. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. ld be applied. The previous history of the case generally offers almost conclu-sive data if rigorously scrutinized. The fact that the abdominalenlargement began froin below, on one side, and with a circum-scribed actual perceptible tumor, points to ovarian disease; theabsence of such a history would be in favor of ascites. The one-sided origin of the tumor is not, however, so often to be madeavailable as is usually stated. In such cases, as observed by thelate Dr. Bright, the growth of this tumo
. The diagnosis, pathology and treatment of diseases of women including the diagnosis of pregnancy. ld be applied. The previous history of the case generally offers almost conclu-sive data if rigorously scrutinized. The fact that the abdominalenlargement began froin below, on one side, and with a circum-scribed actual perceptible tumor, points to ovarian disease; theabsence of such a history would be in favor of ascites. The one-sided origin of the tumor is not, however, so often to be madeavailable as is usually stated. In such cases, as observed by thelate Dr. Bright, the growth of this tumor is, on some occasions,so unperceived, that, though it may have originated on one side,it has already risen into the pubic and even the umbilical region;and when the medical man is first consulted its lateral origin iswith difficulty ascertained. At other times the enlargement is atfirst slow, and after some indefinite period the increase takes placesuddenly, so that in a few months the whole abdomen presents toa common observer the size and appearance of pregnancy far ad-vanced.* Fig. 28. t /. Again, as regards the history, in ovarian disease the enlargementis more often chronic—slower in progress than is the case in as- * Clinical Memoirs on Abdominal Tumors, New Sydenham Societys ed.,p. 63. f Fig 28 (from Bright) shows the general aspect of the abdomen in a caseof great distension from ovarian dropsy. ENLARGEMENT OF ABDOMEN DUE TO FLUID. 257 cites; it is, in the case of ascites, attended with greater disturb-ance of the general health, and, in the latter case, there are gen-erally to be detected signs of serious organic disease of the heart,of the lungs, of the liver, or of the kidneys. Moreover, dropsicaleffusion into the peritoneal cavity is more often than not associatedwith similar effusion (anarsaca) in the lower extremities. It is inthe last stage of ovarian disease only—that is, of the kind ofovarian disease now under consideration, and not including casesof canc
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