On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton.
- Dennis Embleton
- Date:
- 1870
Licence: Public Domain Mark
Credit: On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton. 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.
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![pain, and gives a more definite account of its connection with abscess of the liver, than any other pi’cvious author I have consulted. He mentions this pain as occurring also in a case of abdominal aneurism pressing on the liver. The subjoined extracts will be found of considerable interest. Louis,* * in his paper on Abscess of the Liver, as quoted by Dr. Budd, states that none of his patients, five in number, had any pain of the shoulder, and ho liesitates to believe that this symptom really belongs to di.sease of the liver. He conjectures that, when present, it may depend on concomitant disease of the lung or pleura. Professor Broussais-}* tells us that in hepatitis, “Les douleurs • se propagent quelquefois k I’tipaule, au bras droit, et ju.sque dans la hanche de ce c6y.” Professor G. AndralJ witnesses to the occasional presence of the pain in acute hepatitis, and to its being then sufficient to make the patient cry out, and to its existence in cases of impacted biliary calculi. He also notices|| the pain as one purely sympathetic, and occurring less frequently than had been previously said, but pressure—sometimes, indeed, it is relieved by holding or pi-essiug the shoidder, but it is often increased by pressure on the liver. This sympathetic i)ain in the shoulder is oecjisionally felt iu other diseases of the liver—iu cjises of cancer and of hydatid tumour. In a case of abdominal aneurism, this formed a tumour the size of a man’s head immediately behind the liver, which it had very much flattened, but there was no trace of inflammation about the organ. The bodies of the 1st, 2nd, and 3;jl1 lumbar vertebrae w'ere ])artiallv destroyed.”—(On Diseases of tlie Liver, 2nd Edit., 1852, p. l(i.j, et seej.) * Clinique Medicale de THotel Dieu de Paris. Trausl. by Spillau, 1836, p. 902 t Cours de Pathologie et Therai)eutique G6u6r<'de, 1835, tom ii. p. 183. j Cours de Pathologie Interne, 1836, tom ii. p. 195 et seq.—“ Uue douleur dans I’hypochondre droit s’eteudant souveut i la poitrine, et , jusqu’a rtqjaule du rueine cot6.” /n intense cases.—“L’hypochondre est dune sensibility exquise, la douleur de l’6paule jirrache quelquefois des cris au malatle.” In cases of biliary calculi.—“ La douleur du dos se prolouge jjarfois, dans le sein droit, le cou, ei I’yixiule du mfime cot6.”—Ibid, p. 233. II Clinique Medicale, 1837, tom iv. pp. 190 and 430.—“ II y a d’autres douleurs qui ue se inanifesteut plus seulement hi ou existe le foie, mais en des lieux plus ou moins 61oign6s ; elles sout ]>uremeut symp<ithiques, et resulteut d’une simple in-itiition nerveuse. Ainsi on a depuis long temps noty, sans pouvoir trop s’en remlre coiiqite, la douleur llxye i I’ypaule droite qui accompague uu certiiiu nonibre d’atfections du foie ; cette douleur nous a paru exister moins soiivent qu on ne 1 a dit j cependant dans plus d un cas nous I’avons observye d’une maniyre bieu trauchee. Under Obs. 32, of a case of abscess in the right lobe much nearer to the under than the upper surface.—“ Cette observation est la premiere dans laquelle nous trouvons, au nombre des pheuomyues morbides qui se mani-](https://iiif.wellcomecollection.org/image/b22471911_0012.jp2/full/800%2C/0/default.jpg)
