Cholecystotomy for the removal of gall-stones in dropsy of the gall-bladder / by J. Marion Sims.

  • J. Marion Sims
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Cholecystotomy for the removal of gall-stones in dropsy of the gall-bladder / by J. Marion Sims. 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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    again, the itching was so intolerable that she was compelled to scratch with great violence. She was never clear of the itching and burning sensation in the shin, which was occasionally attended with what is known as “goose-flesh” roughness, with a sense of internal chilliness, but she never had distinct rigors. She passed whole nights without sleeping, simply because of the itching and scratching. No remedy, internal or external, produced any permanent benefit. On January 15 th, 187S, Dr. Noel Gueneau de Mussy saw her in consultation with Dr. Bremond. The swelling in the right hypochon- drium had increased, and was now easily recognised as a distinct tu- mour. For some time, she had complained of constant aching pain and weight in the tumour, extending back to the right lumbar region, with occasional pain under the right shoulder-blade. The pain in the tumour was sometimes lancinating, and, when she turned in bed, she was always conscious of the movement and pressure of the tumour. From this time. Dr. Bremond could see that the tumour grew from day to day. She had had nausea and vomiting from time to time, but now she vomited almost daily. From the inception of the jaundice, her stools had always been clay-coloured, except when they were bloody, and their odour was very offensive. On February 7th, Dr. Labbe was called in consultation with Dr. Bremond and Dr. Gueneau de Mussy ; but, in spite of their best efforts, there was no amelioration of suffering. The previous loss of blood and loss of sleep from itching, the continued enlargement of the tumour and the constant pain, the inability to take food in sufficient quantities and the daily vomiting, all conspired to produce a physical and moral depression that created great anxiety. It is useless to give a daily report of the progress of the case. All days were bad and all more or less alike. The same itching and burning, the same sleepless nights, the same offensive clay-coloured stools, the same pain in the tumour, in the right lumbar region, and under the right shoulder-blade, with occasional vomiting, were suffered every day. Our patient, from being a stout handsome woman, became thin and emaciated; and was jaun- diced, from the second day after her first attack, of a deep-brown ma- hogany colour. The urine was always scanty, intensely high coloured, and gave a bile tinge to the sides of the vessel when shaken. Besides Dr. Moissenet, Dr. Gueneau de Mussy, and Dr. Labbe, she was seen by Dr. Pean, Dr. Bouchut, Dr. Paquelin, and Dr. Dusseris. I saw the patient with Dr. Bremond on March 30th, and obtained the history already given, The tumour, which was continuous with the B 2
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