ULCERATIVE COLITIS
Surgery has been at once the cause of many disasters and the means of saving many lives; it is of the greatest value when applied at the appropriate time; it should be availed of when the occasion requires it.
Abstract
AUTHORITATIVE opinions concerning the causation and treatment of ulcerative colitis are so many and varied that the medical practitioner seeking 'to learn something of this condition is apt to become bewildered. He can, however, seek comfort in the reflexion that the most learned authority is unable either to assign a cause to ulcerative colitis or to prescribe a method of specific therapy. Treatment at spas and the administration by mouth and by anus of innumerable so-called intestinal antiseptics have been advised; pharmacopreial drugs and scores of drugs with fantastic names, doubtful origin and more dubious effect have been experimented with and recommended and used the world over; vaccines and antisera have both been given with an apparent success which has varied with different observers; caecostomy, appendicostomy, ileostomy and ileo-sigmoidostomy are the surgeon's contribution. Surgical treatment is worthy of special mention. At first glance it would appear that in surgery is the solution of the problem of treatment, for the colon is given rest and a means of applying a vis a tergo in the matter of colonic lavage is provided. But the operation most commonly performed-appendicostomy-does not provide a means of resting the colon, and it has yet to be proved that the colon can be more efficiently washed out from above than from below. Surgery has been at once the cause of many disasters and the means of saving many lives. It is of the greatest value when applied at the appropriate time; it should be neither despised nor unduly relied upon, but should be availed of when the occasion requires it. At a meeting 'of the Section of Surgery, Subsection of Proctology, of the Royal Society of Medicine in March of this year, ulcerative colitis was discussed by a number of .authorities, of whom Arthur F. Hurst as physician, P. J. Briggs as radiologist, Cuthbert Dukes as pathologist, and J. P. Lockhart-Mummery as surgeon introduced the subject from their various points of view.'