Vol. 60, 1909 - University of North Carolina at Chapel Hill

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ORIGINAL COMMUNICATIONS, ."iS.S
of sutures^ 1'. inches apart from the costal simple plan, such as described bv Xarath
marg.n above to the free border below, should be done with local anesthesia.
Before closing the pentoneum below, the .5. That abdominal drainage is unnecesomentum
was turned up and fastened to the sary, but mopping the cavity thoroughly
pentoneum below the margin of the liver, dry "
is very important
The wound was closed with tier sutures. 6. That the patient be cautioned against
Convalescence was uneventful. She was the wearing of tight bands or belts about
?l'Tu ^
, n'l ,'^' '^ ""l ^°'-'^'' ^^P^ ^^*^'''^- '^^ ^^'^'^t ^^^^' lea^'i"? tlie hospital, lest the
On the 10th day she was given potassium superficial anastomosis be interfered with
iodide beginning with 5 grains and going a point to be especially emphasized when
up to 1.-) grains, three times a day. She the patient is a woman
has continued _this up to the present time. As to the case under discussion, I am not
On March 1/th, measurements showed prepared to say whether the cirrhosis was
one-half inch gam at the umbilicus and due to a primary heart lesion or not. I do
little or no fluid present. She left the hos- not believe it was specific. The iodide was
pital on March 21st, and has reported at given empirically. lam not prepared to
my office every two or three weeks since establish a relation between the cirrhosis
that time. She goes wherever she wishes, andher peculiar, undeveloped physical coneals
heartily and seems perfectly well and dition or, in the event of such a relation exhappy.
She IS still troubled occasionally isting, to state which is the cause and which
with dyspnea on exertion, and is, at times, the result. It is upon this point, especially
cyanosed. She chills very quickly, show- that I desire the help of the Academy.
ing poor circulation. The liver is some- I do not regard this patient as cured, but
what smaller, measuring two inches less remembering that seven months of almost
below the xyphoid. The abdomen is one complete relief have followed an operation
inch smaller around the umbilicus. which was preceded by nearly three years
On August 25th I gave her thyroid ex- of invalidism growing progressively worse,
tract, three grains three times a day. On latterly threatening her life and requiring
September 20th she came to me with sev- frequent tapping to make life endurable, I
eral quarts of ascitic fluid and lips cya- do claim that this operation is entirely jusnosed.
I put her on a dry diet, stopped the tified even if nothing more is gained.'
thyroid extract, gave her a tablespoonful 10I)0 West Grace Street.
of Epsom salts daily, and in three days the
ascitic fluid disappeared again. Repair oS Recent Lacerations oi the
Pathologic report on excised specimen. Perineum'^
by Dr. !•:. Ouy Hopkins. Capsule thick- '
„,. ^.,,,,,,, ^ ^^^, ^ Richmond, V,,.,
ened and congested. Perilobular connective rrofesssor of Cynecology. Medical College of
tissue increased in amount and contains Virginia; Gynecologist, Memorial Hosnumerous
round cells and leucocvles. Bile P''^'- Surgeon, City Hospital.
!!,y.l' 7TZ'}-u\"^T'^ '" """"!''' ?^^% After rather an extensive opportunity for
nterior of the lobules shows 3 network of
observation, I am convinced that the anatnev
coniiec ive tissue following the cords
^^y, function and repair of the female peri-
•to the central vein. I he blood vessels are „,^^ f^,^ ^ somewhat hazy conception in
conges ed, more especiafly the branches o
the minds of many of the medical profesthe
porta vein. Ihe liver cells are normal
.j^,, ^ ^l^ii ^^t" attempt at this time to
in size, shape and structure.
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