The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
[1906]
Catalogue details

Licence: In copyright

Credit: The symptoms, treatment and sequelae of non-malignant duodenal ulcer / par D'Arcy Power. 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.

    5/18 (page 5)
    1)V marked duodenal ulceralioii, the drug being destructive to the red blood corpuscles and being eliminated by the liver. There seems to be an ill-defined.relation between duodenal ulceration and some , cases of interstitial and tubal nephritis, whilst the stress of anthrax infection may fall upon this part of the alimentary canal. I do not want to weary you with lengthy and uninteresting details of cases of duodenal nicer so that 1 will de- tail the symptoms by a composite picture, premising that every case of duodenal ulcer which has come under my notice with acute symptoms of perforation or luemorrhage has been in a man. ( Women suffer in a smaller proportion of cases and in them 1 have repeatedly performed a gastro-jejunostomy on account of adhe- 'sions and constrict ion owing to the cicatrisation of an ulcer. , (A) PKKFOU..VTING DUODEX.VL ULCIUi rerforation. The subject of a perforating duodenal ulcer is usually a man in the prime of life who assures you that he has either never suffered from any dyspeptic symptoms up to the mo- ment of his sudden illness or has bad so little indigestion that be has taken no account of it. Without warning be is suddenly sei- zed wuth a slomacb-acbe of such severity that he becomes colla- ])sed at once and sends immediately for assistance. He may vo- mit, but from the onset be passes neither flatus nor faeces. Exa- mination within an hour or twm of the attack shows him lying on bis back, afraid to move, bis breathing shallow and rapid, his pulse small, regular and (piick, but not nearly so much accelerated as bis res|)irations. Ho looks pinched and haggard but bis tempe- rature is normal. The patient cannot localise the pain but com- plains that it is worse along the upper half and down the right side of the abdomen. The abdomen is not distended and is not motionless, though it moves less freely during respiration than it. should do. 'At first it is held rigid and the muscles on the right ' side are somewhat more tonically contracted than those on the left. It is everywhere tender and tympanitic. The area of liver dul- ness may not be altered and there is sometimes a point of maxi- mum tenderness in the right bypocondrium. If no operation be per- formed, the fiain becomes less acute and more generalised than it w'as at first. The i)atienl rallies from the initial shock and may fall asleep: be loses bis pinched.appearance, and though the abdo- men is still rigid it moves slightly during respiration. If unfortuu'