Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis : the Middleton-Goldsmith lecture for 1889 / by Reginald H. Fitz.

  • Reginald Heber Fitz
Date:
1889
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Licence: Public Domain Mark

Credit: Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis : the Middleton-Goldsmith lecture for 1889 / by Reginald H. Fitz. 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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    Some years later Xeuiuarm® stated that “death might take j)lace witliiii a few hours fiom a fatal metastasis of the huceal salivation to the pancreas. This hai)pens when in the midst of profuse salivation the pulse sinks and (quickens or the swelling of the salivary glands subsides, and salivation is rej)laced by a green diarrhoia, while the skin is dry and shrunken.” Under such circumstances the pancreas is found decidedly swollen, although but slightly reddened. Classen • knows of no observations in confirmation of Meumann’s statement, and doubts its truth, lie collects, how«-ver, a half-dozen cases, among them Schmaekjd'effer’s, of what he regards as fatal j)anere- atic inflammation, and from them he establishes the symptomatology of lumte ])ancreatitis. I'he views thus obtained essentially prevailed until the pul> lication of Friedreich’s article in Ziemssen’s Cyclo- j)8edia in The lesions found were as follows. In the second case, that of dupjiiiU “a section was made through the panerejis. Its tissue was dense and friable. It was a third larger i-ound than normal; it encircled two-thirds of the duodenum, which it comjtressed, and it atfected the ])ylorus also. . . . The pyloric oixuiing was almost entirely closed and the tip of the little finger could be introduced only with great difficulty and after repeated efforts. A vertical section through the pylorus showed it to be of almost cartilaginous density.” The third case is credited to Casper.® “ All the organs of the remarkably handsome, though exces- sively fat, body were wholly normal with the excep- tion of the j)ancreas. This was swollen to the size of a large list, of cartilaginous density, firmly united to the duodenum, and in part to the stomach, and was of a brownish-red color. 'Its structure was not recognizable.” The fourth observation is also from Casj>er.* 5 Von Uen Krankh. des Meusclien, Uerlin, 183<>; ClUssen, cii., nrj. 6 Op. cit., lys. ' .Jourii. de lued. chir. phariimc., 171)1. Ixlcx. 71); C'liisaen, p. 1500. • WocUell^cllr. f- d. jc®*- Heilkdo..lS3S, 41)7 . Claa^en, op. cit., 207. •> WocUeiisclir. f. d. ges. llellkde., 183C., 43U. ClkiMten, cit., 213