The signs of internal disease, with a brief consideration of the principal symptoms thereof . res). This is certainly too great, three points (1% litres) beingmore nearly correct. The elder Leidy used to say that stomachswhich have never been over-distended were filled Jjy a pint but couJdbe stretched to two quarts (two litres). Gaseous distention of the stomach is recognized by the note oflarge tympany heard over an extended area. It should not be difE-cult to separate this sound from the note of the colon, unless thelatter is also greatly distended. When the stomach is distended by 268 DISEA
The signs of internal disease, with a brief consideration of the principal symptoms thereof . res). This is certainly too great, three points (1% litres) beingmore nearly correct. The elder Leidy used to say that stomachswhich have never been over-distended were filled Jjy a pint but couJdbe stretched to two quarts (two litres). Gaseous distention of the stomach is recognized by the note oflarge tympany heard over an extended area. It should not be difE-cult to separate this sound from the note of the colon, unless thelatter is also greatly distended. When the stomach is distended by 268 DISEASES OF THE ABDOMEN liquid or solid contents the normal tympanitic note is wanting, a ailthe dull area which replaces it will extend from the liver edge downto the umbilicus, and outward on the left until it fuses with thesplenic dullness. When the stomach is partly filled, as some timeafter a meal, the contents gravitate to the dependent part or cul-de-sac and the dullness is limited to that portion of the organ. For thepurpose of detecting these conditions percussion should be made Fig. i)^—Position of stomach in moderate gastroptosis (Rosenheims description).. the patient standing. In case the viscus is empty this is sufficient,but if partially filled the percussion should first be made with thepatient erect, noting the dull area, then ret)eated with the patientlying upon his back, when the dull area will he replaced by the char-acteristic tympany. Almost all forms of dyspepsia and conditions in which stasis ofthe gastric contents occurs are associated with gas formation and tem-porary distention. The stomachs of beer-drinkers are apt to be dis-tended. The increase in size may be permanent, as in gastrectasia,which is a permanent increase in the volume and capacity of the-stomach, arising from muscular atony, or in pyloric obstruction, in;. DISEASES OF THE ABDOMEN 269 which the condition is brought about by the gradual stretching of theTvalls by the retained contents
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectdiagnos, bookyear1906
