Diseases of the gall-bladder and bile-ducts / by A.W. Mayo Robson.

  • Robson A. W. Mayo (Arthur William Mayo), Sir, 1853-1933.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the gall-bladder and bile-ducts / by A.W. Mayo Robson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    fevers, must be mentioned as causes of catarrh, direct or indirect. Murchison gives gout and syphilis as causes, and Dr. Fagge inchides under this heading jaundice' due to fright and that occurring in epidemics. Although it is well known that in cancer of the liver jaundice is a very variable sign, it is not always recognised that the icterus is at times dependent on the associated catarrh, which may be relieved by treatment, though the original disease persists. As the symptoms, diagnosis, and treatment of catarrhal jaundice are so distinctly subjects of medical rather than surgical interest, I will at once pass on to consider the chronic form, which from a diagnostic point of view has important surgical bearings. (b) Chronic cholangitis, or chronic catarrh of the bile-ducts, may be simply a sequel to the acute form, and may then give rise to]a more or less persistent jaundice leading to a suspicion of serious organic disease. Although there are dyspeptic symptoms due to the asso- ciated gastro-intestinal catarrh, with jaundice and some loss of weight, the retention of strength and the absence of serious sequelae, such as ascites and haemorrhage, generally enable a good prognosis to be given, especially as the symptoms usually yield to proper treatment. Catarrh of the bile-ducts probably always accompanies jaundice from whatever cause, and, as Dr. Moxon has pointed out, a colourless mucus is always found in the bile- ducts when an obstruction in the common duct is complete. A search through the pathological records of Guy's Hospital for twenty years failed to discover any exception to this rule. When the obstruction is only partial, the mucus may be well charged with bile, as the backward pressure is not sufficient to stop the secretion and pouring out of bile into the ducts. Specimen 1,420 in Guy's Museum shows dilated biie-ducts in the liver holding a pint of clear mucus (Fig. 10). There was a small cancerous growth in the common duct. Case 35 in my list of operations is an example, the obstruction being due to gall-stones. As a concomitant of cancer of the liver or of the bile-