Deep petrissage of the abdomen as an aid to the diagnosis of tapeworm / by Richard J. Cyriax.
- Cyriax, Richard J.
- Date:
- 1912
Licence: Public Domain Mark
Credit: Deep petrissage of the abdomen as an aid to the diagnosis of tapeworm / by Richard J. Cyriax. Source: Wellcome Collection.
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![Oe 7 mn an as throat well and lungs much improved He left the camp and entered a sanatorium in Sullivan County. CasE IV. S. R., Russian, a painter, married, aged twenty-seven years. This was an incipient case. Apex May 4, t912.] ber 19, 1910, 154 pounds, and left to go back to work to support his family, February 16, 1911, weighing 172 pounds, The lung was clear and the case is evidently an arrested one. Several members of his family had died of tuber- culosis. Case V. M. B., Russian, a tailor, twenty-two years old, admitted December 2, I911, showing moderate advance- ment in both lungs and weighing 130 pounds. He left February 17, 1912, weighing 145 pounds and much im- proved. Case VI. F. B., forty-eight years old, Austrian, a valet, with a bad family and personal history, A heavy drinker and smoker. On first examination I refused to admit him, for his whole upper left lung was consolidated and right apex infiltrated and he also had laryngitis. He entered November 23, 1911. This patient is still in the camp, very much improved. His larynx is well and he weighs 171 pounds, having weighed 148 pounds on ad- mission. Case VII. J. J., twenty-six years old, a Swedish house servant, admitted December 11, 1911, with infiltration of right apex. Weighed 149 pounds. At the present time there are no rales to be heard. Patient is feeling well and weighs 159.5 pounds. Case VIII. B. B., tailor, aged twenty-four years; with infiltration of leit apex, ‘admitted December BL, OTOL; weighing 108 pounds, left January 27, 1912, to enter a san- atorium at Liberty, N. Y., very much improved, weighing 124 pounds and with no riles over the infected area. Case IX. J. K., American, salesman, aged thirty-three years; family history tuberculous, admitted January 3, ‘Physical examination showed infiltration of right apex above third rib, with profuse rales. February 24, 1912, he weighed 155 pounds. All rales have disappeared, also cough and constitutional en ig of the parts. He weighed 145 pounds on admission. The patient improved wonderfully. His voice returned to normal. He left the camp January 20, 1912, weighing 162 pounds. Several facts have been impressed upon me in the treatment of tuberculosis, which are worth men- One great mistake we make is that we allow our patients to return to work too soon, after the disease has been arrested. Many a patient could have been saved from, death by being made to remain at rest, and continue the treatment for six months or more after the disease had become inactive. I have seen many patients come back after a short time at work, with the disease active and very much advanced. In an institution like ours we treat male adults who usually have a fam- ily dependent upon them, and it is most difficult to convince a patient who is feeling strong and well, and has no symptoms, to remain from work for six months more. Again, never excepting in case of extreme emergency, allow a tuberculous patient to undergo a surgical operation, and above all, an operation in the nose or throat. Too often I. have seen patients recovering from pulmonary tubercu- losis, subjected to an operation, and as a conse- quence lose more ground as far as the tuberculosis is concerned, than can be regained in many months. For example: A patient getting well from a tuber- culous infection of the left apex was operated upon for catarrhal appendicitis. He recovered without a hitch from the appendicitis, but immediately had an. afternoon fever with many rales over the 929 area of the disease. This may have been due to the anesthetic. Another patient, with an arrested case, was working every day and came to the night camp taking the routine treatment. A good strong man, weighing 172 pounds, who was recovering from a moderate infection, was operated upon—merely a resection of the nasal septum under local anesthesia. Two weeks after the operation he weighed 150 pounds, and the tuberculosis was most active. At the present time, two years after this operation, he has not regained the loss of those two weeks. Before concluding, let me advise all medical men to learn to diagnosticate pulmonary tuberculosis in its earliest stage, and to look with suspicion upon any patient who is losing weight or has an after- noon fever or a rapid pulse, with or without a cough and for which you can find no definite reason; begin treatment at once in the city, in such case; gain your patient’s confidence, convince him that he is going to get well, and protect his’ family from infection, and you will do more to check both the spread and the fear of the disease which the laity is now suffering from than by any other means in vogue at the present time. 221 WEstT 128TH STREET. DEEP PETRISSAGE OF THE ABDOMEN AS ANCAID TO THE DIAGNOSIS OF TAPEWORM. By RrcHArRD J. Certaxe Ma Ree. SS.) Toe Ce P., Tee Site Sree coe ree, a Sm i call London, Pane. As a general rule, a patient is not suspected of having a tapeworm until segments are passed in the stools, which is naturally pathognomonic of the con- dition, any abdominal symptoms presented by an unsuspected case being ascribed (in the lack of fur- ther evidence) to dyspepsia; but there are some- times sufficient grounds for believing that a tape- worm is present, even when no segments have been passed. In such a case the problem of diagnosis is sometimes a difficult one, unless the same measures are resorted to as when a tapeworm is known defi- nitely to be present—namely, dieting and the ad- ministration of salines, followed by an anthelmintic and a brisk cathartic; thus diagnosis and treatment are often combined. Many authorities hold, how- ever, that these procedures are unjustifiable except in undoubted cases. The administration of a pur- gative alone, without an anthelmintic, is advised by some authors, the motions being subsequently ex- amined for segments and ova; but a purge by itself is apparently not always successful in bringing away proglottides, and examining the feces for ova is a very unpleasant process. Tn any case, diagno- sis by means of anthelmintics involves considerable discomfort and annoyance to the patient, temporari- ly interrupting the daily routine of work in a man- ner particularly harassing to busy people. “When a diagnosis of tapeworm has been confirmed, drastic action of the nature referred to of course becomes necessary, but sometimes cases of unconfirmed sus- picion occur, in which smart purgatives even by themselves are contraindicated and not to be made](https://iiif.wellcomecollection.org/image/b3345291x_0001.jp2/full/800%2C/0/default.jpg)
