Hydatid disease, Vol. II. By the late John Davis Thomas... A collection of papers on hydatid disease / edited and arranged by Alfred Austin Lendon.

  • Thomas, J. Davies (John Davies), 1844-1893.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Hydatid disease, Vol. II. By the late John Davis Thomas... A collection of papers on hydatid disease / edited and arranged by Alfred Austin Lendon. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    the large size, and smooth surface of the waxy liver offer a certain resemblance to some cases of hydatid imbedded in the liver: an explor- atory puncture would readily solve any doubts. 3. From Tropical Abscess.—Unless the hydatid has suppurated, but little difficulty is likely to arise, for ordinary hydatid disease is- unaccompanied by the constitutional disturbance present in most cases of tropical abscess. However, a hydatid may suppurate and cause constitutional dis- turbance, whilst in tropical abscess the disease may lie latent, or pyrexia present may be attributed to the remains of “ fever and ague,” from which the patient suffered in the tropics. Echinococcus disease is so rare in most tropical climates, e.g., British India, Ceylon, and the Straits Settlements, that error will rarely happen from this cause. In cases of doubt an exploratory puncture is indicated. 4. From Enlargement of the Gall-Bladder.—A pedunculated hydatid cyst projecting from the under surface or lower edge of the liver closely simulates an enlarged gall-bladder : either may be moveable laterally, and may be elastic or yield obscure fluctuation ; an exploratory puncture alone will enable the diagnosis to be made. The contents of enlarged gall-bladders vary considerably : sometimes consisting of bile or various mixtures containing bile : at other times, of colourless serum : or it may be of pus or various mixtures of bile and pus.. Hydatid cysts contain either the normal clear hydatid fluid or, if degenerated, a thick yellow fluid closely resembling pus, but consisting of granular matter, large compound cells, and cholesterin crystals; oftenr also, hooklets or shreds of hydatid membrane may be discovered.* 5. From Hydronephrosis and Renal Cysts.—A thin-walled renal cyst may greatly resemble a hydatid cyst of the kidney or under- surface of the liver ; indeed, I have known a renal cyst to be repeatedly tapped and finally to be operated on by abdominal section under the supposition that it was a hydatid cyst; the fluid contained in it was thin, pale, serous-looking, but unfortunately no chemical examination of it was made. The real nature of the case was revealed, partly by the absence of any mother-cyst at the time of operation, partly by the escape by the wound of calculi obviously of renal origin. * The author does not mention that the hydatid fluid may contain bile and yet remain quite clear and transparent, and that degenerated cyst contents are very often bile stained.—(A.A L.)