These papers require little or no comment ; they do not, indeed, suggest any new doctrine; but, besides abounding in important suggestions as to diagnosis and function, they are especially valuable as examples of care and accuracy in observing and in recording observations. This at once suggested the idea that the patient was suffering from retention of urine produced by enlarged prostate or some such mechanical cause.
It is but due to the memory of Bright to state, though without any design of imputing plagiarism to more recent con- tinental pathologists, that the description of acephalocyst hydatids, at page 1 8, ei seq., is altogether original, and certainly an anti^ cipation of similar observations wliich have since been published in Germany. A catheter was introduced by a skilful surgeon, and a few drachms of perfectly healthy urine drawn off, without producing any diminution in the bulk of the tumour.
Observations upon diseased liver in dropsy are also detailed; and these, whilst they point out the connection of ascites with obstructed portal circulation, show also that the necessary connection with diseased liver is limited to that particular form of dropsy. Hydatids in the spleen bursting into the abdomen, and causing death very speedily .... Hydatid of the liver suppurating and bursting into the abdomen, causing death .... Supposed hydatid of the liver bursting into the cavity of the abdomen ..... Hydatids in the liver, supposed to have passed off by the in- testines ..... Hydatid cyst in the liver, discharging itself externally ; and death from haemorrhage OTAEIAN TTIMOUES. The ga U-bladder contained about an ounce and a half of yellow fluid, almost entirely mucus, with a slight bilious tinge.
The most important series of cases consists of fatal cases of it in which the urine was albuminous, and by these observations was the connexion of diseased kidney, albuminous urine, and dropsy established. Bright, as well as to those who have followed him in the same path of discovery, to state that he described three, or, at the most, four forms of disease, with wliich the train of symptoms constituting what is now generally known as Bright's disease were associated ; and that, having done this, he has left the investigation of the minute structural changes to be worked out by others, whilst he devoted himself mainly to the completion of the clinical history. PAGE 13 30 36 37 38 39 40 41 42 44 45 47 49 5° Case I. The whole peritoneal surface of the abdomen showed marks of severe recent in- flammation, having on it shreds of yellow lymph and a considerable quantity of puriform serum. With regard to the hydatids themselves, they differed in no respect from what have been abeady described ; many of them had a num- ber of small holes within them, and some of them presented that peculiar appearance of the inner surface which resembles a heap of transparent granulations arising from their inner surface, such as is represented in Kg. In this case there can be no doubt that the irritation produced in the system by the unhealthy suppuration going on in the cyst, and afterwards the diffused inflammation of the peritoneum, were the immediate causes of death.
BOUGHT WITH THE INCOME FROM THE SAGE ENDOWMENT FUND THE GIFT OF iienrg KJ. There are no known copyright restrictions in the United States on the use of the text. It is not a little remarkable that this faculty of observation dis- played itself before Dr. The symptoms went on increasing ; the sickness became more urgent ; the tongue more dry and red at the edges ; the abdomen more tender.
The task of editing has, therefore, as far as the body of the work is concerned, been restricted to the careful correction of verbal errors and obscurities of expression, and the rearrangement of the plates, so as to bring them into juxta- position with the cases to which they belong. The tumour made pressure on the orifices of both the ureters, which were consequently very much distended with urine ; and the pressure which had been made upon the kidneys by the fulness of the pelves had produced a very extensive absorption of the substance of both. 41 in the meters was puriformj and there were some small clots of blood in the infundibula.
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.
IX serous membranes ; and thus was introduced a modified and rational humoral pathology. The dura mater was in tliis case spotted over its whole internal surface with a great number of bloody points from ruptured vessels. 54, was admitted into Guy's Hospital, labouring under serous effusion, with dyspnoea, and coagu- lable urine.
The doctrines of the solidists, as they were termedj were, however, in the ascendant ; and it was not till after much opposition, that the whole theory of the effects of retained secretion and consequent toxsemic poisoning was generally adopted. In each of the two following cases the only hydatid cyst which was discovered had developed itself in the space between the bladder and the rectum. — Tumour in the pubic region from, an liydati A cyst sittia' ted hehind the bladder. He died after remaining in the hospital some weeks ; and on examining the body a tumour was found, about the size of a very large orange, situated between the bladder and the rectum, so that it had pushed the bladder forwards, and, together with the bladder, presented a projection which was quite obvious before the abdomen was laid open.
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.