Observations on the muscularity of the hepatic and cystic ducts, as explanatory of the production of jaundice by moral causes / [Robert Knox].

  • Knox, Robert, 1791-1862.
Date:
[1836]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the muscularity of the hepatic and cystic ducts, as explanatory of the production of jaundice by moral causes / [Robert Knox]. 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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    Hospital La Charitc/Viindcr the care of Dr Lherniinier, young man, apparently aliout twenty years of age, healthy in every respect, so far as could be judged of, but deeply jaun- dicetl. The medical visits of the Parisian Hospitals, as perhaps most of the Society are aware, are at six a. ni. or soon after- wards. I mention this circumstance because it bears on the case. A well conducted inquiry, with acute cross questioning, elicited from the patient the following statements; I call them statements althougli they are facts, as much so, at least, as we generally obtain in medical investigations. On the evening previous to his admission into the Hospital, this young man was perfectly well, but chancing to pass a Corps de Guarde, he came so suddenly and unexpectedly on the sentinel that the first notice he had of the soldier's presence was tlie gun and bayonet ruffling his chest, and the naked point striking the breastbone with considerable violence. During the night, he became deeply jaundiced, and fancying himself seriously hurt in some way or other, he applied to the Hospital very early in the morning,soon after which we saw h\m. I do not imagine that any difficulty would have occurred in eliciting the facts of the case, and as regards those just mentioned, none did occur, but tlie physician had very early hinted that the patient could not well be a man and be thus terrified at a bayonet, and that he must be a tailor. This roused the ire of the patient, the more so that M. Lherminier's conjecture as to the patient's trade turned out to be a true one, and gave rise to a series of extremely witty repartees on the part of patient and physician, which ultimately brought out the whole facts of the case. From these it appeared that iip to the moment of the rencontre with the sentinel he was in good health. I have often reflected on this vei7 singular, and to me unique case, and although such must have been seen by others, by M. Lherniinier, for example, I do not find them recorded any where. It has a singular interest phisiologically, and has led me to re-examine frequently the apparatus of the bile, and more especially the bile ducts. I shall here take the liberty of submitting the results to the Society. The structure of the ductus communis choledochns, the ductus hepaticus, and ductus cysticus, has been described with the utmost care and fidelity by Soemmering, and no doubt by many anatomists both prior to and since his time. 1 he greater number agree with him in describing the ducts, inclu- ding the gall bladder, as being composed, first of an inner