On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison, M.D.

  • Murchison, Charles, 1830-1879.
Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison, M.D. 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.

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    XXXI. Dr Joseph Bell. Glasgow Medical Journal, January 1857, p. 42, and pnvate letter from Dr Bell. A female, aged 33, admitted into Glasgow Royal Infirmary, July 17, 185G. Enjoyed good health till nine months before, when she had a History. child. Never recovered strength, and soon complained of lanci- nating pains in abdomen, which continued with occasional severe exacerbations. Five months before admission, copious hfematemesis. On admission, much emaciated, and of a deep sallow colour. A large, hard, flat tumour felt in epigastrium, stretching to umbilicus and left hypochondrium, very painful on pressure, and yielding on percussion a clear, somewhat tympani- tic sound. Frequent vomiting. Matters vomited were sometimes only ingesta, at other times they were very offensive; and Dr B., on the authority of the house- surgeon, has no hesitation in believing that feces were vomited. Bowels loose. Debility rapidly increased; and patient died July 31. Peritoneum of viscera and abdominal parietes studded with nodules of cancer- ous matter. Stomach, left lobe of liver, and colon firmly con- Post-Mortem. nected by a tumour, extending backwards to the spine. On opening stomach, it was found to communicate freely, in fact, nearly in its whole length, with transverse colon. The abnormal opening pre- sented a dark fungous-looking appearance. A portion of the tumour intervened between the walls of the two viscera. Ulceration of colon evidently of more recent date than that of stomach. Microscopic elements of cancer in tumour. XXXII. Dr C. Evans Reeves. Case communicated to me bj/Dr R. Alluded to by him in Work on Diseases of Stomach and Duodenum, 1857, p. 166. A male, advanced in years. Had suffered for some time from pain in region of umbilicus, most pronounced from 7 p.m. till 2 or 3 a.m., and History. after eating. Seven weeks before death, began to vomit fecal matter. For first two weeks, vomiting recurred at intervals of six or seven days ; the quantity brought up being scanty, dark coloured, and liquid. Later, it occurred every second or third day ; and during the last nine days of life it was incessant, everything but milk and iced water being imme- diately rejected. Even these, if taken in any quantity, either passed off instantly by the bowels, or were vomited with great straining, particularly if pressure was made over the descending colon, or if he moved in bed. When fluids were injected into colon, if much force was used, and a large quantity thrown up, they passed into stomach and were vomited. He became very feeble and emaciated, and gradually sank. Stomach very small. Mucous membrane deep purple. Pylorus free. Near the fundus, on great curvature, was an irregular opening, rather Post-Mortem. larger than a shilling, with ragged edges, situated in the centre of a cancerous ulcer, and communicating with the transverse arch of colon. The two organs adhered intimately, and the opening was of the same size in both. The walls of colon, to right of opening, were affected with cancer, and the canal so narrowed, that fore-finger could scarcely be passed through it. The colon formed an acute angle at point where communication existed. Hence it passed downwards, and was considerably dilated. XXXIII. Da MuRCHisoN. Trans. Pot//. Society of London, vol. viii.; Lan- cet,l857, i.,480 ; Med. Times and Gazette, 1857, i.,47l; Preparation in Museum of St Mary's Hospital, C.b. 11. A coachman, aged sixty-three, admitted into St. Mary's Hosjjital under Mr Urc, November 11,1853. Following particulars extracted from History. case book of Hospital :—Eighteen months before, whilst mount- ing a carriage, struck left side against the step. Six montiis after, abscess formed just beloAv left costal cartilages ; he lost ai)pc(ite, suffered