Abdominal pain : clinical lecture delivered at St. Bartholomew's Hospital.

  • Brunton, Thomas Lauder, Sir, 1844-1916.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Abdominal pain : clinical lecture delivered at St. Bartholomew's Hospital. 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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    (From International Clinics, 8th Ser., vol. iii. p. Ill, London, T. Lewin and Co., 1899. Reprinted by permission.) Gentlemen,—The subject to which I wish to draw your attention to-day is that of abdominal pain. I do not intend to include all varieties of such pain, but shall confine myself to a few. I do not intend to take up the subject as connected with acute inflammatory disease, and shall deal with some other forms that are less known and often misunderstood. I have been led to take up this subject by the fact that we have several cases presenting abdominal pain of various kinds in the wards at present. We have one more especially who has been transferred to the care of the surgeons, and who was operated upon the other day. In “ Elizabeth ” Ward th.ere is a patient with calculus in the gall duct, and in “Rahere” Ward one with pain in the back, which is suspected to be due to rena1 calculus. Apart from acute inflammation, pains in the abdomen are generally due to one or two causes—(1) Active contraction or cramp of involuntary muscular fibre; (2) excessive passive dilata- tion of involuntary muscular fibre. Most of the organs in the abdomen either consist of, or are largely composed of, involuntary muscular fibre. The first one that attracts our attention is the colon. Spasmodic contraction of the colon gives rise to acute and severe pain, to which the name of colic has been given. This may be due in some instances to cramp-like contraction of the colon, the pain in the involuntary muscular fibre being severe and acute, and just like that which occurs in the calves of the legs after a very long day’s walking. Not infrequently it would appear that the pain in the colon is not due to contraction of the colon throughout its whole length, but is rather due to partial contraction at one place and dilatation at another. The name of colic has been extended from the disease