Carcinoma of the kidney, nephrectomy ; A case of gastrostomy for malignant disease of the oesophagus / by Charles Williams.

  • Williams, Charles, 1827-1907.
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: Carcinoma of the kidney, nephrectomy ; A case of gastrostomy for malignant disease of the oesophagus / by Charles Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    left axilla below the fourth rib, there were dulness or percussion, distant breath sounds, and friction. The heart’s apex beat was in the fourth space in the left nipple line, and there was a loud systolic bruit over the whole base. The patient was ordered raw beef-juice, milk, and champagne. The side was poulticed, and she took a mixture of ammonio-citrate of iron and spirits of chloric ether. Her restlessness and distress of breath- ing were so great that an opiate was given at night with relief. She slowly lost ground until June 12th, when it was noted that the pulse was 160 and remark- ably weak; respiration 72, and so laboured that she was scarcely able to speak’. She had lost feeling in both legs, which were cold and cedematory. The tongue was dry throughout, and covered with black sordes. Her ashy colour and painful restlessness bore a close resemblance to a case of post-partum haemorrhage. The physical signs denoted a small pleuritic effusion only, and bloodlessness was obviously her urgent con- dition. To all appearances death was imminent, and as a last resource transfusion of blood was decided on. Mr. Williams quickly connected the median basilic vein of the donor with that of the patient by means of Galabin’s apparatus, and allowed the stream to flow from one to the other for four minutes. The necessary dissection seemed to cause the patient no pain, and the operation presented no difficulty. Two hours later the patient was decidedly improved, the respiration had fallen to 48°, and the pulse was not only slower (140) but less thready. From this time she slowly made way, though her