This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1896 Excerpt: ...of its surface may be marked. When, ou palpating the liver, we find marked tenderness and some swelling, and, associated with these symptoms, fever, rigors, sweats, and sometimes vomiting, and, in addition, a history that the patient has had dysentery or has had exposure to tropical heat or has swallowed much bad water ...
Read More
This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1896 Excerpt: ...of its surface may be marked. When, ou palpating the liver, we find marked tenderness and some swelling, and, associated with these symptoms, fever, rigors, sweats, and sometimes vomiting, and, in addition, a history that the patient has had dysentery or has had exposure to tropical heat or has swallowed much bad water, we are forced to the belief that an abscess of the liver exists. This may be single or multiple. If the latter, it is probably due to pyaemia, and no spot of fluctuation will be found as a rule; whereas, if it is large and single, fluctuation is sometimes felt. Further, the enlargement of the liver in the pyremic form is uniform, whereas in the single abscess there is often one spot which is swollen or enlarged. If a single large pyriform swelling, which is yielding and somewhat painful on palpation, be found, and there is some fluctuation present, abscess must be thought of, or in its place impaction of the gall-bladder with gall-stones or its distention by obstruction to its duct. The history of the case will usually separate the conditions, one from the other, for diagnostic purposes, for in the case of abscess the history will probably be that of a person exposed to tropical heat or one who has had an injury, an acute infection, or an amoebic dysentery, while if gall-stones be the cause of the swelling there will be a history of gall-stone colic, of jaundice, or of hepatic fever. More rarely a single hepatic swelling may be due to hydatid cyst, but the history and presence of fluctuation, combined with the result of examining the fluid aspirated from the swelling, will decide the diagnosis. The consistency of the liver is usually very hard in cases of cirrhosis, carcinoma, and amyloid degeneration. In cirrhosis there will be some ascites...
Read Less