Dyspeptic and other referred symptoms associated with diseases of the gall bladder and of the appendix : a British Medical Association lecture given to the Norfolk Branch at Norwich, Dec. 19th., 1919 / by Sir Humphry Rolleston.

  • Rolleston, Humphry Davy, Sir, 1862-1944.
Date:
[1920?]
Catalogue details

Licence: In copyright

Credit: Dyspeptic and other referred symptoms associated with diseases of the gall bladder and of the appendix : a British Medical Association lecture given to the Norfolk Branch at Norwich, Dec. 19th., 1919 / by Sir Humphry Rolleston. Source: Wellcome Collection.

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    With the Author’s Compliments. Reprinted from the British Medtcal Journal, 1920, i, 317-20. DYSPEPTIC AND OTHER REFERRED SYMPTOMS ASSOCIATED WITH DISEASE OF THE GALL BLADDER AND OF THE APPENDIX. A British Medical Association Lecture given to the Norfolk Branch at Norwich, Dec. 19th, 1919. BY Sir HUMPHRY ROLLESTON, K.C.B., M.D., F.R.C.P., EMERITUS PHYSICIAN, ST. GEORGE’S. HOSPITAL ; PRESIDENT OF THE ROYAL SOCIETY OF MEDICINE. By referred symptoms is meant those that do not at once suggest local disease of the organ really responsible or that are remote in point of place; they might be described as masked or, as they are often the first manifestations of disease, inaugural, or as larval or frieste. The discussion of this subject has its difficulties; to consider separately the gall bladder and the referred symptoms caused by its disease and then appendicitis and its referred symptoms might be the simplest course; but as this would lead to some tedious repetition it appears advisable to take the symptoms and to refer incidentally to their causation. Most of the infective complications of gall bladder and appendix disease, such as the various forms of hepatic suppuration, empyema and fistulae, and intestinal obstruction due to adhesions, bands or gall stones, will not be mentioned. Except when specially stated, the disease of the gall bladder and appendix is not acute but either the result of a past attack of acute inflammation, such as fibrosis, adhesions or calculi, or a recurrent or chronic inflammation. Further, it may be pointed out that what we commonly call a “ chronic appendix ” is more often the result of a past attack than a progressive and chronic inflammatory process. Mechanism of the Production of Symptoms. The question how morbid changes in the gall bladder and appendix induce symptoms in other viscera and distant parts will be touched on in connexion with these manifestations, but the various mechanisms that may be at work in different cases may be tabulated here as (1) Reflex, (2) Mechanical, (3) Toxic, (4) Infective. [87/20]