Enteralgia and chronic peritonitis / by A. Jacobi.

  • Jacobi, A. (Abraham), 1830-1919.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Enteralgia and chronic peritonitis / by A. Jacobi. 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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    it must be at a distance from the rectum; besides, no vaginal or rectal examination revealed the presence of a tumor or swelling. When the autopsy was made many years afterwards, in Zurich, Switzerland, there were found many discolorations and thicken- ings of the adventitia of the colon, some old adhesions of the de- scending colon to the abdominal wall, and a hard and massive band extending from the left ovary to the junction between the middle and lower third of the colon ; the latter was constricted to half its original size. There was a girl of seven years in Bellevue Hospital five years ago. She entered with a history of enteralgia, emaciation, loss of appetite. Her pain lasted sometimes for hours, sometimes for days; followed exertion, exercise, eating ; was sometimes mild, often excessive; raising the knees, passing of flatus, of urine, or belching would now and then relieve her—at other timesnotatall. Thus it appeared that the attacks were not always alike, and were probably the result of a variety of causes, partly mechanical, partly functional. The underlying cause of them all was chronic peritonitis. There was pain on pressure, some ascites,-and a large number of swellings, more or less hard, of the size of a hazelnut or hen’s egg, numerous, and big enough to be mistaken for neoplasms; now and then an exacerbation of temperature. All this made the diagnosis of chronic peritonitis safe enough. She was kept in bed for months, with careful diet and wine of pepsin ; absolute rest, poultices, a daily enema, and iodide of po- tassium i.n the beginning, iodide of iron afterwards. She left the hospital well and hearty, with no perceptible tumors, with no [tain for many weeks, and supplied with a bandage to protect her. She remained well, and died of a non-tuberculous pneumo- nia two years afterwards. I was fortunate enough to obtain the post-mortem examination. There were whitish discolorations of the adventitia, and thicken- ing of the intestinal wall in many places; very strong and nu- merous adhesions between the convolutions; thickening, and in part shriveling of the omentum, and a few hyperplastic glands of non-tuberculous character. This was a classical case, but one of the unusually severe ones of the class the picture of which I have tried to draw for my fel- low practitioners who are constantly called upon to meet them. The histories of previous acute attacks of peritonitis are often not remembered. One of the greatest physicians and surgeons New York ever called its own, died fourteen years ago, during his convalescence from typhoid fever, of peritonitis. He had often complained of enteralgia and occasional attacks of diarrhoea,