The diagnosis and treatment of diseases of the stomach and intestines / by William Fitch Cheney.

  • Cheney, William Fitch, 1866-1941.
Date:
[1936], ©1936
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis and treatment of diseases of the stomach and intestines / by William Fitch Cheney. Source: Wellcome Collection.

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    not only causing distress in his stomach but a feeling of congestion in his head. His bowels were obstinately constipated. Physical examination was entirely negative. Gastric analysis showed a normal secretion. X-ray examination demonstrated no abnormality in stomach or duodenum, but the appendix was shown to be fixed and immovable and remained filled by the barium for forty-eight hours. Treatment for nine months by diet and medication resulted in no improvement, so that finally appendectomy was advised. This revealed that the appendix and the head of the colon were bound down by old and very dense adhesions, that the appendix was sharply angulated at its base close to the bowel and its distal portion distended and thickened. Following removal of the appen¬ dix and release of all adhesions, the patient’s symptoms all disap¬ peared. Nearly twenty years have elapsed since that operation, and the symptoms have never recurred. 2. A second patient, aged 42, for five or six years had had stomach trouble diagnosed as duodenal ulcer, with recurring attacks of pain, belching, waterbrash, burning, with nausea and vomiting, appearing one hour or two after meals, lasting for weeks at a time, and the symptoms never entirely disappearing even on treatment for ulcer. At the time he sought advice he had no such pain, nausea or vomiting, but complained of a heavy, dragging feeling in the pit of his stomach at all times after eating. No signs were found on physical examination over the upper abdomen, but decided tender¬ ness and a palpable finger-shaped mass over the appendix area. Gastric analysis showed a high-grade hyperchlorhydria with total acidity 84 and free HC1 72. By x-ray films no defect was noted in stomach or duodenum, but the cecum was fixed, the appendix in¬ distinctly outlined, tender to pressure. As the patient was no better after six months observation and medical treatment, operation was advised. When the abdomen was opened, a fibrous band was found extending from the base of the cecum to the abdominal wall, the cecum was twisted upon its axis and bound down to the wall of the pelvis by old inflammatory adhesions, the appendix was buried behind the cecum, bound down by adhesions there. Since