The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1932-09-03
THE ECONOMY OF ANIBULANT
TREATMENT

Within the last 10 eyars progress
sivc physicians have developed salts
factory technic for the ambulant
treatment Of several conditions which
formerly required disqualification and
confinement to bed for periods of days
or weeks. BY ambulant treatment
we mean treatment which is success
fully employed while the patient
keeps at his ordinary work or activi-
ties. First came the injection or
chemical obliteration OF varicose
veins. Then the diathermy eXtirpa-
ton of infected tonsils. Then the
injection treatment of internal hem
orrhoids. Then the injection treat
ment of hernia.
1t is only fair and right to say
that. in competent hands, every one
of these modern methods is giving at
least as satisfactory results as the
old standard surgical treatment gives
in competent hands. I think the
risks involved are rather less in am
bulant treatment than they are in
the older methods Of operating. So
far as can learn the prospect of re-
currencc or of failure to cure or give
lasting relief is no greater when am
bulant treatment is selected than 1t
is when the standard operation is
done.
Some physicians of good standing
and repute still disapprove, condemn
or advise patients against having am
bulant treatment, mainly, fear, be-
cause these good physicians have not
had an opportunity to see such treat
ment applied by man who has made
proper study of the method and
received adequate clinical instruction
in the technic. I know this is the
basis of the unfavOrable view taken
by some throat surgeons OF the dla-
tllermy method for tonsils. From the
character of inquiries have received
from clinical surgeons in reference to
the ambulant treatment OF hernia 1
know they, too, base their prejudice
upon their ignorance Of the sclen-
tific principles of such treatment. The
injection treatment Of hernia has
been most bitterly condemned by well
meaning but nevertheless ignorant
surgeons-ignorant Of this modern
method. Here and there these sur
geons are seeing the light and even
getting down off the high horse ano
seeking clinical instruction in the
ambulant method from colleagues who
have mastered the technic.
Many throat surgeons now advocate
the use of the diathermy method tol
cleaning up tags of tonsil tissue let'
in the throat after the radical tonsil.
lectomy-somehow they prefer to fall
back on the diathermy method rather
than break the news to the patient
that he must undergo another opera
ton. / may be dumb, illogical ane
blind to all the amenities. but it doe:
seem to me that if the diatherml
method is all right for removing what
the guillotine and snare leaves be-
hind, it ought to be the choice IN the
first place.
Insurance carriers find that a her
mia case, treated by the standard op'
Grafton, costs around $400-hospita
expense, doctors fees, and compen'
sation for eight weeks disability. The
ambulant treatment can be given tol
less than half that total cost-n(
hospital charges to pay. no loss o.
time for the patient. Some large IN
dustrial corporations are beginning
to take an interest in this, and ply
sicians and surgeons investigating th<
method for such corporations are con-
strained to report that it does effec'
cure of the hernia. In the circum'
stances it behooves the profession tx
keep an open mind-whicll is some
thing our would-be medical leader!
tno often lack