The treatment of diseases of the digestive system / by Robert Saundby.
- Robert Saundby
- Date:
- 1906
Licence: In copyright
Credit: The treatment of diseases of the digestive system / by Robert Saundby. 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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![peristaltic waves passing across its surface. Sometimes we may tiiid that the severe pain of which comphiint has been made is due to nothing more serious than a crop of herpes zoster, although the severity of the suffering may have suggested renal or biliary colic, or even peritonitis. Having noted all that can be made out by this means we next iml- pate the abdomen. There is probably no means of examin- ing the body more fruitful in giving accurate information, when used by a skilled observer; it is, therefore, important to cultivate the art and to pay attention to the rules for its application. The physician stands on that side of the patient which he desires to examine, facing towards the patient's head and on a level with or rather lower than the hip joint; his near hand should be placed fiat on the abdomen so as to bring the whole surface of the palm and the palmar aspect of the fingers in contact with the skin, preferably at first in the long axis of the body, and the ])atient must be asked to breath deeply and slowly. As the muscles relax during expiration he should endeavour to explore with his fingers the underlying viscera. At first the abdominal muscles may be more or less tense, but by continuing to keep the patient breathing deeply this con- dition, if due to nervousness on the part of the patient, will disappear, and the tips of the fingers will readily detect the outline of any solid body within the abdomen; if the muscles, however, remain rigid, particularly if this rigidity is quite local, there is good ground for suspecting inflam- mation or peritonitis, the tension of the muscles being due to protective reflex contraction. In this way the edge of the liver, especially if enlarged, can be felt, and we may mark the line on the skin with a dermographic pencil; the spleen, if swollen, can be made out in the same way. Masses of new growth are generally tender and more or less fixed, while faecal lumps are usually movable, can be](https://iiif.wellcomecollection.org/image/b21517708_0019.jp2/full/800%2C/0/default.jpg)
