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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    The chief interest of the case lies in the light which it throws on' the pathology of chylous urine. It can scarcely be doubted that the case was generically identical with that curious disorder. The absolute similarity of the discharge with the fibro-albuminous and fatty elements added to the urine in chylous urine, the sudden appearance and cessation of the discharge, the capricious terms of the duration of the discharge in the two disorders, and the actual occurrence of chylous urine on two occasions in the case of Robinson, scarcely leaves any room for doubt on this point. Had the disease in this case, instead .of occupying the subcutaneous tissue of the abdomen, been developed in the submucous tissue of any part of the urinary passages, it is evident that the conditions for the production of an ordinary case of chylous urine would have existed. It is even almost certain that some small part of the urinary membrane—probably that of the front of the bladder—was actually invaded by the disease which affected the abdomen, but no anatomical traces of such extension could be detected at the autopsy, owing probably to the fact that in the last few weeks of life the morbid process had retrograded, and had consequently left no appreciable marks on the surface of the bladder. In the way of treatment, the means tried were the internal administration of styptics of various sorts, especially of tannic acid, which was pushed to large doses. Locally, compression was attempted by means of long wide strips of adhesive plaster, but without any good effect. The discharge moistened and loosened the plaster, and the soft yielding nature of the abdominal wall rendered impossible any effective compression by bandages or belts. Attempts were also made to varnish the surface with a solu- tion of india-rubber in benzole, and with collodion, but every device proved unavailing. The rarity of this disorder is so great, that only one other exactly similar case, so far as I know, has been recorded as having occurred in Great Britain. This is the case published by Dr. A. B. Buchanan, of Glasgow, in the 46th vol. of the ' Medico-Chirur- gical Transactions/ In this case, a woman, 46 years of age, had an excoriated patch of skin, about the size of the palm of the hand, on the inner and posterior aspect of the left thigh, which discharged at