The medical adviser in life assurance / by Edward Henry Sieveking.

  • Sieveking, Edward Henry, Sir, 1816-1904.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: The medical adviser in life assurance / by Edward Henry Sieveking. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    temesis, frequent vomiting, a tendency to haemorr- hoids, are features in the history of the aj)p]icant that would direct special attention to the liver. Actual jaundice at the time of application would necessitate a postponement, and after its cure, which would be speedy if the cause was a catarrhal or some similar passing influence, further inquir}^ should he made. The habitual condition of the evacuations would assist in the conclusion, and if they had fre- quently exliibited a chalky or clayey appearance, the inference would be that the liver was not secretins a due quantity of bile, and, therefore, imperfectly performing its functions. We are as yet far from having attained to as correct an estimate of the variations in the hepatic secretions as we are able to form of the renal secretion, and while even the early stages of kidney disease are generally diag- nosed with certainty from an examination of the urine, we constantly meet with advanced hepatic disorder either in the sick-room or in the deadhouse, where no such indication was to be found during life. There may be a dirty sallow complexion, not amounting to actual jaundice, which indicates a sluggish performance of the hepatic duties. A con- gested state of the congestival vessels, a rubicimd turgid nose, a full, slow, and sluggish pulse, are often associated with the same condition. Owing to the anatomical relation of the inferior hsemorrhoidal veins and the portal vein, congestion in the vessels of the rectum, as manifested in piles and the occurrence of haemorrhage per anum, is to be regarded as evidence of inactivity of the liver, very commonly met with