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Disease of the abdominal viscera was, perhaps, always a favorite object of research with Dr. amination/ and I believe the preparation is in the Museum at Guy's, I will state the facts nearly as I collected them. — in the pubic region from an hydatid cyst situated lehind the bladder.
Bright, and accordingly we find that his last contributions to the literature of his profession was the following series of monog Taphs upon Abdominal Tumours ; which, however, want of health and time did not allow him to finish. — The patient, who had been labouring under other disease, complained of the difficulty he had in retaining his water; and when an examination was made, it appeared that the urine was continually passing away, and that a tumour bearing all the characteristics of a distended bladder presented itse K at the pubic region.
Beprintecl from the ' Guy's Ho.tpital Eeports.' EDITED BY a. Such was the state of knowledge upon this subject when the inquiry was taken up by Dr. And here we may pause, to observe the character of mind which was then brought to bear upon one of the most important investi- gations within the whole range of medical sciejice. Bright was, indeed, a man of naturally clear judgment; and, as far as such a virtue can be said to have been a natural gift, of great industry. Malignant tumour in abdomen, probably ovarian ; discharging constantly from the wound made by paracentesis . At present, her pulse is 84, and sharp; tongue moist, but covered with a brown fur.
It is, however, remarkable that Blackall, although he availed liimself of all opportunities of inspection after death, never Succeeded in connecting the coinci- dence of these two remarkable phenomena, dropsy and albuminous urine, with disease of any internal organ. Wells, too, — a name scarcely less illustrious than Bright or Blackall, — investigated the subject in a most plulosophic spirit, but missed, though narrowly, the discovery of the disease of the kidney. Three weeks ago, when the jaundice had gone off, she suffered a severe rigor, of four hours' continuance, and has not since recovered.
The papers in question being essentially clinical, and consisting X PREFACE. As it was still supposed that urine was retained, more than one medical man attempted to draw it off, and at length the catheter became obstructed by the passing of small hydatids.
The first volume of the ' Select Medical Reports' was published in 1824, ^^^ ill this work, which includes observations on the morbid anatomy of continued fever, and of phthisis, wliich for their carefulness and accuracy would alone have established his reputa- tion as a morbid anatomist and pathologist. Bright valued anatomy only in so far as he could connect structural changes with symptoms during life, and was not satisfied unless he could establish the connection by a rational etiology. Tumour of the abdomen supposed to depend on the presence of hydatids ..... Hydatid connected with liver emptied by paracentesis Case II. The liver seemed healthy, but was thrown out of its shape by the large cyst, which had likewise encroached upon the thorax..
It was not enough that the urine was found to be albuminous; it was also examined as to its difference from the healthy secretion -in other respects. Hydatids k the abdomen, of many years' standing, showiug the acepbalooysts in almost every stage of their existence Case 2. Small simple cyst hanging from the uterine appendages, dis- covered after death . The strong adhesions which subsisted between the cyst and the parietes suggest the probabi Hty that, had this cavity been evacuated by an operation before the inflammation had been set up, the result might possibly have been favorable. — ^Lydia S — was admitted into Guy's Hospital, October 8th, 18 13, labouring under slight jaundice and mania.
This led to the discovery that, not only was there a continual abstraction from the system of a most important constituent of the blood in the form of albumen, but also that there was a non-elimination from the system of the natural ingredients of the urine, particularly of urea; and this led to the examination of the blood by Drs. But the time when such an operation could have been useful must have been long antecedent to her admission into the hospital, before her system had suffered from the slow suppuration of the sac, and still more, before this general peritoneal inflammation was set up, which, from the actively vascular appearance of the tumour, was, no doubt, a consequence of the local disease. It appeared that constipation of the bowels, attended with sickness and pain, had occurred about ten days before, and that two or three days after jaundice came on, ACEPHALOCYST HYDATIDS.
Por some time after the commencement of the present century, dropsy was regarded as in itself a primary disease, dependent upon a deficient action of the absorbents, though it was by no means proved that they were mainly, if at all, concerned in the removal of fluid from the serous membrane and cells of the areolar tissue ; the cause, then, which was commonly assigned for dropsical effusion was in the first place not a vera causa; since, as the function ascribed to the absorbents could not be proved, thus, a defect of function must also be a gratuitous assumption. Slow ex- haustion and death ; adhesions of the tumour to the parietes discerned during life . His own statement of the progress of the disease was, that about six years before he had a severe illness, which he believed to be scarlatina, and at that time his abdomen was enlarged.
Theke has been no English physician — perhaps it may be said none of any country — since the time of Harvey, who has effected not only so great an advance in the knowledge of particular dis- ease Sj but also so great a revolution in our habits of thought, and methods of investigating morbid phenomena and tracing the etiology of disease, as has the late Dr. To those who have received the knowledge of the connections of dropsy, albuminous urine, and disease of the kidney, among the first rudiments of medicine, the facts which establish that con- nection may appear so simple and so easily ascertained, that the amoimt of labour, the accuracy of the observation, and the rigid adlierence to the inductive method which characterised the whole of Bright's researches, may hardly have been suspected, sti U less adequately appreciated. The motions were rather pale, and the urine high coloured.