Читать книгу Old Age Deferred. The causes of old age and its postponement by hygienic and therapeutic measures онлайн

131 страница из 141

On examining the liver we must not forget the sclerotics, and must note whether, on looking upward, there is any yellow discoloration.

While palpating the liver we must specially note whether it is tender, and also if the gall-bladder is tender. This is a typical symptom of chronic inflammation of the gall-bladder, or cholecystitis, which is so frequently associated with gall-stones. We find such a tender gall-bladder very frequently in elderly women, in whom gall-stones are particularly common. In fact, they occur so frequently that Halck^[135] in Copenhagen, found them in 29 per cent. of 4140 autopsies on persons above 50 years of age. However the mere presence of gall-stones does not constitute gall-stone disease, the essential point being an inflammation of the gall-bladder and bile-ducts. Such an inflammation of the gall-bladder is revealed by tenderness on pressure with the examining hand. It is a frequent symptom of all those conditions (as we have found and communicated to the French Congress of Medicine, 1905) in which the thyroid or sexual glands are diseased. For instance, after pregnancies, after infectious diseases in old age, etc., it is often accompanied and preceded by obesity, which is also a consequence of inactivity of the thyroid and sexual glands. Frerich, many years ago, observed enlargement of the liver and a tender gall-bladder in women at the climacteric, and many other authors have made similar observations. Hertoghe found such conditions common in women suffering from inactivity of the thyroid or hypothyroidia.