Actinomycosis of the colon, liver, and lung / by R.F.C. Leith.

  • Leith, R. F. C. (Robert Fraser Calder)
Date:
[1894?]
Catalogue details

Licence: Public Domain Mark

Credit: Actinomycosis of the colon, liver, and lung / by R.F.C. Leith. 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.

    6/72 (page 126)
    Progress of the ease.—Tlie patient remained in much the same condition, his temperature becoming normal in the morning and usually rising in the evening to a little over 101° or 102°, his bowels only moving after an enemata, until the 27th September, when Mr. Caird operated in order to, if possible, remove the tumour. He first cut down in the kimbar region posteriorly, reach- ing the kidney comparatively easily. It seemed to be considerably enlarged, but its surface was smooth and pre- sented no palpable lesion, although its upper border could not be reached. He then cut down in front, making a long vertical incision. On inserting his finger he found that the structures were much matted together, and, on exploring the upper part of the wound, he discovered a large tumour, occupying either the lower part of the right lobe of the liver or the upper part of the kidney, and adherent in front to the anterior abdominal wall, he could not determine which, and, as he discovered that the hepatic flexure of the colon was quite gangrenous, tearing at once when touched, he did not consider it justifiable to explore further. He inserted a bent glass drainage-tube, and closed the wound. The patient's pulse remained steady all through the operation, and he rallied well. He passed flatus on the same evening and seemed to be progressing satisfactorily. His condition seemed to improve a httle during the next few days, and then his cough began to increase considerably. Expectoration now became fairly copious and crepitations were abundantly heard all over his chest. His temperature, cough, and expec- toration led to a suspicion of the development of acute phthisis, but no microscopic examination of the sputum was made. He became steadily worse, and, gradually losing strength, sank and died on the 20 th of October. The post-mortem examination was made by me sixteen hours after death. External charaeters.—The body was muscular, and fairly well nourished. There was well-marked lividity posteriorly, and a greenish discoloration of the abdomen. Rigidity was present,and apowerfully offensive odour emanated from the body. There were two surgical incisions on the right side, the one