Indurative mediastino-pericarditis / by Thomas Harris.

  • Harris, Thomas.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Indurative mediastino-pericarditis / by Thomas Harris. Source: Wellcome Collection.

    26/78 (page 20)
    As regards tlie digestive system, the appetite was good and there was no sickness. Tlie bowels were regular. The distension of the abdomen caused slight discomfort, but no acute pain. The abdomen measured 33in. in circumference at the umbilicus. It was quite free from tenderness, and a very marked thrill could be obtained by placing the hand on one side and tapping the opposite side. The distension was a distinctly uniform one. The veins of the abdominal walls were only slightly more marked than usual. The liver dulness commenced above at the level of the fifth rib in the right mammary line, but the lower limit of the organ could not be ascertained on account of the ascites. The splenic dulness could not be ascertained for the same reason. Area of Dulness and of Bronchial llosplration. Bubbles and Rhonolii. Fig. 7. Case 2.—J. M., xt S. Diagram representing the area of dulness over the right supra-scapular and the upper part of the right interscapular regions. Also representing the bubbles and rhonchi which were audible over the posterior part of the chest on April 8th, 1893. The urine was acid, of specific gravity 1022, and contained neither albumen nor sugar. I'he nervous system presented nothing unusual. Five days after admission the abdomen was punctured, and 167 ounces of clear slightly yellow fluid were withdrawn. After removal of the ascitic fluid, the lower margin of the Uver could be felt Ifin. below the costal margin in the right mammary line, and the surface of the organ felt smooth and firm. The upper limit of the liver dulness after the tapping was in the fifth intercostal space. The upper limit of the precordial dulness also fell to the lower border of the second left costal cartilage, and the transverse measurement of the cardiac dulness was considerably less than before the tapping. There still remained a small area of dulness over the lower part of the abdomen, due to a