Among my ambulatory patients, especially in the office, I have been surprised to find a relatively large number who have applied for relief of various symptoms in whom a palpable, usually tender and enlarged liver could be demonstrated. The symptoms, in the main, were in many patients those of neurasthenia, in others myalgia or a mono-neuritis, or, most frequently, some gastro-intestinal disturbance. In a few cases arthritis was complained of and the affected joints showed evidence of that trouble.
AN ILLUSTRATIVE CASE.
—B. M. F., aged 54, male, lumber dealer, residence Chicago. The father died of tuberculosis. No other history of inherited disease in the family. Has used alcohol to a very moderate and irregular degree. Smokes moderately.
—The patient had typhoid fever when 15, from which he made a good recovery and enjoyed perfect health until about 20 years ago. Since that time he has
BILLINGS F. CLINICAL MANIFESTATIONS OF THE EARLY STAGES OF CIRRHOSIS OF THE LIVER. JAMA. 1902;XXXVIII(23):1496–1501. doi:10.1001/jama.1902.62480230014001c
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