IS DR. PATRICK BLAIR'S DESCRIPTION OF PYLORIC STENOSIS IN 1717 THE EARLIEST ON RECORD?

[摘要] The first description of pyloric stenosis in infants has been attributed successively to earlier and earlier writers. Hezekiah Beardsley of Connecticut described such a case in 1788.1 George Armstrong recorded the case of an infant similarly affected in 1777.2 However, the credit for drawing attention to the earliest description on record belongs to the late Ernest Caulfield of Connecticut, who pointed out that in 1717 Patrick Blair (1665-1728) reported to the Royal Society a clinical history and autopsy report of a 5-month-old boy who had pyloric stenosis. Blair's description follows:The Child was five months old and was so emaciated that he appear'd rather to have decreased than to have encreased [sic] in Bulk from the time of his Birth, the whole Body not weighing above five Pounds. The Skin and Muscles of the Abdomen were very thin, but the Peritoneum was preternaturally thick. The Ventriculus was more like to an Intestine than to a Stomach, its length being five inches and its breadth but one inch. The Coats of it were thick and fleshy, and the cavity very inconsiderable. The Pylorus and almost half the Duodenum were cartilaginous and something inclined to an ossification, so that no nourishment could have passed into the Intestines tho' the Stomach had been capable of Containing it, which makes it no wonder that the Body was so emaciated....Upon enquiring after the Symptoms this Child had been affected with, his Mother told me he seem'd to be healthy till he was about a Month old, when he was seized with a violent Vomiting and a Stoppage of Urine and Stool. Some time after both these became more regular, but the Vomiting still continued. He seem'd to have a great Appetite, taking what Suck, Drink, or other Food was offer'd him with a kind of eagerness but he immediately threw it all up again.... There could be nothing more emaciated than this Child was.

[学科分类] 儿科学