. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fio. 10.—Tumor of the abdomen caused by a dilated stomach; case of Sarah a photograph taken during life. vomiting and after lavage, the depth to which the stomachtube could pass, and the irregular waves of protrusion leftno doubt that the distention was due to an enormously di-lated stomach. She died November 16, 1889. The photo-graphs (Figs. 9 and 10) show the profile and front viewstaken during life, and Fig. 11, from a photograph taken afterdeath, shows the positio
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fio. 10.—Tumor of the abdomen caused by a dilated stomach; case of Sarah a photograph taken during life. vomiting and after lavage, the depth to which the stomachtube could pass, and the irregular waves of protrusion leftno doubt that the distention was due to an enormously di-lated stomach. She died November 16, 1889. The photo-graphs (Figs. 9 and 10) show the profile and front viewstaken during life, and Fig. 11, from a photograph taken afterdeath, shows the position of the organ and its enormousenlargement. There was cancerous stricture of the most prominent distention is usually in the left 24 THE DIAGNOSIS OP ABDOMINAL TUMORS. half of the umbilical region, but it may be chiefly belowthe navel. A definite stomach contour may bo seen veryplainly in many instances of dilatation from stenosis ofthe pylorus. At intervals, during the contraction of the. Fig 11.—Showing the position and size of the stomach in Sarah a photograph taken at the autopsy. stomach walls, the outline of the greater curvature de-scends on the left side, curving at a level of the anteriorsuperior spine, and passing to the right at a variable dis-tance above the pubes, sometimes not more than three orfour centimetres, sometimes midway between the pubes TUMORS OF THE STOMACH, 25 and the naval. Curving upward, it ends either in the leftlumbar or more frequently in the right upper quadrant ofthe umbilical region, sometimes appearing to pass beneaththe right costal margin. The lesser curve is frequently-much more distinct, the line passing vertically parallelwith the left border of the sternum or in the parasternalline, curving to the left of the navel, and often during thecontraction of the organ forming a very well marked,sharply defined contour at or a little below the level of thenavel. I have found the greatest surprise expressed bypractitioners
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