Clinical lectures on diseases of the liver, jaundice and abdominal dropsy : including the Croonian Lectures on functional derangements of the liver delivered at the Royal College of Physicians in 1874.

  • Murchison, Charles, 1830-1879.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on diseases of the liver, jaundice and abdominal dropsy : including the Croonian Lectures on functional derangements of the liver delivered at the Royal College of Physicians in 1874. Source: Wellcome Collection.

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

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    APPENDIX. Page 75. Since Lecture III. passed tliroiTgli the press, the following case of hydatid of the liver, treated successfully by paracentesis, has come under my notice. Case OLXXVII.—Hydatid of Liver—Paracentesis—Recovery. William 0 , aged 31, bootmaker, admitted into St. Thomas's Hosp. Dec. 6, 1876. Habits temperate; taken no stimulants for 14 years. Never out of England. As a rule digestion good, and no pain after food; but for a year or more liable at intervals of a week or month to attacks of flatulence and vomit- ing, usually in evening, A week ago first noticed a swelling in right h}^ochon- driimi, where for two or three weeks before there had been shght pain. Up to this time followed work. Tumom* had enlarged slightly. On admission there was a roimded, smooth, elastic, painless tumour in epigastric and right hypochondriac regions, causing ribs to bulge outwards, and throwing forwards belly of rectus, evidently connected with liver. Lower margin of tiunom* reached to umbihcus, and hepatic dulness in r. m. 1., including tumom, measm-ed 9 in.; girth of r. chest, 2 in. below nipple, 17^ in.; of left, 16| in. Slight dull pain in hepatic region. All other organs healthy. Tongue coated ; appetite bad ; bowels regular. P. 84; temp, normal. Dec. 13.—Paracentesis with fine trocar; 6 oz. of fiuid drawn ofi, clear, sp. gr. 1009 ; much chlorides, but not a trace of albumen ; no echinococci. Some hours after operation patient had a severe attack of abdominal pain, and temp, rose from 98° to 101'2°. Pain was relieved at once by subcutaneous injection of morphia gr. ^. Next day felt quite well, but temp, varied from 101-2° to 102-6°. On 14th, temp, normal and ap. good. After this had no bad symptom; and when patient left hospital on Dec. 23, tumoiu could not be felt, and girth on two sides of chest equal. Page 134. Among the blood-poisons causing congestive enlargement of the liver, special attention ought to have been directed to syphilis. Both the liver and the spleeu are not unfrequently found to be greatly enlarged in children who are the subjects of inherited syphilis, and that this enlargement is not waxy, and in all probability congestive, is shown by the rapidity and completeness with which it often disappears under treatment, or independently.' A similar enlargement is occasionally