The Practitioner (Volume 49)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1892 Excerpt: ...there might be suppuration of the liver, and induced me to have an exploratory puncture made. On two subsequent occasions the operation was repeated. The first two tappings were without result. But on the last occasion (when circumstances suggested to me the propriety of having the puncture made from behind) although again no pus escaped, the patient fell into a state of collapse, and died after the lapse of a few hours. The post-mortem examination showed that the inimediate cause of death was haemorrhage into the peritoneal cavity due to the puncture of the liver, and that he had been suffering from suppuration in the course of the ramifications of the portal vein. There was also some evidence of old disease, and of recent inflammation, in the neighbourhood of the caecum. Case I.--Suppuration of the Portal Vein--Ague-like Paroxysms--Purpura--Death due immediately to Haemorrhage from the Liver, caused by puncturing it with a Trocar and Cannula. M. H., a labourer 28 years of age, was admitted under my care on the 3rd July 1886, suffering, it was supposed, from ague of eight or ten days duration. He had lived in the neighbourhood of Ely during the earlier part of his life, but the last twelve years had been passed in London. He had never had ague, or any other serious illness, and had enjoyed excellent health until his present illness began. On the 22nd of June he had some pain in the right hypochondrium, but it did not trouble him much, or prevent him from going to work. The next day, however, it was worse, and he was compelled to remain at home. From that time it got worse and kept him awake at night, he lost appetite and felt ill. In the course of two or three days he began to suffer from attacks of shivering, followed by sweats: the attacks coming on at l...