Identifier: wisconsin16jane (find matches)
Title: Wisconsin medical recorder
Year: 1913 (1910s)
Authors:
Subjects: Medicine
Publisher: Janesville : Hall & Thorne
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: Open Knowledge Commons and the National Endowment for the Humanities

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of the tumor,the occasional hematuria, the absenceof lever and the sudden relief of symp-tohs due to spontaneous untwisting ofthe ureter should clear the diagnosis. In women, pyosalpinx and ovarianabscess may easily be contused withappendicitis. While the conditionspresent points of similarity there arecharactertistic differences, which inconnection with the case historyshould prevenl mistakes. Abdominalpain associated with \\\rv nausea andvomiting are common to tubal, ovar-ian and appendiceal inflammations. Inappendicitis the pain is most intenseOver Mcliurneys point. In tubo-ovar-ian inflammations the pain is locatedmore deeply in the pelvis immediatelyabove Pouparts ligament. Rigidityof i he right reel us is marked in appen-(licit is. I ut is less distinct or c\ enabsenl in pelvic inflammations. Withpyosalpinx there is often a thick puru-leni discharge from the vagina whichmay exist several days before the on-sii of the pelvic pain. <bi examination WISCONSIN MEDICAL RECORDER 293
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294 WISCONSIN MEDICAL RECORDER a distinct swelling is rarely found inthe early stages of any of these condi-tions. Later, there may be a decidedinduration or thickening of the tissues.In tubal and ovarian inflammationsthis swelling is situated close to andcontinuous with the uterus while in ap-pendicitis it is higher up in the iliacfossa. A chronic salpingitis or oophor-itis may be and not infrequently isassociated with chronic appendicitis. Bxtra-uterne pregnancy usuallygives a fairly characteristic history ofmenstrual abnormality, morning nau-sea, mammary engorgement and col-icky pains associated with faintness.A severe pain in the lower portion oftlie recto-vaginal septum is often pres-ent. Before rupture, physical exam-ination may show a somewhat round-ed mass to one side of the uterus. Rup-ture of the tube is characterized by asudden agonizing pain followed im-mediately by collapse with all thesymptoms of severe internal haemorr-hage. The differentation between ex-tra-uterine pre

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