. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. onguehas a light white fur. The abdomen is below the level of the costal margin. In the upper zone, occupying the left epi-gastric, the left umbilical, and theleft hypochondriac regions, there isan irregular swelling which at inter-vals shows waves of peristalsis andassumes a shape suggestive of a dis-tended stomach, A lesser curvaturecan be distinctly seen three finger-breadths from the ensiform carti-lage; a greater curvature about twoinches below the level of the
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. onguehas a light white fur. The abdomen is below the level of the costal margin. In the upper zone, occupying the left epi-gastric, the left umbilical, and theleft hypochondriac regions, there isan irregular swelling which at inter-vals shows waves of peristalsis andassumes a shape suggestive of a dis-tended stomach, A lesser curvaturecan be distinctly seen three finger-breadths from the ensiform carti-lage; a greater curvature about twoinches below the level of the most marked prominence is justbeneath the left costal margin. Tothe right the outline of the swellingextends beyond the nipple line. Thecontrast between the upper and lowerabdominal zones is very striking, andthe diagnosis of the condition couldbe made at a glance, as the organ hardened when the waves ofperistalsis passed over it. On palpation, the abdomen was everywhere soft and there wasno tenderness. During contraction the stomach was firm and re-sistant. There was no nodular tumor to be felt, although between. Fig. 3.—Showing: the stomach out-lines in Case II. TUMORS OF THE STOMACH. 7 the navel and the right costal margin there was a sense of in-creased resistance, particularly beneath the ribs. The area of liverdullness was diminished. There was no enlargement of the super-ficial glands. The patient was ordered to have the stomach washed out everymorning, and to take a diet of milk and egg-white. October 17th.—Patient was seen again to-day with Dr. Salzer,partly with a view of determining the advisability of a Loretasoperation. Since the last note the patient has improved consider-ably under the daily use of the stomach tube, and he has been ableto take Leubes beef extract, meat balls, and small quantities ofmilk without discomfort. He has not, however, gained in weight;still looks very haggard and emaciated, and says he at times feelsvery queer in his head, as if he
Size: 1228px × 2035px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidlecturesondi, bookyear1901
