Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

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    active habits in a day or two after each puncture. Dr. Hamper* has recorded the history of a woman in whom ovarian dropsy came on after labour. The patient was treated by mercurial inunction, tight bandaging, and puncture of the cyst through the vagina, with complete success. Dr. Marshall Hallf has suggested that before resorting to any operative measures for the cure of an ovarian tumour, a probe be introduced and passed round it, so as to discover whether or no adhesions exist; also that an exploratory puncture should be made in order to ascertain the nature of its contents. Mr. Cazeaux,^ in an essay on the treatment of ovarian dropsy, records a case in which permanent cure followed medical treatment and a single puncture of the cyst. He next relates the unsuccessful issue of an attempt to maintain a fistulous opening into an ovarian cyst, fatal peritonitis having been induced A third instance is detailed in which death from peritonitis followed on puncture per vaginam, and an attempt to keep an elastic canula in the puncture. He states that puncture per vaginam has been performed twelve times; that the details are incomplete in three instances, that three of the patients died, that a relapse occurred once, and that five of the patients were completely cured. He lastly gives the particulars of another fatal case, in which death from peritonitis fol¬ lowed on a modification of the minor operation, the cyst having been only partially extracted, in consequence of the presence of some tumours, which rendered its complete removal impossible. Four cases of the successful extirpation of the ovaria by the small incision are recorded by Dr. F. Bird, Dr. Emiliani, and Mr. Page,§ and three of a successful result following the major operation in the hands of Drs. Bowles, Clay, and Atlee.|| In the case recorded by Dr. Emiliani, the operation had been performed by his father in the year 1815; the patient had since given birth to five children, two of whom were twins, and was in perfect health at the time of his writing the history of her case. Dr. Clay’s patient was sufficiently recovered to re¬ turn to her home, which was at a considerable distance, fifteen days after the operation. Dr. W. L. Atlee’s patient had an attack of intense peritonitis im¬ mediately after the operation, but did well eventually. He assumes, in the history he has given, that the tumour was not ovarian, but that it grew from the surface of the uterus, and therefore calls the case one of extirpation of a fibrous tumour of the uterus. This idea did not strike him while performing the operation, but was an after thought [for which there does not appear to be any reasonable foundation.] Dr. J L. Atlee^J has published a full account of the case in which he successfully removed both ovaries, and to which re¬ ference was made in the last Report Only one case of failure of the opera¬ tion has been recorded during the past 18 months. It occurred in the prac¬ tice of Dr. W. L. Atlee,** the patient dying of peritonitis five days afterwards. Mr. Walne has likewise published the particulars of his two unsuccessful cases mentioned in the last Report. Dr. Churchill, Mr. B. Phillips, Dr. Jeaffreson, and Dr. W. L. Atlee+f have investigated the statistics of the operation, and have drawn up more or less elaborate illustrative tables. The chief results at which they have arrived are here thrown into a tabular form ; the former table showing the rate of mortality from both operations in all cases where the extirpation of the ovary was either attempted or actually performed, and the latter the comparative mortality from the two operations in all cases in * Oesterr. Med. Wochenschr. July 20, 1844. t Lancet, March 9, 1844. J Annales de la Chirurgie, Oct. 1844. § Med. Gaz. March 22 and Aug. 16, 1844; Bulletino delle Scienze Mediche di Bologna. Dec. 1843; and Lancet, April 5, 1845. || American Journal of Medical Sciences, January 1845, p.255 ; Medical Times, Feb. 15-22, 1845; American Journal, April 1845. American Journal of Med. Sciences, Jan. 1844. Ibid. July 1844. '** Med. Gaz. Feb. 23, 1844. ft Dublin Journal, July 1844 ; Medico-Chirurg. Transact, vol. xxvii, p. 468 ; Med. Gaz. Oct. 18, 1844; American Journal, April, 1845.