A case of disease of the lymphatics of the abdominal integuments, with occasional discharge of large quantities of a chylous fluid / by William Roberts, M.D.

  • Roberts, William, Sir, 1830-1899.
Date:
[©1870?]
Catalogue details

Licence: Public Domain Mark

Credit: A case of disease of the lymphatics of the abdominal integuments, with occasional discharge of large quantities of a chylous fluid / by William Roberts, M.D. 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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    it does not pit. The integument is manifestly hypertrophied, and this gives to the lower part of the belly a protuberant appearance. This dull-red tumid area is somewhat more extensive than the limits of the vesicles, and fades at the circumference into the healthy skin about an inch beyond the furthest vesicle in all directions. The skin around the larger vesicles, and groups of vesicles, is raised into soft nipple-like elevations, and has a more decidedly spongy feel than elsewhere. Slight pressure causes no pain, but the whole arc is more or less tender on deep pressure. The total number of vesicles is about two hundred and fifty. It may be said that in their normal state they do not discharge externally. But very frequently one, two, or three vesicles are ruptured and discharge freely a fluid resembling milk. The patient remained in the Infirmary from September, 1868, until his death in May, 1869. He continued in a stationary condition of health until about the end of March, when symptoms of pulmonary consumption set in, and increased rapidly, finally carrying him off on May 22nd. During this period he was care- fully watched, not only by myself but also by Mr. Cullingworth, our able physician's assistant, and by my clinical clerk, Mr. W. A. Patchett, from whose careful diary this history has been chiefly drawn up. In their normal state the vesicles were, as I have said, closed, and the immense majority remained throughout in this condition; but some dozen or so of the largest vesicles were, at one time or other, in a ruptured state, and discharged immense quantities of a chylous or lymphous fluid. The cause of rupture appeared to be some slight movement or violence. Sometimes the act of turning in bed sufficed to set the discharge in motion. It rarely happened that more than two or three vesicles were discharging at the same time. The quantity of this discharge, and its occurrence and arrest, were most irregular. Sometimes several pints would be discharged in a day and night, and sometimes only sufficient to moisten the cloths with which the patient girded himself. The patient was some- times continuously wet for three and four weeks; at other times the flow would continue only a few hours or a few days. The