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Mitchell, S. Weir (Silas Weir), 1829-1914

"Fat and Blood An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria"

The lower border
of the stomach was fully two inches below the navel in the middle-line,
even when only a glass of water had been taken. It was a little lower
after a small meal. The colon was distended and very variable in
position, probably changing its relations with the landmarks as it
happened to be more or less filled with food or gases. The abdominal
walls were flabby, relaxed, and pendulous, and the whole surface tender.
The patient gave a history of sudden loss of flesh with almost no
reason some three years before, and increasing indigestion in all forms
ever since. The tenderness made careful abdominal study difficult, but
lessened enough after a few days in bed to permit the perception of a
displacement of the right kidney, whose lower edge could be felt on a
level with the umbilicus and two inches to the right of it. No change of
position would bring it any lower. Examined with the patient prone,
two-thirds of the kidney could be outlined, extremely tender, and
causing nausea and sinking if pressed upon.
The chief trouble in treatment proved to be the irritability of the
intestines, which was brought on in most unexpected fashion by foods of
the simplest kind.


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