Colostomy

HiSTORICAL. IN pre-Listerian dlays surgeonis werc afraid, and righlitly so, to open the peritoneal cavity. The antiseptic metho(ds of the post-Listeriaii era, and(l the asceptic technique of the present time, were then unlleard of, yet there was no lacking in the anatomical knowledge of the great meni of that period, who must be hailed as the founders of the surgical profession. Their vivid anatomical descriptions will stan(d as monuments to their memory and an inspiration to those who are attempting to follow in their footsteps. It is to Petit that we are indebted for the term colostomy. He suggested in 1886 that its application be limited to permanent artificial anus, and that the older term colotomy be reserved for the temporary variety. In 1710 Littre in "The Memoirs of the Academy of Sciences of Paris" suggested the operation of colostomy for imperforate anus, but there is no record of his having performed it. He advised uising the sigmoid flexure via the peritoneal route. In 1776 Pillore Rouen made a caecostomy openinig for intestinal obstruction in an adult. Then in the next twenty years Duboise, Dinet, an(l Desault all performed the operation for imperforate anus. In 1787 Fire did a transverse colostomy during an operation in which he intended opening the small bowel for obstruction. In 1796 Callisen suggested that the (lescending colon should be reached extraperitoneallv by a lumbar inlcisionI; this was soon abandoned, however, on account of the difliculty and the mutilationi of tissue which was required in order to find the bowel. In addition, the infectioni that followed this operation was just as fatal as the peritonitis which resultedl from the peritoneal route. So we find for the next thirty years the inguinal inlcisioIn was favoured, but the lumbar operation was again revived by Amtussat, who, in a series of articles (1839-41), showedl that it could be (lonie witlhout any considerable (latger, and in support of this view he records six cases, five of which were successful. In 1849 colostomy was first done for vescio-rectal fistula secondary to ulcerative colitis. Allingham, Reeves, and Cripps were eventually responsible for the abandonment of lumbar colostomv. 'I'hey sliowec that it was impossible to (1o the operationi without inijuring the peritonieumil, and also tllat the positionl was a very unsuitable one in which to have a bowel opening. In 1895 F. T. Paul, surgeon to the Royal Infirmary, Liverpool, in an1 article …