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. 1909 Excerpt: ...rise of temperature occurring in the afternoon and the drenching sweats at night; (d) hepatic pain of a dull nature, frequently only vague but readily elicited, according to Stitt, by jolting the liver between the hands of the examiner. It is suggested by the same author that a single good hard jolt be depended upon, ...
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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. 1909 Excerpt: ...rise of temperature occurring in the afternoon and the drenching sweats at night; (d) hepatic pain of a dull nature, frequently only vague but readily elicited, according to Stitt, by jolting the liver between the hands of the examiner. It is suggested by the same author that a single good hard jolt be depended upon, as the patient may object to a second attempt; (e) the ducubitus is usually a right-sided one, the patient generally lying toward his abscess to relieve the tension upon the inflamed ligaments; (/) pain referred by way of the phrenic nerve to the right shoulder is present in one-sixth of the cases, but this is found in other conditions; (g) a subicteric tinge is usually present: (A) Rogers reports from his cases in India that lcucocytosis, of from fifteen to thirty thousand, is fairly constant and that the differential polymorphonuclears are low, only about 75 to 77 per cent, while the large mononuclears, so characteristic of protozoal infection, are moderately increased; (i) Axissa reports from his cases in Egypt that a constant increase of ammonia in the urine, equal to from 9 to 24 per cent of the total nitrogen with simultaneous reduction of the propor tion of urea, together with a coincident alimentary levulosuria, justifies exploratory laparotomy in dubious cases. In conclusion, it is suggested that other observations, like those of Rogers and Axissa--perhaps something along the line of determination of the opsonic power, may serve to simplify the diagnosis of this most gravely important, but too often obscure, surgical disease of the Tropics. Every available simple, rapid, and efficient method of clinical determination must be employed in the study and observation of cases of tropical abscess. Ammonia in the urine is now estimated in les...
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