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.

    17/56 (page 17)
    After suppuration.—The enlargement of the liver is no longer uniform, but the natural outline is changed by the projection of a smooth globular mass, in which fluctuation, more or less distinct, can generally be made out ; and this obscurely fluctuating region is surrounded by a more or less well-marked hard indurated zone; if, however, the abscess is very deep, the sense of fluctuation may be wanting. The pain and tenderness are not generally very acute, but become more so as the pus approaches the surface. Ascites, enlargement of the spleen, and oedema of the lower limbs are not prominent symptoms, and jaundice is not generally persistent. Pyrexia is present at some period of the twenty-four hours. Rigors and profuse perspirations are not so well marked as in pyaemic abscess. There is generally loss of appetite, accom- panied by obstinate vomiting, and a coated or red tongue. The duration of the disease, before coming to a climax, may vary from two to three weeks to many months ; and this is probably the explanation of the cases of this disease seen in this country. It is most common in India or China; rare in the West Indies; and generally occurs between the ages of 25 and 45, in persons of indolent habits, who either eat or drink to excess. Case I. The following case was in the Middlesex Hospital, under the care of the late Dr. Murchison, while I was a pupil of that institution :— F. K., aged 39, admitted Jan. 5, 1871. History.—He left Japan about sixteen months ago, and went to Madras ; and while there he acknowledges that he was a free drinker, especially of gin. He landed in England in July, 1870. His health continued good for the first three months. He never had dysentery in India. In October, 1870, he noticed that he was losing flesh, and that his appetite was failing. For some weeks past he has suffered from night-sweats, and a month ago was obliged to give up work. About this time he noticed a swelling in the right hypochon- driac region, which has since increased. State on admission.—Patient is considerably emaciated, and complains of great weakness and loss of appetite. No cough. B