. Annals of surgery. ciples I wasadvocating, I endeavored to show that the secret of success ingall-stone operations was efficient drainage of the pouch demon-strated. The object of my present contribution is by the relation ofsubsequent cases to draw attention to some points which havespecially interested me, and to emphasize my belief in the impor-tance of a recognition of the anatomy of the right hypochon-drium. The series of cases on which the bulk of my remarks arebased are : 1 British Medical Journal, November 3, 1894. l82 RUTHERFORD MOR/SON. Case I.—Mrs. A. D., aged forty-two years, a p
. Annals of surgery. ciples I wasadvocating, I endeavored to show that the secret of success ingall-stone operations was efficient drainage of the pouch demon-strated. The object of my present contribution is by the relation ofsubsequent cases to draw attention to some points which havespecially interested me, and to emphasize my belief in the impor-tance of a recognition of the anatomy of the right hypochon-drium. The series of cases on which the bulk of my remarks arebased are : 1 British Medical Journal, November 3, 1894. l82 RUTHERFORD MOR/SON. Case I.—Mrs. A. D., aged forty-two years, a patient of , of Gateshead-on-Tyne, complained of a rounded swellingin her abdomen. History.—Three years ago she began to suffer from attacks ofspasms, described as pains commencing in the stomach, makingher sick, shiver, and sweat. These attacks recurred about every threeweeks for two years. One year ago, after an attack, she discoveredthe lump by accident, and since that time has had no pain till a week. Fig. I.—Mrs. D. before I saw her. The lump was always movable, and she could feelit as distinctly as if it were in her hand. A week ago she was takenwith pain in the lump, which extended all over her right side tothe navel, round her l)ack, and over the chest. She vomited a quan-tity of green matter, felt hot and cold, and was very then the lump has l)een tender and painful, her appetite hasbeen poor, and she has been depressed and ill. ON GALL-STONES. 183 On examination a rounded swelling like a small cocoa-nut is feltprojecting from underneath the costal margin in the right hypochon-drium. (See Fig. i.) It naturally lies with its long axis in a line drawnfrom the ninth costal cartilage to the umbilicus, but can be pushedeasily into the epigastrium on the left side, or into the right lumbarregion on the right side, when it can then be felt from the loin like akidney. The kidney is movable, however, and can be distinctlyfelt apart by dipping the
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
