What to observe at the bed-side and after death in medical cases.

  • London Medical Society of Observation
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: What to observe at the bed-side and after death in medical cases. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    § Xr. D.] SI>ECIAL PORTIONS OP INTESTINES. [pART II. Miucular coat. Nubatance of wall— thickness. wounds. perforation. rupture. adliesion. examination for poisons. Special portions Ilf Intestines. Duodenum— Brunner’s giands. ductus com- munis. .lejunum and ileum— valvule conni- Tcntes. villi. Peyer’s patches. solitary glands. ^ crypts of Lieberktthn. CtBCum— appendix ver- miformis. 407. Muscular coat:—thickness; alterations in thickness (general or partial), esjtecially in parts altered in calibre (401);—development of longitudinal fibres ; of circular fibres. 408. Substance of wall of intestine:—transparency, when held between observer and the light;—thickness (measured in various parts), especially in parts altered in calibre (404).—Wounds {02C> et seq.).— Perfora- tions (625); exact situation, near attached or distal side of tube.—Ruptun;; its scat, extent, direction, etc. —If adhesion be observed between intestine and any other part, note if it corresponds in position with ulcers, cicatrices, j)erforations, or abnormal growths or deposits. — “ In cases of snapected ])oisouing, “ examiue tissue chemically for mineral poisons.” Special portions of Intestines. 409. Thiodentm.—Brunner's glands: degree of development;—if there be ulceration, note the rela- tion of smallest ulcers to orifices of glands.—Ductus communis: condition of orifice;—i>ermeability of com- mon and biliary ducts. 410. Jejunum and ileum.— Valvula conniventes: “present or absent?” size; peculiarities;—extent of in- testine occupied by them.—Villi: degrtu! of development; colour.—Beyer'sjtalches: number; situation;—matters adhering, mucus, j)liosj)hates, etc. (594);—degree of visibility; level at, above, or below that of adjacent mem- brane?—rugm; pits; saceidi;—deposit; its colour, con- sistence; in separate points, in one layer; situatiou, on mucous membrane, in sacciili, in sub-mucous tissue, in muscular tissue, in sub-peritoneal tissue, in several or all of the above;—colour of patch (595), conilition of vessels, etc.;—transparency, of patch, of tissues around; — consistence; length of strips obtainable from mucous membrane; adhesion between coats of intestine in situation of patch;—ulcers (624); sloughs (618 ef sey.); cicatrices (629); puckering—condition of peritoneum corresponding to patch. — Solitary glands: number ; situation; degree of prominence; —deposit; colour; ulcers, etc. — Cryyts of Lieber- kiihn: degree of visibility; colour. 411. Cacum:—situation; extent uncovered by peritoneum;—gelatinous softening.—Appendix vermi-