344 INFECTIONS OF THE DIGESTIVE TRACT 



verse colon with the rectum instead of making a com- 

 munication in the abdominal or lumbar region. 



It is to be remembered that operations like those just 

 discussed would seldom be undertaken except where 

 life is in danger from the persistence of a process which 

 has been unsuccessfully treated by the usual hygienic 

 and medical resources of the physician. There are 

 conditions of mental depression and conditions of 

 anaemia in which I believe an operation involving the 

 shortening of the intestine to be justified. There is 

 much to be said in favor of urging operation before the 

 establishment of extreme conditions of deranged function 

 in the nervous system or the development of anaemia 

 associated with greatly impaired regenerative capacity of 

 the blood. It is easy to understand that by too long wait- 

 ing a biological situation, susceptible of great improve- 

 ment by timely operation, might be rendered so extreme 

 that the recuperative powers of the damaged cells would 

 not suffice to restore even a fair degree of health. 



The operation of connecting the vermiform appendix 

 with the outer world through a fistulous opening has 

 been repeatedly performed in cases of chronic dysentery, 

 for the purpose of giving patients the benefit of thorough 

 irrigation of the large intestine. It is possible that this 

 operation (which might entail fewer risks to the patient 

 than operations of the class just mentioned) may be 

 worthy of trial for the relief of chronic intoxications 

 leading to extreme anaemia or to serious disorders of 

 the nervous system. 



The possibility of checking the progress of specific 



