. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fig. 8.—Outline of the stomach inCase X, showing the positionof the ridge-like mass. 22 THE DIAGNOSIS OF ABDOMINAL TUMORS. had on several occasions vomited blood, this was very probably aninstance of dilatation from the cicatrization of an ulcer ; and thesmall, elongated nodular thickening in the region of the pylorusalso suggested this condition. General Remarks on the Diagnosis of the Tumor causedhy Dilated Stomach.—Inspection gives most important in-formation, the value o
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. Fig. 8.—Outline of the stomach inCase X, showing the positionof the ridge-like mass. 22 THE DIAGNOSIS OF ABDOMINAL TUMORS. had on several occasions vomited blood, this was very probably aninstance of dilatation from the cicatrization of an ulcer ; and thesmall, elongated nodular thickening in the region of the pylorusalso suggested this condition. General Remarks on the Diagnosis of the Tumor causedhy Dilated Stomach.—Inspection gives most important in-formation, the value of which may be gathered from thefact that in these ten cases the diagnosis was made de in mind, in the first place, that a dilated stomach mayoccupy every region of the abdomen except the upper partof the epigastric and may form a very prominent Fig. 9.—Profile view of the abdomen of Sarah A., aged sixty-five, showing the tumorformed by the dilated stomach. From a photograph taken during life. The photographs (Figs. 9 and 10) which I show you illus-trate this very well. They were taken during life from awoman, aged sixty-five years, who was admitted to thehospital complaining of attacks of vomiting which hadpersisted for nearly two years, during which time she hadbecome gradually emaciated and very weak. She had atintervals brought up enormous quantities of fluid. Ou in-spection, the abdomen was greatly distended, particularlyon the left side and in the umbilical and hypochondriac TUMORS OF THE STOMACH. 23 regions. It was uniform, but at intervals there were slightirregularities and elevations; no marked waves of contrac-tion. On palpation, the abdomen was everywhere soft, ex-cept at a point to the right of and just below the navel,where there was a hard, resistant mass. At first it seemedscarcely possible that the entire a
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