. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fia. 28.—Cancer of the liver, showing the enormous increase in the area of dullness. Theshaded areas show the situation of the visible tumor masses. cancer with great enlargement of the organ. Cases of pri-mary cancer, and especially the peculiar form of cancerwith cirrhosis, may be extremely difficult to recognize. Avery large proportion of all cases are secondary, and char-acterized by a very rapid growth, profound cachexia, and 90 THE DIAGNOSIS OF ABDOMINAL TUMORS. often
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fia. 28.—Cancer of the liver, showing the enormous increase in the area of dullness. Theshaded areas show the situation of the visible tumor masses. cancer with great enlargement of the organ. Cases of pri-mary cancer, and especially the peculiar form of cancerwith cirrhosis, may be extremely difficult to recognize. Avery large proportion of all cases are secondary, and char-acterized by a very rapid growth, profound cachexia, and 90 THE DIAGNOSIS OF ABDOMINAL TUMORS. often jaundice. The new growth may be so diffusely scat-tered throughout the organ that the enlargement is uni-form and the surface is smooth; but more commonly thereare large outgrowths on the surface or at the edge of theliver, which form prominent tumors of the greatest valuein diagnosis. Not infrequently, indeed, they project be-yond the surface of the liver far enough to be seen throughthe thin abdominal walls, as in this photograph from a casein the hospital last year (Fig. 28). In a patient with cancerof the liv
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