Enteroptosis and its relation to functional disturbances / by W.F. Hamilton.

  • Hamilton, W. F. (William Fawcett), 1865-1948.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Enteroptosis and its relation to functional disturbances / by W.F. Hamilton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    4/22 (page 2)
    It may be mentioned here, however, that Ewald’s methods of investi gation were more accurate than those of Glenard—for while it appears the latter did not employ any means of inflating the stomach or intestines, Ewald claimed that such was a necessity and thus by Glenard’s method of diagnosis, mistakes were likely to creep in. Treves, in England, has contributed to the study of the symptom- atology and treatment of this disease, while Osier was the first in America to include this subject in a text-book in 1892. Glenard’s disease or Enteroptosis or Splanchnoptosis, as it may be called, according to Stiller’s suggestion, should be considered indepen- dently of those conditions of visceral displacement resulting from former inflammatory process, such as frequently occur about the genital organs, of females and result in pulling down portions of intestine or an isolated organ. This view, however, is open to the criticism, that, upon the normal position of any one organ the position of the others largely depends, and it is possible to have very general ptosis result from such a cause associated with all those signs incident to the true disease. It is acknowledged, however, that in a large number of such instances the signs of the true disease are not prominent in the clinical picture and may be absent entirely. Meinert urges that the prominent pendulous abdomen resulting from numerous pregnancies “has nothing whatever to do with Glenard’s disease. Such an abdomen holds a dilated stomach, not a dislocated one.” However conflicting these views may be concerning the classifi- cation of cases under this head, it may be accepted as safe teaching, at least for the present, that (I.) Enteroptosis may exist without subjective signs, that (II.) the Enteroptosis of Glenard is associated with the most pronounced subjective signs, chiefly of a neurasthenic type, that (III.) in those cases where a pendulous abdomen is present the nervous fea- tures of the case are less pronounced than in thin subjects with greatly flattened belly walls, and that (IV.) Enteroptosis arising from inflam- matory processes in the abdomen may be typically characteristic.— (Treves). The view of Mathieu is thus expressed, that Enteroptosis is of two varieties, (I.) the form which shows itself plainly from without by a pendulous abdomen and is rarely found associated with nervous manifes- tations. The second form (II.) is that in which the abdomen is thin and flat and where the neurotic element is very prominent,—the internal variety. The organs displaced in this disease may be all those found below the diaphragm. Most frequently, however, the colon and small intestines, the stomach, the right kidney and the liver are found in altered rela- tions. It is not rare to find the left kidney also displaced ; the spleen