Time as an Element in Abdominal Surgery [excerpt]

     In acute abdominal emergencies—all of which are signalized by abdominal pain more or less severe—is it justifiable to waste the precious moments which alone make recovery possible in waiting for symptoms confirming a probable diagnosis? The answer to this question depends somewhat perhaps upon the suspected lesion. Some conditions certainly permit greater latitude in verifying diagnosis than others. Moreover, in very few instances is it possible for the physician to reach the bedside of the patient before the signs sufficiently confirmatory of the diagnosis exist; and still longer time must elapse before the surgeon can be called and before he can make his preparations for operation. [383][384]
     Occasionally the surgeon sees the case at the very earliest possible time. I have always thought that the extraordinary promptness of the surgical intervention in the case of the late President McKinley gave him the only possible chance of recovery. We cannot often hope, however, to be called so early in the acute emergencies of abdominal surgery. Even if the surgeon is sent for at the very onset of acute abdominal pain caused by any of the lesions that I have mentioned, before he can reach the patient and complete his preparations for operation, secondary signs of great importance will have supervened, and he will be reasonably sure that he is on the right track.