AlexG. R Foulerton
1889 The Lancet  
Here, then, the operation was urgently called for. In my three cases each were in extremis; there were nausea and vomiting, absolute constipation, tongue coated, all appetite lost, and pulse enfeebled, and extreme emaciation; great torture endured in any attempt to obtain an evacuation, which became impossible. The three patients were actually on the point of death. I submit that in these cases the urgency for relief was so great-for, as is usually found, any proposal of operation at an early
more » ... ation at an early stage is put off by patients, and their sanction is not obtained until all hopes are given up-that to carry out my colleague's "novel method," and to await a further "four or five" days before an evacuation could be induced or the passing of flatus possible, and little or no food administered, would, in my small experience, jeopardise any chance of recovery for the patient. Although these cases were in extremis at the time of operation, all made a good and rapid recovery and increased in flesh, and two now present an admirable appearance; one has since died. I therefore demur that the "novel method " is at all times applicable in advanced cases of malignant disease of the rectum. I am, Sirs, yours faithfully, F. A. PURCELL, M.D., M.Ch. Manchester-square, Dec. 8th, 1889.
doi:10.1016/s0140-6736(02)12183-0 fatcat:kws3bldf4nbjjfjqimmj6u2wx4