Discussion on the nature of visceroptosis, usually described as Glenard's disease / introduced by Arthur Keith.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Discussion on the nature of visceroptosis, usually described as Glenard's disease / introduced by Arthur Keith. 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.

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    descend to 2^ inches below this line; that level seemed to be the furthest to which the dia- phragm could descend. When I began to plot out my observations on the level of the diaphragm made on dissecting room subjects, I found there were several in which the diaphragm was situated from i£ to 2^- inches below the sterno-ensiform line—seen more frequently in women than men, and chiefly in old people. It was plain that in these subjects the abdominal viscera had sunk into a permanent inspiratory position, and so had the diaphragm. How did such people breathe ? By good fortune I had formed a friendship with Professor Wenckebach, of Groningen—chiefly over heart work. He offered to show me a num- ber of cases of visceroptosis under the X-ray screen if I would come to Holland, when I went he had five cases to show me. The first was a man who complained of dyspnoea, this patient breathed by extending his back and lifting his thorax, as it were, off his abdomen. Under the X-rays the diaphragm and abdominal viscera were seen to have sunk over 2 inches below the sterno- ensiform plane, and occupied an inspiratory position. Wenckebach had already recognised visceroptosis as a cause of dyspnoea. Some time before going to Holland I got to know of the observations which had already been made on the Continent regarding visceroptosis. I found that, away back in the “eighties,” Landor, of Berlin, had described and investigated the flattening of the liver and the deformation of the abdominal viscera, which had attracted my attention in the dissecting room. I found that Glenard, a French physician practising at Vichy, had recognised a subsidence or sinking of the viscera as a clinical entity ten years before my attention was drawn to the condition. Glenard found it in a great number of the gouty, neuras- thenic, dyspeptic, idle people, that sought a cure