis these details have been a good deal simplified, but to the baths of Harrogate is likely to prove a most useful the danger to the patient where asepsis is practised is all one and the corporation of Harrogate may be congratulated the greater if by chance any of the procedure is not carried on the enterprise which has just been completed. out with scrupulous accuracy. Whether the surgeon looks after these things himself or is compelled from the pressure CONGRESS OF THE INTERNATIONAL of work to intrust them to others there can be no question OF SURGERY. but that he must be held responsible in the case of any AT the first Congress of the International Society ofaccident occurring. If he has any doubt as to the capability his nurses then it is his duty to see that their work is < Surgery, which will be held in Brussels from Sept. 18th to of 23rd, one of the subjects for discussion will be the Surgical properly supervised and checked. If he does not give clear ] Treatment of Non-Cancerous Affections of the Stomach. Theand definite instructions—and whenever it is possible these discussion will be opened by Dr. A. Monprofit, professorsshould be written-then he is alone to blame if his orders are of clinical surgery in the Medical School of Angers in not executed in their entirety. In hospital practice it is France ; Mr. A. W. Mayo Robson, Vice-President of the (obvious that much must be left to resident officers and Royal College of Surgeons of England ; Dr. J. Rotgans of nurses, but even here it is the duty of the surgeon to inquire Amsterdam ; and Dr. A. Mattoli of Rome. From abstractsfrom time to time into the manner in which these duties of the forthcoming addresses, published by the secretary ofare performed. There is always a tendency on the part of the Congress, it appears that Dr. Monprofit will include in 1the most conscientious man or woman, although inspired his remarks the operations of puncture of the stomach ,with the best intentions, to become a little careless in the through the abdominal wall, paragastric exploratory performance of duties which are of the nature of a routine 1 be carried on quite without superv i,ion. It would seem laparotomy, extragastric and intragastric dilatation of to the pylorus, pyloroplasty, exploratory gastrotomy, gastror- hardly necessary to call attention to such an obvious truth, 1 from time time instances occur in which a surgeon, rhaphy, curetting and cauterisation of gastric ulcers, gastro- but J human fallibility, has trusted too much to others stomy, partial gastrectomy in various situations, gastro- forgetting plasty, gastropexy, gastro-anastomosis, anagastrostomosis,and has neglected to overlook properly their subordinate total gastrectomy, and gastro-enterostomy. This last is work, with disastrous results to the patient. A great the operation which he considers to be the most ]responsibility rests upon every surgeon with regard to all, applicable in the majority of these diseases of theeven the minutest, details of an operative procedure, no
tract, such
SOCIETY
to