. Gynecology : . r the ache between the shouldersand the tired feeling at the base of the skurThe circulation is sluggish, the hands and feet are habitually cold and clammy, and especiallyso when the patient is under nervous strain. The blood shows secondary anemia, and in thistype the blood-pressure is usually subnormal while the temperature is always subnormal inthe morning. Examination of the abdomen generally shows it to be of the scaphoid varietywith a very acute sternocostal angle. The ribs are long and reach nearly to the crest of theileum. There is often some tenderness with spasm in t
. Gynecology : . r the ache between the shouldersand the tired feeling at the base of the skurThe circulation is sluggish, the hands and feet are habitually cold and clammy, and especiallyso when the patient is under nervous strain. The blood shows secondary anemia, and in thistype the blood-pressure is usually subnormal while the temperature is always subnormal inthe morning. Examination of the abdomen generally shows it to be of the scaphoid varietywith a very acute sternocostal angle. The ribs are long and reach nearly to the crest of theileum. There is often some tenderness with spasm in the epigastrium or a little to the right ofit. The cecal region is tympanitic and the corded sigmoid is usually present. Pressure overthe epigastrium causes a characteristic feeling of nausea and distress similar to the habitualdiscomfort experienced by the patients. Their loins are thin and the right kidney is either pal-pable or actually movable. Not seldom the edge of the liver can be felt and the aorta is pal-. Fig. 24.—Enteroptosis with Changes inthe Body Contour. RELATIONSHIP OF GYNECOLOGY TO THE GENERAL ORGANISM 163 pable in its whole length. With the patient on his face there is a distinct hollowing in the costo-vertebral angle, showing an absence of retroperitoneal fat. About 10 per cent, of such caseshave slight lateral curvatures. The urine usually is normal. The gastric analysis may shownormal findings, or hyperacidity or anacidity, and this varies from time to time. The stoolshows, as a rule, considerable undigested material. The x-rays show the long, tubular drain-trap stomach, some stasis with lack of peristalsis. The small intestines are rarely visible be-cause of hypermotility, as demonstrated by the early filling of the cecum. In this type thesmall intestines have a tendency to be short. The radiograms of the colon show stasis at thececum or at the transverse sag. It seems probable that a mechanical obstruction of the boweltakes place, producing malnutrition,
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