On a case of syphilitic affection of the liver / by T. Grainger Stewart, M.D.

  • Stewart, Thomas Grainger, 1837-1900.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: On a case of syphilitic affection of the liver / by T. Grainger Stewart, 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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    OP SYPHILITIC AEEECTION OF THE LIVEE. In the following paper I pro]iose to describe a rare form of waxv or amyloid degeneration of the liver, and to indicate its relation to the hitherto recognised syphilitic aflFections of that organ. The patient from whose body the specimens were obtained was under my observa- tion for about four yeai's, and the history of his case has been recorded as a typical instance of the symptoms which atteud the waxy degene- ration of the kidneys and other organs.^ I subjoin an abstract of the case. Edward Burns, a bricklayer's labourer, aged thirty, first came under my observation in the Royal Infirmary, in January, 1860. His gene- ral health had previously been good, excepting that for some years he had been affected with constitutional syphilis. His throat was ul- cerated, his voice was husky, and he had a harsh cough. The respi- ratory murmurs were harsh, but the percussion notes were normal; the cardiac sounds were natural j the blood was poor in corpuscles, the white relatively more numerous, the red pale and flabby. The tongue was clean, the appetite pretty good, and the bowels open. The liver extended from the sixth rib to the umbilicus; the spleen was also enlarged. He passed upwards of 100 oz. of urine daily ; it was of low specific gravity, never contained a trace of sugar, but abundant albumen, and a few hyaline tube-casts. There was no drops)'-, or at the utmost a little oedema of the feet at night. He remained in the Infirmary about four months, and under iodide of potassium his liver diminished considerably. During the years which followed, his liver gradually diminished, while his urinary symptoms remained unaltered. The respiration became by degrees more interfered with, and ulti- mately a blowing murmur with the first sound became audible over both ba.se and apex of the heart. He died in November, 18G3, of bronchitis and cedema of the lungs. Autopsy.—The body was somewhat emaciated. The heart was en- larged ; its left side was much hyperbropliied; the aortic valves were competent, but there was a calcareous mass at the base of one ot the ' Edin. Med. Journal, Feb. 1861, and Aug. 1864.