Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    95. Stomach.—The stomach varies in size more than any organ in the body. When empty and contracted (79) it lies at the back of the abdomen, overlapped by the left lobe of the liver, and in front of the pancreas. When very full, it turns on its axis and swells up towards the front, coming close behind the wall of the abdomen, occupying most of the left hypochondrium and epigastrium, displacing the other con- tiguous organs, pushing in every direction, and often inter- fering with the action of the heart and left lung. Hence the palpitation and distressing heart-symptoms in indigestion and flatulence. The cardiac orifice of the stomach lies to the left of the middle line, just below the level of the junction of the seventh costal cartilage with the sternum. 96. Pylorus.—The pylorus lies under the liver, on the right side, near the end of the cartilage of the eighth rib ; but it cannot be felt unless occasionally when enlarged and hardened by disease. 97. Spleen—The spleen, if healthy, cannot be felt, so completely is it sheltered by the ribs. It lies on the left side, connected to the great end of the stomach, beneath the ninth) tenth, and eleventh ribs, between the axillary lines—lines drawn vertically downwards from the anterior and posterior margins of the axilla. Its upper edge is on a level with the spine of the ninth dorsal vertebra, its lower with the spine of the eleventh. Its position and size, therefore, in health can only be ascertained, and not very accurately, by the extent of dul- ness on percussion. The greatest amount of dulness would be over the tenth and eleventh ribs ; above this the thin edge of the lung would intervene between the spleen and the abdominal wall. If, therefore, the spleen can be distinctly felt below the ribs, it must be enlarged. In proportion to its enlargement, so can its lower rounded border be detected below the tenth and eleventh ribs, especially when forced downwards by a deep inspiration.5 98. Pancreas.—The pancreas lies transversely behind the stomach, and crosses the aorta and the spine about the