. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. termined on palpation, and are of special importancein diagnosis. In the following cases tumor masses werepresent: Case XXXII. Cancer of the Liver; Chills, Fever, and Siveats.—Mrs. S., aged sixty-nine years, seen with Dr. Amanda Norris onApril 30th. Family history good; husband died in 1879 of cancerof the stomach. The patient has been a strong, healthy woman. During thepast winter has not been in good health, has been losing in weight,and has had indigestion. She has kept a
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. termined on palpation, and are of special importancein diagnosis. In the following cases tumor masses werepresent: Case XXXII. Cancer of the Liver; Chills, Fever, and Siveats.—Mrs. S., aged sixty-nine years, seen with Dr. Amanda Norris onApril 30th. Family history good; husband died in 1879 of cancerof the stomach. The patient has been a strong, healthy woman. During thepast winter has not been in good health, has been losing in weight,and has had indigestion. She has kept about, and the conditionwas not thought to be serious until March 4th, when she had asevere chill with pair in the right side. There was no cough, nosigns of any pleural or pulmonary trouble, nor had she any jaun-dice. The chills recurred very frequently, sometimes every day;she was in bed for three weeks. The fever rose, and she hadheavy sweats. She had also marked gastric symptoms, and vom-ited almost every day; never brought up any blood, and neververy large quantities. She got somewhat better, and for a couple. 10 92 THE DIAGNOSIS OF ABDOMINAL TUMORS. of weeks was up and about and seemed improving, and she had nochills. During the past three weeks the chills and fever have beenagain present, and she has had vomiting and inability to takemuch food. The temperature goes up to 102° and 103°, and thechills are sometimes severe. The bowels have been constipated;she has never had any jaundice. Present Condition.—Patient is not cachectic-looking; face hasa grayish, rather anaemic aspect. Tongue is slightly furred. Ex-amination of the thoracic organs is negative. The abdomen is somewhat full; panniculus moderately thick;the upper zone of the abdomen a little prominent. On palpation,it is everywhere soft on the left side and below. Occupying theupper umbilical and all of the epigastric regions and extending tothe right in an oblique line toward the anterior superior spinethere
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