Diseases of the stomach : including dietetic and medicinal treatment / by George Roe Lockwood ... ; illustrated with 126 engravings and plates.

Lockwood, George Roe

Date:: 1913

Credit: Diseases of the stomach : including dietetic and medicinal treatment / by George Roe Lockwood ... ; illustrated with 126 engravings and plates. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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$granules take basic stains, and are usually small in size, appearing like fine points. Often, howe\'er, the size varies, some being as large as eosinophile granules. Granular basophilia is found in other diseases, but in none of them is it so evidently out of proportion to the degree of anemia, and in this lies a diagnostic sign of the greatest value. At any time one of the more characteristic symptoms may appear, colic being more often the first. It is apparently due to spasm of the bowel, and is usually preceded by obstinate constipation, and often by premonitory pain of less severity. Sooner or later, and frequently beginning at night, there is a violent outbreak of spasmodic abdominal pain. It may be chiefly umbilical, or epigastric, or diffuse over the entire abdomen. Schmidt^ states that it is often accompanied by sharp lumbar pain. Vomiting is common. During the paroxysm, the abdominal wall is usually hard and retracted, pressure often giving relief, although at other times the entire abdomen is markedly tender. Between the violent spasms which last a few minutes the patient is in comparative comfort for a short interval. The severity of the attack is variable, some being so agonizing as to cause complete prostration, while others are tolerable. It may last from a few hours, or with remissions may extend over several days. The attacks recur at various intervals if exposure is continued. The distinguishing characteristic of lead neuritis is its distribution. It eventually produces bilateral wrist drop from paralysis of the extensors of the fingers and wrists. Less frequently' and usually later the perinei and extensors of the toes and ankles become involved. The paralysis may become quite general, progressing from the per- iphery, or more rarely other atypical forms of paralysis may appear at first. Delirium, coma, convulsions, epileptiform or unilateral, or variable are the most striking cerebral symptoms. They are always dangerous, and sometimes of extremely grave portent. They may be precipitated by unusual indulgence in alcohol, and are said to occur in a larger percentage of negroes than of other patients. There is no constancy in the order of appearance of the different symptoms. Colic, paralysis, or even coma may be the first indication of illness to the patient or his friends. Other constant but less charac- teristic symptoms are evidences of arterial and cardiac sclerosis, of interstitial nephritis and ocular symptoms, such as muscular paralyses, hemianopsia, and general and gradual impairment of vision. Of the ocular disturbances some are due to the ence])hal()pathy, others to optic neuritis, and neuritis of the nerves of supply of the external eye muscles. ' Pain, its Causation and Diagnostic Significance in Internal Diseases, 1908.$