Diseases of the gall-bladder and bile ducts, including gall-stones

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W. Wood, 1900 - 313 pages

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Page 39 - Thus, we see how purgatives act beneficially in the early stage of the feverish state ; and, of all purgatives, calomel and other mercurial preparations. These promote free action of all the glands which pour their secretions into every part of the alimentary canal, from the mouth to the anus. By this free excretion quantities of peccant substances are removed from the blood, which otherwise would have remained there.
Page 12 - Having reached the descending portion of the duodenum, it continues downwards on the inner and posterior aspect of that part of the intestine, covered by or included in the head of the pancreas, and, for a short distance, in contact with the right side of the pancreatic duct. Together with that duct, it then perforates the muscular wall of the intestine, and after running obliquely for three-quarters of an inch between its several coats, and forming an elevation beneath the mucous membrane, it becomes...
Page 22 - It is interesting to note that it is capable of holding nearly a pint of fluid before it overflows into the general peritoneal cavity, through the foramen of Winslow or over the pelvic brim.
Page 22 - A deformity of the liver, congenital or acquired, known as the linguiform process, may at times lead to a difficulty in diagnosis or in treatment. The common form is a tongue-shaped prolongation of the right lobe, which may project below the costal margin for several inches, and simulate a tumour of the liver or an enlarged gall-bladder.
Page 256 - The large peritoneal pouch, bounded above by the right lobe of the liver, below by the ascending layer of the transverse mesocolon covering the duodenum internally, externally by the peritoneum lining the parietes down to the crest of the ilium, posteriorly by the ascending mesocolon covering the kidney, and internally by the peritoneum covering the spine, has been long recognized, but perhaps not sufficiently appreciated in gall-bladder surgery.
Page 128 - ... curative. New Growths. — Of the tumours dependent on new growth, cancer of the gall-bladder is the most important, innocent growth, except of inflammatory origin, being extremely rare. The alleviation of symptoms, especially of pain by sedatives, is usually all that can be done, except in those rare cases where the disease is limited to the gall-bladder, when cholecystectomy may be performed. In a limited number of cases in which the liver is affected by direct extension from the gall-bladder...
Page 52 - There can be no doubt in the minds of those who have observed many of these cases that it is better to anticipate the complication, and as soon as medical treatment has been fairly tried and failed, the removal of gall-stones by surgical means should be resorted to before infection of the bile passages has occurred.
Page iii - Hunterian Professor of Surgery and Pathology at the Royal College of Surgeons of England.
Page 163 - Ulceration of the bile passages, establishing a fistula between them and the intestine. 7. Stricture of the cystic or common duct. 8. Abscess of the liver. 9. Localized peritoneal abscess. 10. Abscess in the abdominal wall. 11. Fistula at the umbilicus, or elsewhere on the surface of the abdomen, discharging mucus, muco-pus, or bile. 12. Empyema of the gall bladder.
Page 158 - ... cholelithiasis are paroxysmal attacks of pain, which, occurring at irregular intervals and often without apparent cause, start in the right hypochondrium or in the epigastrium, and radiate thence over the abdomen and through to the right subscapular region. These attacks are often accompanied by sickness or vomiting, and, if severe, by collapse. They may be followed by jaundice with its well-known symptoms, but this is frequently absent. At times a feeling of fulness in the right hypochondrium...

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