Tenderness. Local and General Enlargement.
The abdomen is the portion of the body between the chest and pelvis, and encloses the large cavity containing the digestive and urinary organs and a portion of the generative organs. It is evident that many conditions of the organs mentioned will produce noticeable abdominal symptoms, and the observation of these and of their particular localities and characteristics will often lead to the recognition of the seat and nature of diseased conditions.The opening advice of the "diseases and treatment" section!
Tenderness usually denotes inflammation. If the tenderness is superficial the muscular structures only are involved; but if it is deep seated and increased by continued pressure the internal organs are affected.
Local enlargement of the abdomen is very frequent. If it is in the upper and center portion, the stomach is usually affected. If it is upon the right side, the liver is involved. If it is upon the left side spleenic trouble should be suspected. If it is toward the groins, ovarian troubles or appendicitis or obstructions of the bowels may be the cause. If it is low down, the bladder or the womb may be the source of trouble.
General enlargement of the abdomen may be due to inflammations of the bowels or womb or peritoneum (peritonitis). Dropsy[1] may also give general enlargement; but in that case a doughy feeling and fluctuation may be readily recognized. Pregnancy will, of course, enlarge the abdomen, and in the cases of women, must always be borne in mind when no other cause of the enlargement is manifest.
Many acute diseases are at times accompanied by abdominal enlargements, and such enlargements are usually of serious import. They not infrequently occur in typhus and typhoid fever. But it must be remembered that abdominal enlargement does not always signify serious difficulties; for instance, it usually accompanies ordinary colic, from the intestines being distended with gas.
Treatment. — It is evident that no general treatment can be given for the removal of abdominal symptoms, as they may be the result of a variety of causes which must be removed according to the treatment given for the diseases of the special organs affected. But, as a rule, tenderness and pain in the abdomen, accompanied by enlargement may be relieved by the outward application of stimulating liniments or washes, or the laying on of flannel cloths wrung out of hot water, or the application of mustard[2] or capsicum plasters[3]. Such relief would, of course, be but temporary when deep seated organs are involved. To resort to the use of hypodermic injections or other methods of using opiates, would be more detrimental than beneficial.
[1] Dropsy, or what is now known as edema, is swelling due to an abnormal accumulation of fluid beneath the skin.
[2] Mustard plasters, or sinapisms, can cause blistering of the skin. The intention is to improve circulation
[3] Capsicum plasters seemingly remain in use within Korea for prevention of sore throats, vomiting and nausea, and post-operative pain.