. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. The man (Case XLIX), aged about thirty years, was admitted,April 14, 1893, with a greatly swollen abdomen, measuring over forty inches in circumference. Hisillness dated from January, 1890,when, without any fall or injury,he had for three days severe colic,not associated with vomiting or withjaundice. A month later he had asecond attack, also lasting three days;in this one he vomited, and noticedfor the first time swelling of the ab-domen. Then the attacks recurredfrequently
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. The man (Case XLIX), aged about thirty years, was admitted,April 14, 1893, with a greatly swollen abdomen, measuring over forty inches in circumference. Hisillness dated from January, 1890,when, without any fall or injury,he had for three days severe colic,not associated with vomiting or withjaundice. A month later he had asecond attack, also lasting three days;in this one he vomited, and noticedfor the first time swelling of the ab-domen. Then the attacks recurredfrequently, two or three a month,each time with nausea, vomiting, andcolic, and the abdomen progressivelyenlarged until July, 1890, after whichhe had no further attacks of abdomen remained large, but hisgeneral condition was good and hewas able to do light work. In July1892, he fell out of a wagon, jumped up, got into it again, butimmediately had a severe attack of colic, and had to go to bed ina hotel near by for two days. He had nausea, vomiting, andgreat pain. The swelling gradually disappeared, and in ten days. Fig. 36.—a cyst in the abdomen,probably of the pancreas (CaseXLIX). TUMORS OF THE PANCREAS. 141 the girth of the abdomen decreased from forty-three to thirty-oneinches. He had profuse diarrhoea, but he does not think there waspus or blood in the stools. He gained in weight rapidly, and wentto work. He was married in October, and remained well untilJanuary of this year, when he felt his trousers were tight at thewaist ; and during the past three months, without colic, vomiting,or jaundice, the abdomen has gradually increased in size. A truly remarkable history! The man was unusually intelli-gent, and insisted that his statement about the complete disappear-ance of the tumor after the fall from a wagon was he came under observation the entire abdomen was dis-tended, particularly in the ujjper zone ; the ensiform cartilageand the lower ribs were everted.
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