Hydatid disease of the liver : its diagnosis and treatment / by Mortimer Balding.

Date:
[1881?]
Catalogue details

Licence: Public Domain Mark

Credit: Hydatid disease of the liver : its diagnosis and treatment / by Mortimer Balding. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    present, and are markedly increased on deep inspiration. Jaundice is present in about four-fifths of the cases. Impedi- ment to portal circulation, enlargement of the veins of the abdomen, and ascites are rare ; but the spleen is generally enlarged. Pyrexia is always present, and varies much in its intensity at different times in the same case. Rigors are usually present, and vary much in their inten- sity and in the intervals between them, and the oscillations of temperature are very sudden; profuse perspirations are generally present; emaciation is progressive, and diarrhoea common. Dry brown tongue and delirium generally end the case. The disease rarely lasts more than six months, but, according to the late Mr. De Morgan, it may last a year or more. There must exist in the patient some source from which the putrefactive products of suppuration can be absorbed into the system, but it is not requisite that this should have direct communication with the exterior of the body. B 3. Tropical Abscess.—Under the above head I include those cases of abscess of the liver which are generally of large size and single. There may, however, in rare cases be two or three, but they are never numerous and are of an idiopathic origin, having no connection with pyaemia, or, in other words, with small multiple abscess of the liver. The symptoms of this disease may be divided into those which take place before suppuration, and those which take place after suppuration. Before suppuration.—During the first week or ten days the symptoms are mainly those of congestion of the liver, which yet has a smooth surface and is enlarged in all directions. There is remittent pyrexia, with a feeling of weight and oppression in the region of the liver. There is frequently slight jaundice, nausea, headache, dyspnoea, and dirty tongue, but no very acute pain ; the urine is scanty, and loaded with urates, and often the earliest indication that you have incipient tropical abscess to deal with, and not malaria, is obtained from the fact that the case does not yield to quinine. The whole of the symptoms may, however, recede from this stage without going on to suppuration.