A dissertation on the importance of physical signs in the various diseases of the abdomen and thorax / by Robert W. Haxall.

  • Haxall, Robert W. (Robert William), 1802-1872.
Date:
1836
Catalogue details

Licence: Public Domain Mark

Credit: A dissertation on the importance of physical signs in the various diseases of the abdomen and thorax / by Robert W. Haxall. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    The various tunics which enter into the composition of the gall-bladder, the cystic and hepatic ducts, and the cho- ledochus common to the two, are liable to the same morbid alterations that are discoverable in other organs ; and these tissues may be separately or simultaneously diseased. The functional symptoms of icterus and discoloration of the feces, are constant in some of these lesions, but yet are incapable in themselves alone, of indicating the exact affection ; some of their diseases too, with the aid both of general and local symptoms are recognizable only after death. Whatever cause, operating mechanically, produces an obliteration or offers an obstruction to the free course of the ductus chole- dochus, will give rise to the two symptoms. With respect to those causes which are purely mechanical, and which act in no other way than by obstructing the canal, may be classed the different varieties of calculus, whether primitive in their formation, or the result of the inspissation of the ingredients which enter into the composition of the bile. The general and functional symptoms dependent upon this condition are known to all; the pain is frequently exquisite, and as the biliary fluid can find no exit, and its secretion still goes on, a reflux into the gall-bladder takes place, causing its distention and thus forming a tumor. In inflammation of the mucous lining of this duct, the cystic, and the gall- bladder itself, we also are enabled to discover a tumor by the touch, which will afford indications of increasing pain or pressure ; while in the case of a mere mechanical obstruc- tion, this will not be observed at least in so great a degree The reason here is obvious ; in their diseased conditions the' vital actions are exalted, sensibility is increased, and pain is the consequence. The situation of the tumor formed by the distended gall- bladder, will generally be found immediately under the cartilaginous border of the ribs, in the position which it naturally occupies; but. when the augmentation is great it may be felt lower down in the right hypochondrium ; and