Tuberculous occlusion of the oesophagus, with partial cancerous infiltration / by William Pepper and D. L. Edsall.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculous occlusion of the oesophagus, with partial cancerous infiltration / by William Pepper and D. L. Edsall. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Extracted from The American Journal of the Medical Sciences, July, 1897. TUBERCULOUS OCCLUSION OF THE CESOPHAGUS, WITH PARTIAL CANCEROUS INFILTRATION. By William Pepper, M.D., LL.D., DIRECTOR OF THE LABORATORY, AND D. L. Edsall, M.D., ASSOCIATE IN CLINICAL MEDICINE. {From the Pepper Laboratory of Clinical Medicine, No. 7.) On December 3, 1895, was admitted to the University Hospital a Russian cigarmaker, aged forty-two years, who had been seven years in America. His family history had no bearing on the case, and was entirely good. His father died at the age of sixty-eight, of joueumonia. His mother was killed in an accident, and his brothers and sisters, five in number, were living and well. There was no history of consumption or cancer in near relatives. His personal history up to March, 1895, was good, and he could remember no serious illness. He had never suffered any injury to the cesophagus. Syphilis was denied, and he had no evidences of it. In March, 1895, he had a severe and somewhat protracted cold. From tills he recovered, bat noticed, almost at once afterward, a feel- ing of constriction and oppression in his throat. Later he found swal- lowing was becoming difficult, and increasingly so. Once, upon attempt- ing to force down with his finger a piece of meat that had caught in his throat, he vomited, and the vomit contained blood. With this exception there was never vomiting, regurgitation, or discharge of blood. Severe pain was never present, and the history was solely that of dysphagia of increasing degree and with moderate loss of strength up to July, 1895. At that time his voice became weak and hoarse, and he found, for a time, he could not swallow even milk, and his strength failed so rajiidly he had to give up work. Not long after he again became able to swallow liquids, but could never afterward take solid food. The hoarseness persisted and increased, as did the loss cf flesh and strength, and in September he was admitted to the Jefferson Hospital, where the stenosis was diagnosticated and a gastric fistula establislied by Dr. Keen, with entirely successful operative result. He recovered well from tlie operation and left there six weeks after admission, and had since been fed through the tube in his fistula. His general condition, however, grew worse, and upon admission to the