The record-union., 1898-01-30
SURGERY OF THE STOMACH.
HOW THE DOCTORS REGARD
SCHLATTERS OPERATION.
Climax of a Long Series of Exper1-
meuts ON Excising Portions
Of the Stomach.

Of the Stomach.
Medical science the world over mas
been aroused of late by the report OF Dr.
Carl Schlatter of the University OF Au-
rich. describing in detail how, three
months ago, he performed the unpreced-
ented operation of taking out the stom-
ach of a Swiss peasant woman, how ne
Joined the end of the oesophagus with
the beginning of the intestines and how
this woman, the first in history to 1--we
without a stomach, is not only IN 1alrly
good health to-day, but can actuahy
work about the hospital wards ana sur
fers little inconvenience. On some hands
this operation is regarded as the begin
ming of a new era in surgery, and 1t is
said that the medical theories of the past
and present regarding the necessity OF
the stomach as part of the digestive
system Will have to be revised
Even those who do mot ADMIT
this and prefer to wait Tor
the light of further experiments, call 1t
one of the most brilliant pieces of surg
cry that this end of the century has
brought forth, and have nothing but
praise for the rare technical skill ana
daring of the young German surgeon.
Only the bare facts have been told,
however, outside of the medical papers,
1.-The Medical Record" of this city,
whose Zurich correspondent, DIR. {. Z.
Wendt, of New York, sent on all the de-
tails and the London Lancet Even
these do not give all the information or
interest that this remarkable operation
brings to the fore. Dr. Schlatter's work
is one more link in the science Of Stoln-
ach surgery, which in the last twenty
years has developed greatly. DIR. Schlat-
ter, it is true, has gone much further
than any one else has dared, and he mas
proved this strange thing that the stom-
ach is a much overrated organ OF the
body: that it is not absolutely essential
to the process of digestion and that
human being can live without ii. Yet
this operation, though the greatest ever
known in stomach surgery, is but one OF
chain of operations, and is not mod
err miracle of science.
In medical archives there are many
data concerning this branch of surgery.
Large portions of the stomach have Of
ten heen removed on occasions as
much as seven-eighths of stomach
has been cut away by surgeons knife,
and the patient has survived the opera
ton, only to die in a few weeks or
months, however, in nearly every case,
as the records show. Surgical work has
gone even further than this. though
As long ago as 1878. Czerny. the Aus
trian, and his pupils, Serbia and Kaiser,
began experimenting with dogs to this
end, and they and the European scient-
lists. Pachon, Carvallo. Monassi and FIJI
ippi. took out in many instances the
stomachs OF these animals, proving that
the operation was a possible one. A
dog of CZerny, in fact, lived five years
after his stomach had been removed,
and finally, while in good health, was
destroyed for anatomical purposes. IN
this case it was found, after the dog $
death, that not quite all the stomach
had been excised a portion of the cardi-
&C, or oessophagel, end remaining, and
that this had exercised gastric func-
tiuns on small scale.
The ether dogs spoken of, however.
We're all left completely without stom-
achs, and though losing weight steadily
in some cases, continued to exist with
comfort. The German surgeon, Mon
ari, published an interesting paper on
this subject a year ago. in which he
showed that animals could live stom-
achless. and as dogs and human beings
have much the same internal structure,
it seemed as if the same would be pos
sible in the case of a man or woman.
Bilroth, the Austrian, started the
work with reference to human beings n
1881, and his operations quickly be-
came world famed. The schools Of
German and Austrian surgical science
speedily followed in his wake, Czerny,
Woeaer. Loretta, MikulisZ and Esmarch
the men that accomplished and dared
the most. 1t was found possible to re-
move more and more of the stomach
without destroying its gastric functions,
and in several instances so little of the
organ has been left that it could have
been of little practical use in digestion.
Nevertheless, the patients lived. and
the diseases for which they We're treat
ed-cancer and malignant tumors-
seemed to be arrested in their develop
ment.
In America. and more particularly in
New York, abdominal surgery has ad
vanced no less than it has on the Con-
tinent, though, with far fewer hospit-
ais under governmental management
original experimenting are not so num-
erous. Yet American surgeons are no
less skillful with their instruments. ana
just as remarkable operations are con-
tinually performed here as abroad
The men of New York who are world
famed for this sort of work are DR.
Robert f. Weir, Or. William T. Bull,
DR.. Robert Able DR.. Gerster and DR..
George F. Shardy. With them. and
even few OF the lesser surgical lights,
the operation of excising a large part
of the stomach is no new thing, and,
While not frequently done because Of
its danger. is more than possible.
A stomach is removed. in part or as a
whole, as in the SchIatter case, be-
cause of some form of malignant tumor
or obstruction to the passage of the ALI
mentary canal. which includes throat,
oesophagus. stomach and intestines. y
tumor generally grows in the pylorie or
intestinal end Of the stomach. and a
structure is in most instances located
there. In the case OF Anna Lands, The
woman whose stomach DR.. Schlatter
removed. the entir. stomach was af-
fected and complete exc.sion was nee
essary The operation Of removing a
portion of the stomach and fitting ;he
intestines into what remains, so that
the passage of food in the process of
digestion may be possible, is known as
gastronomy. the operation Of making
a new mouth into the stomach
That is done in a very curious and
interesting way That portion of the
stomach that is diseased is cut out of
fna a kot