Ddating advice direct 267 txt 267
more carefully prosecuted, the Hver was fouad structurally changed, the internal lesion upon which dropsy depended was supposed to have hence been satisfactorily demonstrated. He has never been decidedly i H in his feelings, nor has he been jaundiced. The favorite notion, also, of referring every disease to the Hver was not without influence, and since, when morbid anatomy began to be VI PREFACE. After about three months of active treatment, he became better ; and though never quite well, he continued ia tolerable health till three years ago, when his abdomen swelled, and a year after he first perceived the unequal tumours of which the swelling is now composed.This rigid and self- denying honesty in scientific investigation is no ordinary virtue; but in Bright it reaped its reward, for there have been few, if anj', who have observed and recorded so much, and have reasoned so extensively upon those observations, who have subsequently been required to correct or retract so little. tlie pathology of dropsj^; we say advisedly joa^^ofo^y, for Dr. Death from suppuration of the sac and its consequences , , Case 6. Tumour in the pubic region from an hydatid cyst situated behind the bladder .... Tumour in the pubic region from an hydatid cyst situated behind the bladder .... Hydatid cyst connected with the liver, emptied by paracentesis Case 10. The cyst itse K, owing to the sup- puration that was going on, had assumed a worm-eaten appearance.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..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.chiefly of well-grouped examples of tlie diseases under consideration, it lias been considered better to reprint them almost exactly as they were originally published. When this was dis- covered a sucking-pump was apphed to the catheter, and thus a considerable quantity of the debris of hydatids were removed ; how- ever, the symptoms of this disease remained, his other complaints increased, and ultimately the patient died. — The tumour which appeared on opening the body, filling the whole pubic region, proved to be a large hydatid cyst, attached to the posterior part and the fundus of the bladder, and pressing so much forwards as to prevent entirely the bladder from being filled with urine ; and this was the source at once of the tumour and of the constant escape of urine.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.
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.
There was one other quality by wliich Bright was eminently distinguished, and that was his philosopliic truthfulness. Incipient ovarian dropsy, probably of a malignant character . Diseased ovary with cysts in a case of extensive malignant disease of other organs . The parietes of the abdomen were attached very firmly by old adhesions to the tumour, which occupied chiefly the right lobe of the liver; the tumour was of a membranous appearance and vascular, and contained nearly a washhand-basin full of hydatids, of a U sizes, from that of a Trench walnut to a pea, but chiefly of about the size of a hazel-nut. greater number were burst and opaqu Bj but many retained their globular form.
He was, indeed, in all the relations of life, a man without guile, and as he would have scorned an untruth, so would he not endure that the slightest bias should be given to any observation, in order to favour any particular views or opinions. The fluid in which they were closely impacted was puriform^ and the parietes of the large cavity were lined internally with a layer of thick pus-like matter, with slireds and cakes of a cheesy substance, adliering closely.
CLINICAL MEMOIRS ABDOMINAL TUMOUES AND INTUMESCENCE. vn lie had leaxned to exercise his industry upon objects worthy of his energetic pursuit. Death from peritonitis, after the fluid was partially drawn from the cyst . Ovarian dropsy of many years' duration, showing several cysts in different conditions ; with the analysis of the fluids they con- tained . There is a tumour at the pit of the stopiach, extending almost to the umbilicus, tender on pressure, elastic to the feel, and appearing to have a solid base.
But the strongest powers of intellect languish and become feeble, if not matured by exercise, and industry which is not consistently exercised upon some definite object degenerates into a fitful restlessness. Bright brought not only these gifts to the study of his profession, but that his clear and vigorous intellect had been rendered more discriminating by the strict discip Hne of a sound and extended education, by which, too, PREFACE. There is great appearance of prostration, the bowels are relaxed, and the stools of a very dark colour.