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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1919 Excerpt:...and upward into the right auricle and left ventricle, causing mechanical embarrassment to the tricuspid valve. The nodules in the lungs were most likely derived from emboli from this portion of the tumor. Of the right renal veins (there being two), the inferior one was distended with red thrombus extending in from the inferior vena cava as far as the renal pelvis. The orifices of the hepatic veins were plugged with the tumor and metastases were present in the liver substance. The first noticeable symptoms occurred seven and one-half months before death. They were in the nature of loss of appetite, sense of fulness after eating, and gastro-intestinal discomfort of more or less vague character. Edema of the legs and scrotum appeared five months later, during which time there was a loss in weight of 70 pounds. However, the patient was able to attend to his work right up to the time of his entrance to the hospital, where he came merely to get "rested up." The absence of hematuria. The late appearance of definite signs of obstruction of the inferior vena cava in spite of the fact that that vessel was occluded in its entire length at necropsy. The acute swelling and centro-acinous necrosis of the liver from thrombosis of the hepatic veins and death in acidosis. The sudden enlargement of the liver noted clinically was probably associated with the hepatic thrombosis. It is noted that other neoplasms, such as carcinoma and teratoma of the testis, have produced extensive deposits in the inferior vena cava. Thrombosis may give rise to a similar train of symptoms from occlusion of the inferior cava, hepatic veins and extension into the right auricle. In the instance reported here, twenty-four hours before death, the liver suddenly became greatly enlarged, the...

    Practical medicine series Volume 1

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