Duodenal ulcer / by B. G. A. Moynihan.

  • Berkeley Moynihan
Date:
1910
Catalogue details

Licence: In copyright

Credit: Duodenal ulcer / by B. G. A. Moynihan. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    died in a warm bath at 6 a. m., about thirteen hours after the attack of pain. I pass over the formalities of medical treatment; suffice it to say that all the obvious means of relief were perseveringly employed without any sensible effect. Inspection of the Body.—The peritoneum was univer- sally inflamed; recent adhesions attached the contiguous folds of the intestines to each other; a large quantity of fluid deeply tinged with bile was contained in the pelvis; and about a finger's breadth below the pylorus appeared a circular foramen, having a peritoneal margin, of the diameter of a writing-pen. It proved to be the centre of an irregular superficial ulcer of the mucous coat including in its extent two-thirds of the ring of the pylorus. There was no other appearance of ulceration in the intestinal canal. Case 2.—Mills, a hairdresser, had occasionally for the seven preceding years suffered sudden and very violent attacks of abdominal pain, from which he had always been speedily relieved by a wineglassful of brandy. On the dav of the fatal attack he had endured without interruption, attending to his business, and in the evening went to the market to buy fish for his supper. On his return the pain became intolerable, and he took the usual dose of brandy, but did not obtain from it the expected relief; he sat in a bent posture, with a sunken countenance expressive of much agony. Now and then he vomited. He dreaded going upstairs, but at length, making a desperate effort, he ran up, and fell as he entered his room. It was evident that he was inflamed at this time, and the brandy appears to have aggra- vated the symptoms. He died in thirty-six hours from the commencement of acute pain; ever)^ part of the peritoneum was inflamed; a circular aperture of the peritoneum large enough to admit a crow's quill was found at the junction of the duodenum and stomach. It was the centre of an ulcer that had destroyed the villous and muscular coats of the bowel to the extent of half an inch. . Coagulable lymph was effused about the pylorus, but not in quantity sufficient to produce an adhesion of the adjoining parts, so as to exclude the aperture from the cavity of the peritoneum. The margin