File:Annals of surgery (1885) (14596959937).jpg

Identifier: annalsofsurgery44philuoft (find matches)
Title: Annals of surgery
Year: 1885 (1880s)
Authors:
Subjects: Surgery
Publisher: Philadelphia Lippincott
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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ngto effusions which stain gauze sponges a golden yellow colora biliary origin. In a case recently of rupture of the liver, as soon as the ab-domen was opened black liquid and clotted blood poured out;when this was rapidly cleansed away the intestines were seenstained over a large area a dirty yellowish-brown color. Theywere positively stained and not, as in the former cases, of a redcolor and bathed in a dirty liquid. On examining the liver a deep rent was seen to the right ofthe gall-bladder, extending completely through its substance fromthe transverse fissure on its lower surface up through the freeedge to the coronary ligament on top. This man died four dayslater, possibly of biliary toxaemia but not of haemorrhage orperitonitis. THE WEAKENING EFFECT OF A LONGITUDINAL INCISIONTHROUGH THE RECTUS MUSCLE. Dr. Gwilym G. Davis reported the case of a man aboutforty-six years of age, who had been operated on for appendicitisabout a year previously. It was a suppurative case, with drain-
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INCISION THROUGH RECTUS MUSCLE. 721 age, and the incision was made through the right rectus muscleabout an inch from its outer border. It extended from an inchand a-half above the umbiUcus to three inches below. He wasa stout man and wore an abdominal belt After recovery therectus muscle in the region of the wound began to protrude andparticularly when the belt was off gave him considerable discom-fort. He applied for treatment because during the past twomonths the protrusion had markedly increased. On examination the scar was found firm in its full extent;there was no parting of the muscle with hernial protrusionthrough the line of incision. There was no ventral hernia but thewhole rectus muscle opposite the level of the incision bulged for-ward. The line of the incision can be distinctly seen in thephotograph (Fig. i), not as a protrusion but as a depression withthe bulging of the paralyzed muscle alongside. In this caseit is probable the tenth, eleventh, and twelfth thoracic nerves

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