'Common' cirrhosis of the liver : an analysis of 121 cases / by T.N. Kelynack.

  • Kelynack, T. N. (Theophilus Nicholas), 1866-1944.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: 'Common' cirrhosis of the liver : an analysis of 121 cases / by T.N. Kelynack. 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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    COMPARISONS BETWEEN SPLEEN IN CARDIAC ” AND “cirrhotic CASES. Dr. Graham Steell first drew ray attention to the fact that the enlargement of the spleen in “cardiac” cases was less than that in hepatic “cirrhosis.” As Dr. Fo.xwell well says: “ The anatomy of its circulation would appear to insist that it should enlarge to a smaller extent than the liver when the condition is one of thoracic obstruction, as the liver then acts as a buffer between it and the thorax.” As far as I know, this difference has hitherto not been clearly expressed by any definite figures. I have therefore collected details as to the weight of the “cardiac” spleen as compared with that occurring in connection with hepatic cirrhosis. I have records of 56 cases of “ nutmeg” liver. All were from uncomplicated “ cardiac ” cases. I have excluded cases where there was malignant endocarditis, distinct febrile processes, or other conditions likely to affect the size of the spleen in any other way than by direct venous engorgement. Of the 56,33 occurring in males averaged 55‘i4 ounces; 23 occurring in females averaged 55 ounces. The age of the patients was obtained in 54; the males averaged 40 years, and the females averaged 3875 years. The weight of the spleen was as follows :— WEIGHT. Maximum Minimum Average MALES. 16 ounces 2^4 „ 7‘32 ,, FEMALES. 11^ ounces 3 M 7’32 „ It is thus clearly seen that the “hepatic” spleen is con- siderably heavier than the “ cardiac ” spleen, and one may also, I think, safely infer that it is considerably larger. The difference may be compared thus :— AVERAGE WEIGHT. “ Hepatic” spleen “ Cardiac ” spleen MALES. FEMALES. BOTH SEXES. i4‘25 ii'62 i2‘93 7’32 7-32 7‘32