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Instruments left in the peritoneal cavity
REVIEWS
AND
Cooke: A Study of the Factors Influencing ~~ecOlogic Laparotomies. The American Cooke deals with the problem by standardizing the selection of ness of operation, postoperative crease from 1.00 per cent to 0.75 of 0.75 per cent to 0.11 per cent 400 laporatomies where all rules
743
ABSTRACTS Mortality Journal
and Morbidity Following of Surgery, 192.7, iii, 473.
of mortality and morbidity following laparotomy cases, preoperative preparation, speed, and gentleHe was able to show a mortality decare, etc. per cent where speed was reduced, and a decrease where gentleness was practiced. In a series of were observed the mortality rate was nil. WILLIAM KERIVIN.
White, Cword: Instruments Left in the Peritoneal Cavity. Journal tries and Gynecology of the British Empire, 1523, xxx, 601.
of Obstet-
Immediate removal, the patient’s condition permitting, is the best treatment for foreign bodies left in the abdominal cavity at operation. If removal at once is impossible or the loss of the instrument is not noted there seems to be no grave risk from a few days delay. A blood soaked sponge is more likely to The use of long .cause the rapid onset of peritonitis than a solid instrument. gauze rolls reduces the likelihood of this accident. The fewer instruments, particularly small instruments, used in an operation the less common is acciddnt. Towel clips should be replaced by sutures. Twenty-nine of 44 foreign bodies left in the abdomen were artery forceps. Eleven of the 44 patients died. In seven of nine fatal cases the foreign body had been in the abdomen at least a year. Of the 33 cases recovering, the foreign body was removed at a second operation in 26. This operation was done within a few hours in five cases, within 48 hours in four, within a few weeks in eight cases and after six months in the remaining 16. II. W. SHUT?YER.
Miscellaneous Worthington, Hygiene,
George 1925, xi,
E.: 257.
Compulsory
Sterilization
Laws.
Journal
of
Social
Sterilization bills have been passed by sixteen states from March 30, 1905, to January 1, 1925. In seven states these laws were declared to be unconstitutional, and in other states the laws have been practically unused. The three general types of sterilization laws are given as punitive, therapeutic, and eugenic. Legislation for sterilization is not considered as a practical measure at tile present time. Dr. Fernald has shown that only 50 per cent of feeble-minded owe their defect to heredity, the rest being due to accidents of birth or infectious disease during the first two years of life. There is no proof that the 50 per cent of defective8 transmit this condition to their offspring. The modern psychiatrist thinks of feeble-mindedness as a complex problem. Segregation would be unwise economically as well as socially. Legal objections to sterilization laws are that (1) they are in advance of public opinion; (2) violate the bill of rights contained in our federal and state constitutions ; (3) that there is no adequate legal classification sticiently describing persons who should be subject to compulsory sterilization; (4) compulsory sterilization of defective degenerates will prevent their segregation in institutions. Arguments in favor of sterilization are: (1) Socially inadequate persons are a menace to the next generation. (2) The protection to future generations provided by compulsory sterilization is a sound public policy. (3) The right and duty of self defense apply to nations as well as to individuals, and nations must defend
AND
Cooke: A Study of the Factors Influencing ~~ecOlogic Laparotomies. The American Cooke deals with the problem by standardizing the selection of ness of operation, postoperative crease from 1.00 per cent to 0.75 of 0.75 per cent to 0.11 per cent 400 laporatomies where all rules
743
ABSTRACTS Mortality Journal
and Morbidity Following of Surgery, 192.7, iii, 473.
of mortality and morbidity following laparotomy cases, preoperative preparation, speed, and gentleHe was able to show a mortality decare, etc. per cent where speed was reduced, and a decrease where gentleness was practiced. In a series of were observed the mortality rate was nil. WILLIAM KERIVIN.
White, Cword: Instruments Left in the Peritoneal Cavity. Journal tries and Gynecology of the British Empire, 1523, xxx, 601.
of Obstet-
Immediate removal, the patient’s condition permitting, is the best treatment for foreign bodies left in the abdominal cavity at operation. If removal at once is impossible or the loss of the instrument is not noted there seems to be no grave risk from a few days delay. A blood soaked sponge is more likely to The use of long .cause the rapid onset of peritonitis than a solid instrument. gauze rolls reduces the likelihood of this accident. The fewer instruments, particularly small instruments, used in an operation the less common is acciddnt. Towel clips should be replaced by sutures. Twenty-nine of 44 foreign bodies left in the abdomen were artery forceps. Eleven of the 44 patients died. In seven of nine fatal cases the foreign body had been in the abdomen at least a year. Of the 33 cases recovering, the foreign body was removed at a second operation in 26. This operation was done within a few hours in five cases, within 48 hours in four, within a few weeks in eight cases and after six months in the remaining 16. II. W. SHUT?YER.
Miscellaneous Worthington, Hygiene,
George 1925, xi,
E.: 257.
Compulsory
Sterilization
Laws.
Journal
of
Social
Sterilization bills have been passed by sixteen states from March 30, 1905, to January 1, 1925. In seven states these laws were declared to be unconstitutional, and in other states the laws have been practically unused. The three general types of sterilization laws are given as punitive, therapeutic, and eugenic. Legislation for sterilization is not considered as a practical measure at tile present time. Dr. Fernald has shown that only 50 per cent of feeble-minded owe their defect to heredity, the rest being due to accidents of birth or infectious disease during the first two years of life. There is no proof that the 50 per cent of defective8 transmit this condition to their offspring. The modern psychiatrist thinks of feeble-mindedness as a complex problem. Segregation would be unwise economically as well as socially. Legal objections to sterilization laws are that (1) they are in advance of public opinion; (2) violate the bill of rights contained in our federal and state constitutions ; (3) that there is no adequate legal classification sticiently describing persons who should be subject to compulsory sterilization; (4) compulsory sterilization of defective degenerates will prevent their segregation in institutions. Arguments in favor of sterilization are: (1) Socially inadequate persons are a menace to the next generation. (2) The protection to future generations provided by compulsory sterilization is a sound public policy. (3) The right and duty of self defense apply to nations as well as to individuals, and nations must defend