On acute dilatation of the stomach / by C. Hilton Fagge.

  • Fagge, Charles Hilton, 1838-1883.
Date:
[between 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On acute dilatation of the stomach / by C. Hilton Fagge. 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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    obliquely on its surface. A dilated stomach will generally betray its position by visible peristaltic movements, w^hich usually begin near the left costal cartilages, descend below the umbilicus, and after passing over to the right terminate by ascending more or less towards the right hypochondrium. In a case lately under my care a rounded protuberance displayed itself, as large as a foetal head, and appeared to revolve slowly as it followed the course I have indicated. Sometimes, also, faint waves may be seen passing in the opposite direction across the surface of the stomach, due, therefore, to an antiperistalsis. Often, when no contractions are at first visible, they may be induced by manipulating the abdomen rather roughly or by flicking the surface with a cold wet towel. When the con- tractions are considerable, they may be attended with a rumbling noise, audible at some distance from the patient, and with more or less griping pain. The course taken by their movements, and their position, are probably sufficient to dis- tinguish them from the peristaltic contractions of any other part of the alimentary canal. The movements of the small intes- tines, so frequently seen in cases of chronic intestinal obstruc- tion, present very different characters ; and in the transverse colon direct peristalsis would produce a wave passing from right to left, or in the reverse direction to that which has been described as belonging ordinarily to the gastric contractions. In one instance, indeed, in which all the symptoms pointed to the existence of chronic obstruction of the large intestine, with dilatation of the transverse colon, I observed movement from left to right, which must, therefore, have been due to an anti- peristalsis ; but the seat of distension was then very different from that met with in cases of dilated stomach, and the sacculi of the bowel appeared to be plainly visible.^ I have entered into the more detail with regard to the physical diagnosis of what may be termed chronic dilatation of ^ Dr. Brinton, as is well known, denied the occurrence of antiperistaltic con- tractions of the intestine. But Engelmann has recently observed such contractions in dogs, rabbits, and cats (' PflUger's Archiv,' 1871, iv, p. 33). Even were Dr. Brinton's views correct, they would not, I presume, be applicable to the stomach, in which organ reverse movements of the contents are believed to occur regularly during digestion.