Medical diagnosis : a manual of clinical methods / John James Graham Brown.

  • Brown, J. J. Graham (John James Graham)
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis : a manual of clinical methods / John James Graham Brown. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    a table-knife. The result of the mixture of these solutions in the stomach is the development in that viscus of a large quantity of carbonic acid gas, and consequent distension. In a few seconds the position of the greater curvature, and the general outline of the stomach, can be made out with great distinctness. This method is but seldom resorted to in this country, and is not to be recommended. Tumours of the stomach sometimes cause visible prominence of the abdominal wall. In some cases such tumours do not alter their position with the respiratory movements, and may thus be distinguished from tumours of the liver and spleen, which rise and fall with the respiration; but sometimes this is not so, the gastric tumour mass having contracted such adhesions to neighbouring parts that it moves synchronously with the diaphragm. Liver.—In the healthy adult1 the liver gives rise to no visible prominence of the abdominal walls. When enlargement takes place, it usually shows itself first under the margin of the ribs, in the right hypochondrium, unless the left lobe be chiefly affected, when the tumefaction appears in the epigastrium. The edge of the liver, or the tumour arising from that organ when visible, may be seen to rise and fall with the respiratory movements—an important diagnostic point. Splenic Tumours, when of large size, cause visible tumefaction of the abdomen generally, particularly on the left side. Tumours of the kidneys and omentum do not, as a rule, cause visible swelling. Ovarian tumours are usually at first lateral in position, but subsequently they may develop to so great a size as to distend the whole abdomen. Abdominal movements other than those of normal respiration may be seen—(a) respiratory, (b) pulsatory, (c) peristaltic. 1 In children the liver is, normally, large in proportion to the size of other viscera, and occasions a considerable degree of fulness of the abdomen, extending from the lower border of the ribs on the right side to the level of the umbilicus.