Elmer D. Barber, D. O.
DISEASES OF THE SPLEEN
The spleen is the largest and most important ductless
gland. It is undoubtedly related to the vascular system, yet its
anatomical relations to the stomach and physiological relations to the
liver may allow it to be described as an accessory to the digestive tract.
It is placed deep in the left hypochondrium, between the fundus of the
stomach and the diaphragm, above the descending colon. There is usually
but one spleen, yet observation shows it may be congenitally lacking, or
may be multiple, as many as twenty-three having been found in one body.
These are called accessory or supernumerary spleens, and are probably occasioned
by the deep notching of the anterior margin and separation of the included
parts. They may be connected with the mother organ by thin bridges
of splenic tissue, or only by a portion of capsule. They are usually
wholly isolated, and situated in the gastro-splenic omentum, great omentum,
transverse mesocolon, or in the pancreas on a branch of the splenic artery;
frequently one or two are in the region of the hilus. They are the size
of a hazel-nut, red, to almost black, in color, and of a rounded form.
The spleen varies more in volume than any other organ, being relatively
well developed in children, and atrophied in old age. It varies with
the same individual, with sex, degree of fullness of the portal vein. state
of health, or disease, and with the influence of certain drugs. It
is hypertrophied in all infectious diseases. It may be so large as
to reach the pelvis, and weigh many pounds.
The spleen is situated, under cover of the ribs,
on the left side, being separated from them by the diaphragm, and above
by a small portion of the lower margin of the left lung. Its position
corresponds to the ninth, tenth, and eleventh ribs.
Blood Vessels. - The splenic artery arises
from the celiac axis, and is large and tortuous,._ dividing at the hilum
into five or six branches, each supplying a segment of the organ, and terminating
either in the venous radicles or in the lacunar spaces.
The splenic vein arises by radicles, partly from
the capillary, partly from the lacunar spaces, and empties into the portal
Nerves. - The splenic nerves are derived
from the semilunar ganglion of the solar plexus and the right pneumogastric,
forming the splenic plexus.
Function. - Leading authorities regard the
spleen as a prominent source of white blood corpuscles, which seems to
be proven by the enormous number of them found in the blood in cases of
leucocythemia as well as by the fact that they are more numerous in the
region of the spleen than in any other part of the body. It is a
very vascular organ, capable of very great distension, and becomes, in
a passive way, a sort of safety-valve in relieving the portal system.
It is also regarded as an organ in which many of the red blood corpuscles
undergo degeneration when their usefulness is impaired.
(Inflammation of the spleen.)
Nausea; vomiting; aggravated respiration; elevation
of temperature: pain and tenderness in the left hvpochondrium.
1. Place the patient on the side; beginning
at the upper dorsal, move the muscles upward and outward, gently but very
deep, the entire length of the dorsal region. being very thorough where
any tenderness or abnormal temperature is discovered. Treat the opposite
side in a similar manner.
2. Place the patient on a stool; the thumb
of the right hand on the angle of the eighth rib, with the left
hand draw the left arm slowly but very strongly above the head,
pressing hard upon the angle of the rib as the arm is lowered with
a backward motion; place the thumb upon the angle of the next lower
rib; raise the arm; and repeat, until the eleventh rib has been
treated in a similar manner (cut
27). This portion of the treatment usually gives immediate
3. Place the patient on the back; with
the hand resting lightly over the spleen, vibrate gently three or
4. Place the hands on the sides of the
neck, fingers almost meeting over the upper cervicals; press gently
three or four minutes upon the vaso-motor to reduce the fever.
This treatment will occupy about fifteen minutes,
and should be given each day.
(Enlargement of the spleen. May occur as the result of blood
Fever; weakness; diarrhea; disposition to hemorrhages;
pain in the splenic region, which may extend to the left shoulder.
1. See Splenitis.
2. Flex the limb strongly against the abdomen,
adducting the knee strongly as it is extended with a light jerk; repeat
two or three times; treat the opposite limb in a similar manner.
This treatment stretches the abductor muscles of the thigh, and thereby
starts the circulation to the limb.
3. Place one hand under the chin, the other
under the occipital, and give thorough extension of the neck; also manipulate
the front and sides of the neck thoroughly, thus freeing the circulation
to the head.
4. Place the patient upon a stool; bend strongly
backwards over the operator's knee, the knee being placed against the spine
just below the last rib; hold in this position a moment and repeat.
This last treatment will almost invariably check the diarrhea in a very
This treatment will occupy from twenty to twenty-five
minutes, and should be given every other day until recovery.
SPLENIC HYDATID CYST
(Tumor of the spleen.)
When large enough to permit palpation, fluctuation
may be detected, and characteristic cystic fluid may be withdrawn by aspiration.
1. Place the patient upon the right side;
place the fingers of the right hand as far as possible under the ribs immediately
over the spleen; with the left hand draw patient's left arm above the head,
at the same instant, with the right hand raising the ribs as much as possible
from the spleen. This treatment usually gives immediate relief.
2. Place the hand lightly over the spleen,
and vibrate four or five minutes. Treatment should be given
every other day.
(Mobility of the organ, due to relaxation of its attachments.)
The absence of the organ from its usual position.
The presence of a solid body in an unusual position.
1. A thorough Treatment to Equalize the
Circulation will nourish and strengthen the attachments of the spleen,
thereby enabling them to hold the organ in place.
After each treatment for the circulation, the operator should
endeavor, by any manipulation which seems most suitable to the case, to move
the organ toward its normal position.
Treatment should be given every other day.