Clinical lectures on diseases of the liver, jaundice and abdominal dropsy / by Charles Murchison.

  • Murchison, Charles, 1830-1879.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on diseases of the liver, jaundice and abdominal dropsy / by Charles Murchison. Source: Wellcome Collection.

    42/619 (page 16)
    in consequence of disease in the chest, the descent of its lower margin is probably due to a combination of causes; for when there is disease in the chest suf- ficient to depress the diaphragm, there is usually also cono-estion with slight enlargement of the liver. Apparent enlargements of the liver from the causes now referred to have the following distinguishing fea- 1 A previous history of pleurisy, pericarditis, bronchitis and emphysema, pneumonia, or phthisis endino- in pneumothorax. At the same time it is well to remember that extensive effusion sometimes takes place into the pleura in a very latent manner 2. A degree of dyspnoea far greater than would be accounted for by the amount of enlargement of the liver, even if real. 3 The physical signs of the vane™ thoracic diseases above referred to. In the case of emphy- sema and pneumothorax, there is no difficulty m defining the upper margin of the liver and in ascer- taining that the extent of hepatic dulness is not iTereaL, so that percussion will at oncereveal the nature of the case. But-« £ impossible to say where the dnlness l effusion ends and the hepatic duhiess begins, and here as in some forms of true hepatic enlargement tie I may he bulging of the ribs and obliteration of ft intercostal spaces. Tinder such circumstances, ftere are several characters of considerable impor- tance in diagnosis—to- >