Notes of three cases of acute yellow atrophy of the liver / by Dyce Duckworth, M.D. and J. Wickham Legg, M.D.

  • Duckworth, Dyce, Sir, 1840-1928.
Date:
[cbetween 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: Notes of three cases of acute yellow atrophy of the liver / by Dyce Duckworth, M.D. and J. Wickham Legg, M.D. Source: Wellcome Collection.

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

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    By Dr. Harris's kind permission the following notes, taken from his Ward Book, are added : May 19.—Is somewhat wasted, and tlie whole integument excessively jaundiced. Pulse 120 to 130. Chest is well fonned. Kespiratory and cardiac sounds are normal. The hepatic dullness is somewhat diminished, and cannot be traced below the seventh rib. The abdomen is soft and flaccid, and allows of free depression; but the margm of the liver is not to be detected. Has repeated attacks of the most furious delirium with intervals of comparative ease and sleep. Tem- perature 99-4° F. Ordered pil. hyd. gr. v. and pil. rhei. co. gr. V. May 20.—Passed a quiet night after taking the pill: has had no return of the delirium. Is now in a comatose condi- tion. Had almost incessant vomiting of semibilious and bloody fluid during the morning. The bowels have not acted since admission. Died at 4 p.m. As the patient passed urine involuntarily, none could be obtained during life for examination. The post-mortem examination was made twenty hours after death. Weather warm. The skin was everywhere stained a deep yellow colour, except on the backs of the arms and trunk, where the surface was of a deep livid violet. A chocolate-coloured fluid was escaping from the nose and mouth. Rigor mortis was present. The body Was fairly nourished: no ecchymoses were noticed on the skin. The spinal chord was not examined. The sutures and calvaria were natural. The longitudinal sinus contained no clot. The convolutions seemed more pressed against the skull than natural. The ventricles contained about half a fluid-ounce of a turbid fluid. The fornix was much softened and could not be raised. The venas magnae Galeni were natural. At the base of the brain, along the fissure of Sylvius, and over the central parts of the base, the membranes looked perfectly healthy. The optic thalami, corpora striata, crura cerebri, pons Varolii, medulla oblongata, together with the cerebellum and circumferential parts of the brain, showed no signs of disease. The vessels and brain substance were not examined microscopically. The sinuses at the base of the skull contained a considerable quantity of semi- fluid blood. The larynx, tongue, and pharynx were not examined. On opening the abdominal cavity, numerous ecchymoses were seen studding the omentum and colon.