The Pathology of the Living And Other Essays

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But if the disease is recognised early, and the patient's condition be otherwise favour- able for operation, a rare case for surgical treatment may be encountered. The relief then (in no more than three cases of my own) is great, and the awful distress, inevitable if jaundice develops deeply, may be entirely avoided. Some faint tinge of yellowness, 197 OBSTRUCTIVE JAUNDICE.
however, remains in the skin, but the itching, even when felt, is never unbearable.
The operation of cholecystenterostomy
...finds its most suitable application in cases where the obstruction of the duct is considerable, likely to be permanent, and is of a non-malignant character. Chronic pancreatitis is certainly the disease most often needing this relief. But here a word of warning is needed. The range and the role of chronic pancreatitis must not be unduly enlarged. It is a very real disease, but it is not to be diagnosed in any rough and haphazard manner. I have known cases in which large stones were present in the lower part of the common duct treated by a short- circuiting operation, the concomitant enlargement and induration of the head of the pancreas being then attributed to chronic inflammation.

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