Hysterectomy without clamps or ligatures / by W.F. Metcalf.

  • Metcalf, W. F.
Date:
[1894?]
Catalogue details

Licence: Public Domain Mark

Credit: Hysterectomy without clamps or ligatures / by W.F. Metcalf. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    * — 3 — pain would begin in the left ovarian region, pass up to the cardiac region, when suffocation would come on and she would tear the clothing from her chest in her effort to get air. She had been subjected to trachelorrhaphy, perineorrhaphy and local treatments. I found the left ovary considerably enlarged, and on February 2, 1894,1 dissected beneath the covering of the cervix and entered the peritoneal cavity anteriorly, intending to examine the ovaries and remove only what was pathological. I found a tear beginning about a quarter of an inch below the os internum and extending one inch up the bodjr of the uterus;, both ovaries were completely degenerated, although the tubes were apparently normal. I therefore removed the uterus and its appendages. She slept two hours that afternoon and nearly all that night without morphine. (She had averaged a grain and a half of morphine a day for a month previous to operation). Her lowest temperature was 97.3°; highest 99.6°. Highest pulse rate 128; lowest 72. Thirteen days after operation she was taken home in an ordinary carriage. She has been well since. Case III.—Mrs. B., aged thirty-two j-ears. A fibroid tumor of uterus, too large to be removed per vaginam. I made abdominal incision from umbilicus to pubis; freed tube and ovary to its junction with the uterus; at which point I made an incision in the side of the enlarged organ and ligated the spurting vessel. The same was done upon the opposite side. I then dissected downward beneath the lateral vessels to the cervix where the amputation was completed. Then placing the patient in the lithotomy position I removed the cervix, which was involved in the growth, without the necessity of tying a vessel; sewed up the opening in the peritoneum and packed from below. Her highest tempera- ture was 100°, and highest pulse rate 100. This was five hours after opera- tion. The next morning her temperature was normal and did not after that exceed 99°. She sat upon the ninth day, convalesced rapidly and is now in excellent health. Case IV.—Mrs. D., aged thirtj'-one years. Had had constant pain in the pelvis for years. Extreme tenderness over body of uterus. Among the ordi- nary reflex symptoms present in pelvic disorders, that of chorea developed. Pressure upon either ovary or the passing of a sound would bring on violent choreic movements, which would sometimes continue for days. In operating October 20, I found the ovaries degenerated, the left one gelatinous, the uterus friable and spongy. In this case also I found a tear extending up into the uterine body. Her highest temperature was 100° and highest pulse rate 106. She left the hospital thirteen days after operation. Her chorea is apparently cured and she is convalescing rapidly. Tbe dark circles ever present around her eyes, which probably indicated that the irritation reached constantly the ophthal- mic ganglia on the supraorbital, have almost wholly disappeared. Case V.—Mrs. P., aged twenty-six years. She had constant pain in the left ovarian region, constipation, coated tongue, headache, backache and melancholia. She said she was married at fifteen ; had five children and had had many miscar- riages. She had an abortion produced which was followed by peritonitis. She had contracted gonorrhea three years ago and had been treated locally ever since with no marked benefit. I found the left ovary and tube prolapsed, enlarged and adherent. As she was still young I wished to preserve the reproductive function. After turning the uterus upside down, I removed one tube and ovary,