2. =Musculature.= The muscles of the neck, thorax and abdomen are
examined with reference to the following points: size (atrophy,
hypertrophy), color (normally bright brownish-red, may be paler
than normal, deep brown, yellow or grayish), consistence (pale
muscle usually tears easily, brownish muscle usually tears less
easily), moisture (moist in œdema, inflammation, and as a result
of transfusion; dry in anæmias, severe diarrhœas, long-continued
fevers), translucency (increased in Zenker’s necrosis, fatty
infiltration, fatty degeneration, atrophy, anæmia; diminished
in cloudy swelling and simple necrosis), blood-content (anæmia,
hyperæmia), hemorrhages (trauma, surgical, hypodermic injections,
toxic, infective, hæmatoma of abdominal rectus in typhoid fever),
inflammation (acute, chronic, focal, diffuse, primary, secondary,
abscess, fibroid, etc.), bony formations (myositis ossificans),
parasites (trichina the most common, especially frequent in muscles
of neck and in the intercostals and diaphragm, small whitish, oval
bodies looking and feeling like grains of sand; echinococcus and
cysticercus are more rare), neoplasms (not common, the spindle-cell
fibrosarcoma or “recurrent fibroid” of abdominal wall the most
frequent form). Zenker’s necrosis (hyaline, waxy or “fish-flesh”
degeneration) is of frequent occurrence in the abdominal muscles
in typhoid and other severe fevers and intoxications. Anomalies of
sternal and pectoral muscles are not rare.
3. =Abdominal Cavity.= Watch carefully for the escape of gas when
the first cut through the peritoneum is made. A lighted match may
be held over the opening, or the skin incision may be filled with
water and the peritoneum opened through the water, noting the escape
of bubbles. The odor (sour, sweetish, yeasty, fécal, putrid, etc.)
should be noted. Abnormal contents of the peritoneal cavity are to
be measured and described as to color (amber, greenish-yellow, color
of bile, red, bloody, brown, gray, creamy, milky, opalescent, etc.),
consistence (thin, clear, watery, serous, pea-soup-like, gruel-like,
creamy, jelly-like, colloid, semi-solid, etc.), odor (fécal or foul,
due usually to the presence of the colon bacillus; acid or yeasty
in perforation of stomach; fruity in diabetes, acute hemorrhagic
pancreatitis; odor of ether, chloroform, alcohol, etc.), contents
(blood, bile, féces, stomach-contents [distinguish perforations due
to postmortem digestion], fibrin, fat, chyle, pus, foreign-bodies,
mucin or pseudomucin, parasites) and reaction (acid, alkaline).
Non-inflammatory ascites occurs in portal stasis, hepatic cirrhosis,
thrombosis or compression of portal or splenic veins, chronic
passive congestion, chronic valvular lesions with incompensation,
nephritis, severe anæmia, obstruction or rupture of thoracic
duct, etc. The fluid of transudates is usually clear, odorless,
alkaline, low specific gravity (below 1.016), small albumin- and
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