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About Medford mail tribune. (Medford, Or.) 1909-1989 | View Entire Issue (June 13, 1963)
1 THURSDAY. JUNE 13. 1963 MEDFOrD MAIL TRIBUNE. MEDFORD. OREGON Tho Medical Roundup ftt Cmtnuu Cm 0 nnftlltant tn Mtdlelnt lyo cnnit Emarilus Pro(eoi or sudicint Mayo Clinic (Rtfitur and Trlbun SyndlcaU. mi) Intestinal Obstruction It 1 very Important that people, and especially older people, quickly recognize the eariy my mr to mi of intes- tinal obstruc tion. Usually there is severe a b d o m inal pain, perhaps likeawoman'f at labor pains, five minuate intervals-per- wa naps eacn pain ending in a gurgle. There may be nausea and perhaps vom iting, and perhaps an inabil ity to pass gas or to move the bowels. 'Because the commonest cause of obstruction is an ad' hesion, intestinal obstruction is much more likely to occur in a person who has had an abdominal operation than In a person who never had one. A common cause of intestinal obstruction Is a rupture in the groin that has come down and won't go back. Another cause is an adhesion formed after an appendix ruptured. Sometimes a person can feel that the bowel is blocked; and every few minutes a wave of contraction presses down against the obstruction. Often times the abdomen gets dis tended with gas. The person may soon become toxic and dull, and his pulse rate will become rapid. Occasionally there ii some bloody diarrhea. Eventually the person can go into state of shock. An X-ray film made of the abdomen often shows great dilation of part of the bowel with gas. The diagnosis is harder to make when the person is very stout. Possible at Any Time Intestinal obstruction can take place at any time in a person's life, from infancy to old age. The diagnosis must be made quickly if the person's ' life is to be saved. An impor tant factor in making the diag nosis may be that the person was kept awake all night with intermittent pains. A patient with such a story should be taken immediately to a hos pital. There one of the first things the surgeon may do la to put a tube into the stomach so as to suck air out of that or gan. When there la an enor mous amount of gas in the right side of the colon, a small incision may be made through the abdominal wall and into the colon. The removal of much gas can save the per sons lite. - It is important to give fluid through Uiu veins-fluid to re place the large amount lost by vomiting. It helps in these cases to give an antibiotic, be cause this lowers the death rate. The dunger is great when the bowel is, as we phy sicians say, strangulated, This means that blood Is not able to get into a segment of bowel that is perhaps twisted. Some times then at operation, the bloodless segment of bowel is found black and dead, and it must be removed. Drs. Zollinger, Kiruey and Grant, of the Ohio SUte Uni versity at Columbus, recently wrote about operating on in testinal obstructions. As the doctors said, in spite of all their efforts, whenever a bow el was strangulated, 1 in 3 ol the patients died. The mortal ity rate is doubled if the dlug nosis and treatment are de layed tor more than 24 hours, In two-thirds of those cases in which the patient failed to re cover, he or she had not been placed in the hands of a sur geon quickly enough. Obstruc tions due to cancer of the bowel are very dangerous to life. Didn't Rtallie Sometimes a woman loses her life with an intestinal ob struction because for months or years she had-in a way. been crying wolf about a pain due to nervousness, or an ir ritable bowel. As a result, when her bowel became ob structed, her physician did not realize that at last she had a very severe and different pain which called for an immed iate operation. Of the 311 cases of obstruc tion of the small bowel stud ied by Dr. Zollinger and his associates, adhesions caused 65 per cent; a hernia (rup ture) of some kind caused 13 per cent; a tumor in the bowel caused 12 per cent; and sev eral other rare conditions caused the remainder. The mortality rate of 10 per cent was really excellent. Years ago, when I was an in tern in a big city hospital, the - mortality rate must have been nearly SO per cent. One rea son why intestinal obstruction is so commonly fatal Is that in more than half of the cases, the patients were over 60 years of age. Such persons cannot so easily stand the se vere shock of an Intestinal obstruction. fort can be caused by what commonly Is called colitis. If you'd like Dr. Alvarez' book' let which fully explains coll tis, send 23 cents and a self -addressed, stamped en velope with your request for it to Dr. Walter C. Alvarez, Dept. MMT, Box 957, Des Moines 4, Iowa. Trendelenberging May Be Detrimental In Cases of Shock Br DELOS SMITH UPI Science Editor New York -l!PU- The Tren delenberg position is neither a wrestling technique nor a chess gambit, but a posture which sur geons have long favored for certain pa- . , ... , y, t Vl i n e n i a ana I 1 V ' which now is I 1." LJ- f 'under scien- i tine attack ,-4 after some 70 y e a r s of re spectability. When you have been Trendelenberged your feet are higher than your head is - you're lying down but you're tilted 43 degrees off 8, Uiloi smith the horizontal. This is the heads-down position taught in medical schools and even to lay-people taking first - aid courses. It is supposed to help the body to stave off the life threatening consequences of a suddenly lowered blood pres sure and of shock in general. The attacker is Dr. Max H. Weil of the University of Southern California, Los An geles, who has devoted years to the study of shock. He and his research asso ciates titlted scores of mice and rats, since you can not properly subject people to such an indignity without reason. These animals were required to live for 48 hours with their heads either ele vated or lowered from the horizontal, to demonstarte that in normal circumstances neither position did any harm to rodent health Then the scientists imposed physiological shock on them, with suddenly lowered blood pressure and the other ill con sequences. The scientists did it by injecting various sub stances. One was a normal body chemical which is in volved in massive allergic shock. Another was a bac terial poison which also causes shock In people. A third was a sedative that in overdoses is fatal. The idea was to find out which rodents withstood shock best - those with heads down, those with heads up or those who were in the true horizontal. The horizontals fared the best by a wide margin. In Weil's words, the alleged helpfulness of the Trendelenberg position "was excluded with very high sta tistical confidence." In his report to the Ameri can College of Surgeons, he said Trendelenberging might effectively restore conscious ness to a person who had fainted or it could be useful in the first moments of shock following the loss of blood. It will usually cause a small in crease in blood pressure but only because the arms are lower than the heart, he said. But in patients with pro longed lowered blood pressure it may well delay recovery, he said. It prevents a return of normal reflexes and the con tents of the abdominal cavity fall against the diaphragm and decrease lung volume. The Trendelenberg position was Improvised by the cele brated 19th century German Surgeon, Dr. Friedrich Tren delenberg (1844-1924) to fa cilitate certain surgical pro cedures. During World War I it came into widespread use as a means of combatting sur gical shock. It is reasoned that when the head is down venous blood returns more rapidly to the heart and there may be better blood flow to the brain. "To our knowledge such effects have not been demonstarted," Weil commented. The science of surgery should re-evaluate Trendelen berging completely because "its prolonged use is not necessarily associated with in creased survival but may, in fact, be detrimental." What a treat for every occasion! llyfelCE CREAM Lower abdominal discom- "Meat Makes the Meal" -The Best for Less at Tfmnrfefr COMPARE OUR EVERYDAY LOW PRICES WITH SO-CALLED DISCOUNT PRICES Fresh dressed "tender grown" plump, meaty birds. Always a winner for that Sunday dinner. ft-.." A .'All. J. ..rV M h tr. M-E PrraM8r'(? T)OS!pIUp f))PP Sliced BacoiffiS145a. - 2 fc 89c Bacon Ends & Pieces. 89e Polish Rings 35'.. 2. 69e Swift Premium fancy milk-fed calves at the peak of perfection! Veal Sho. Chops 59 Veal Sho. 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