In the surgery of intestinal obstruction, the steps of chief importance in the operative technique are the removal of the cause of the obstruction when located, and the repair, if necessary, of the wounded bowel. Final success, however, depends upon the general condition in which the patient is left at the end of the operation, as much as upon the condition of the liberated intestine. All the preliminary steps, therefore, should be so ordered as to avoid unnecessary sacrifice of time or the infliction of injury by mischievous bowel manipulation.
In addition to the remote danger of intestinal paresis and peritonitis, there is another more imminent. Shock is the prominent element of danger in the operative interference for relief of this condition. It is already present, usually in a marked degree, as a result of the injury the intestine has sustained, as well as from the depressing effects of the