Acute abdominal diseases : including abdominal injuries and the complications of external hernia / by Joseph E. Adams and Maurice A. Cassidy.

  • Adams, Joseph E. (Joseph Ebenezer), 1878-
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Acute abdominal diseases : including abdominal injuries and the complications of external hernia / by Joseph E. Adams and Maurice A. Cassidy. Source: Wellcome Collection.

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    where later on, vine nature of the pain, “ griping’”’ and paroxysmal, or ‘‘gnawing”’ and continuous, or “ throb- bing ’’; and when the patient first took to his bed. If pane has occurred, it is important to ascertain if it synchronised with the onset of the pain; if the vomiting was repeated, inquiry should be made as to how many times on each day of the illness, as to whether the vomiting occurred apart from the taking of food and as to the appear- ance, quantity, and odour of the vomit. A complete account of the action of the bowels must never be omitted, paying particular attention to the date on which the bowels were last opened, to the passage of flatus and to the presence of diarrhoea at any stage of the illness. One should ask also if anything like “ matter,’ “ blood,” or “ jelly,” has been observed in the stools. Pain or difficulty in micturition 1s an important symptom which is sometimes not mentioned by the patient unless inquiries are made as to this point. Retention of urine is common, and may be either a reflex or a paralytic phenomenon. Finally, in certain cases it is well to ascertain if there have been any rigors or sweats, any expectoration (possibly rusty), any headache, or pains in the limbs or back. A vaginal discharge, hemorrhagic or purulent, is always a suggestive symptom, but it must be remembered that the normal menstrual flow is often “brought on’”’ a few days earlier by any acute abdominal lesion occurring during the week before menstruation is expected. Especially is this the case with appendicitis ; we have often seen a comparatively mild attack induce menstruation as long as a week before the normal date. Of all these symptoms, pain is the most constant, and the one which should yield the most valuable information to the clinician; but, unhappily for him, the amount of such information usually varies directly with the intelligence of the patient, for often patients of the hospital class either cannot or will not localise their pain with sufficient certainty to help us very much. On the other hand an intelligent patient will frequently indicate the exact area of his original