File:A practical treatise on medical diagnosis for students and physicians (1904) (14758068882).jpg

Identifier: practicaltreatis1904muss (find matches)
Title: A practical treatise on medical diagnosis for students and physicians
Year: 1904 (1900s)
Authors: Musser, John Herr, 1856-1912 Pancoast, Henry
Subjects: Diagnosis Diagnosis, Radioscopic Diagnosis
Publisher: Philadelphia and New York : Lea
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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iincil. 4. Absence of Effusion and Tumors, AMicn eifiision and tumors are notpresent, the increased thit-kncss of the peritoneum and of the intestinalwalls produces a modified duhiess over the entire abdomen. When re-traction takes place, tiie resonance is of a woodeny character, the abdomenis more or less tender, and an ill-detiued induration to which the termcarreau is applied may be present. The only other distinctive symptoms, apart from those descril)ed, arethe symptoms, if any be present, of tuberculosis iu other situations. Theappetite is usually impaired, there is some atonic dyspepsia, vomiting mayoccur at regular intervals, and the bowels may be constipated, althoughin my experience they have usually been relaxed. Anaemia develops,and the skin becomes harsh and dry ; the emaciation is often extreme,and the body covered with eruptions and boils ; oedema is sometimes pres-ent over the ankles. Death results from exhaustion and from tuberculosi&in other localities. Fig. 365.
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Tuberculous peritonitis. Note the emaciation, the length of the arm, the enlargement of the\yrist, the size of the hand, and the tapering fingers. Diagnosis. Cases belonging to the first and fourth classes above men-tioned probably present the greatest difficulties. Age is an important factor;peritoneal tumors, with or without effusion, in young subjects are almostalways due to tuberculosis-; in the aged they must be distinguished fromcarcinoma or chronic peritonitis from other causes. The existence ofdiarrhoea is rather against carcinoma. In males the primary lesion oftendevelops in the testicles. Sacculated peritoneal effusions may be con-fomided with ovarian or other abdominal tumors, especially if the tu-bercles develop primarily in the tubes or uterus. In a recent case theautopsy disclosed a large caseating nicer inside the uterus, with tubercu-lous disease of the Fallopian tubes and of the peritoneum. The righttube was chiefly affected. The effusion during life was encysted andc

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