On abdominal abscess : a clinical lecture delivered in the Royal Infirmary, Edinburgh / by T. Grainger Stewart.

Date:
[1875?]
Catalogue details

Licence: Public Domain Mark

Credit: On abdominal abscess : a clinical lecture delivered in the Royal Infirmary, Edinburgh / by T. Grainger Stewart. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    {Lecture delivered May 1875.) Gentlemen,—We Lave lately had in my wards some good illustrations of a group of diseases not very often met with, but wliich now and then occur in the practice of a physician, and with which it is essential that you should be acquainted. I refer to cases of abdominal abscess. You will remember that on making our visit ten days ago, we found in Ward VIII. a woman wlio had just been admitted, complaining of abdominal pain. She was evidently very seriously ill, and we proceeded at once to investigate her case. Let me remind you of the facts we elicited. Slie was forty-seven years of age; was a mill worker; had always been healthy till towards the end of April, wlien after violent exertion she was seized with a shivering, > and pain in the left side, in the region of the kidney. She managed to work on for about five days, and then had to give in and take to bed; when there she discovered a fulness at the painful part between the ilium and the ribs on the left side. Slie remarked that it was very tender to the touch. It gradu- ally increased in size. There was no history of renal calculus. Tlie face was flushed ; the skin hot; the thermometer registered, after only five minutes in the axilla, 102° ; the pulse was rapid and not strong. There was no lesion to be discovered, except- ing a large slightly nodulated mass, situated in the left side of the abdomen, and extending from the crest of the ilium to the ribs, being continuous with the kidney at the back, and reach- ing in front nearly to the umbilicus. The mass was quite dis- tinct from the spleen and the liver. It was tolerably firm, but at the central and most prominent part there was deep fluctua- tion. The urine was acid; deposited urates on cooling; and contained neither albumen nor tube-casts. The patient had suffered a good deal from constipation, but action had been readily obtained by laxative medicines. With these facts before us I was pleased to find that some of you at once diagnosed perinephric abscess; and as I judged that the case required immediate attention, I asked Mr Annandale to give us the benefit of his advice and assistance. You remember that a moderately fine needle, connected with an aspirator, was intro- duced through the anterior abdominal wall into the most pro- minent part of the mass, and that immediately on the valves being opened, pus escaped freely. The pus was singularly