Appendicitis : with original report and analysis of one hundred and forty-one histories and laparotomies for that disease under personal observation : read before the Pan-American Medical Congress / by J.B. Murphy.

  • Murphy, J. B. (John Benjamin), 1857-1916.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Appendicitis : with original report and analysis of one hundred and forty-one histories and laparotomies for that disease under personal observation : read before the Pan-American Medical Congress / by J.B. Murphy. 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.

    60/60
    operation with sudden pain, followed by nausea and vomit- ing. The patient was brought to the Cook County Hospi- tal on the first day of sickness, and early the next morning he was operated upon, eighteen hours after onset, tem- perature at the time of operation 99 degrees, pulse 100. Slight tympanites; no induration to be felt. Operation: Lateral incision an inch towards the median line from the old scar. General peritoneal cavity opened. Sero-purulent fluid around the himd of the colon. Peritoneum congested, but not abraded. *The appendix was situated across the iliac vessels, adherent behind, half of it hung over brim of pelvis. Appendix and cecum were elevated out of the wound. About three drachms of sero-purulent fluid was sponged out. There were no limiting adhesions around the pus The seat of penetration of infection could be easily recognized on the peritoneal surface of the appendix Ap- pendix ligated, amputated ; gauze drain; recovery. Patho- logic conditions: The proximal two-thirds of the membrane of appendix greatly swollen. A small ulcer er^ isted where the infection penetrated the wall, but there was no perforation. What could have been the result in this case under expectant treatment? n f Drs Case 145 —Date of operation Feb. 12,1894. Operators,, v . Murphy and Verity. Mrs. E. P„ aged 42 years Patient had firJt attack in July 1893 Had a ifst^elow the 1894 which commenced with severe pain ]us mar’e-in of the last rib. This was accompanied by nausea, hnt guo vomiting. For the first few days there was fever; temperature not taken. This subsided, but the pain and tenderness continued until the time of JS?tic- had never been jaundiced. Examination : W ith anesthetic, an induration extending from the margin of the mnth parfilae-e downward three inches could be felt dis “nX It »!s stationary during the respiratory aot„ It SfeSKSSffisfe; the margin of the ribs. pus • the cecum was the remains of an abscess detected,, Pl^ fa<Jg of the adherent to and folded upon the poste )erforate(i at ascending colon. The appen K ‘ cavity. It could be its tip communicating with tlies abscessica .y terior wall seen where the abscess had e P Appendix ligated, am- of the colon at its hepatic flexure. Appenuix B putated Kecovery have found the cecum Remarks : This is the lirst tii iQn The abscess folded on to the posterior aurtMotthewton- was situated just below the edge of the live .