The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1932-10-26
GETTING RID OF THAT BILE

From the way we regular quackS
talk one might think that our great
ambition nowadays is to cut out the
gall bladder of every tiresome patient
who comes bellyaching around just
as we are ready to snuk over to the
bowling green. Sir Francis Drake
didn't stop at that when they inter-
rupted his game.
At that, We do devote our knowledge
and talents largely to the endeavor to
rid the patient of bile. Any luckless
wight who has ever had his gall
| bladder surgically drained knows what
a great success we make of this en-
| deayor.
can regard the appendectomy adj
venture from the patients point of
| view, for I've been there with deep
and abiding drainage all complete. At
worst it is a bore, and with halfway
! pleasant environment, such as friends
who don't take things too seriously
and nurses who belong in the picture,
it is jolly excursion. But I don't
know about this cholecystectony or
| cholecystotomy; sometimes it looks to
me as though the victims lot is 10
times worse while the big drainage is
going on than it was before the opera
ton. But happily after what must
! seem thousand years or SO the
drainage is over and the case is closed,
| permanently, it is to be hoped. The
| patient then feels SO fine, in contrast
With his Wretchcd state in hospital,
! that he readily believes the operation
has helped him lot. And maybe it
has. In fact we know it has, in prac-
tlcally every case. Only we must give
the patient credit for his unflagging
optimism. I wonder if his spirit is
not buoyed up by the thought of all
that bad bile he has gotten rid of?
I am sure the average surgeon cher
ishes some such notion. Surgeons, you
know, the very best operators in the
business, are generally pretty dumb
when it comes to question of thera-
peutic technic aside from the method
of operation. And the very best
American surgeons recognize their
own incompetence in the fine points
of preparatory and after-treatment-
indeed, they usually leave these re-
sponsibilities to the hands of physi-
clans who are skilled in such fields
or defer to the judgment of medical
colleagues when any such question
arises in the course of the operation
Fifteen years ago method of non
surgical drainage of the bile passages
and gall bladder was introduced by
Lyon. This consists of the insertion
of a fine tube in the manner of the
common stomach tube, but this ont
reaches the duodenum just beyond
the pylorus or lower gateway of tn,
stomach; through the tube solution
Of magnesium sulphate (epsom salts
is passed. and this eXcites the empty
ing of the gall-bladder and the bile
ducts; the bile thus elected into tn
duodenum is Withdrawn through tn
tube. For time this non surgica
drainage proved quite popular ant
probably saved many patients from
surgical drainage. But later it wa
found by careful tests that a dose O
EPSON salts swallowed by the patien
excites precisely the same election o
bile into the duodenum, the sam
mon surgical hillary drainage" am
hard-headed. honest doctors conclud
ed that the tube method perhaps ha
one advantage over the taking o
salts, namely, that it impresses tn
patient by the sight of dark maiig
nant-looking bile.
Another time we'll look over some