Fourteen cases of ovariotomy / by Thomas Keith.

  • Keith, Thomas, 1827-1895.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Fourteen cases of ovariotomy / by Thomas Keith. 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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    diverscs pochcs, ne parvint Jt determiner le retrait sur aucun poinlf de I'dpigastre au pubis et d'un flanc I'autre. fjvidcmment ilj y aurait eu imprudence k tenter I'extiiioation d'une telle turaeirfj dont les adh^rences etaient si fortes et si ^tendues qu'elles auraiedl erap6che probablement le chirui-gien de terminer Toperation. II esl Evident que, dans ces circonstances, I'operation est contra-indiqu(SeJ et que la maladie pardit indvitablement mortelle ; mais c'est un caJ a rapporter aux contre-indications naturelles de I'ovariotomie. | The abdomen was entirely occupied by a large irregular semiJ solid niass. There was only one cyst of any size, which occupied! the epigasti-ic space, extending under the sternum. The ribs were! already being pushed outwards, and the ensiform cartilage pointed: slightly upwards. In the left hypochondrium the tumour bulged outwards, and felt veiy hard and near the skin. She had long suffered from severe pain in this region, and here firm adhesion was evident.j In the right iliac region the tumour felt also very hard and near the' surface, and here, too, pain had been from time to time complained of. The pelvis was occupied by a solid mass coming below the brim, and the uterus, though it could not be moved from off the tumoiu, had a sort of rotation upon it, giving the impression that the pedicle was very short, rather than that adhesion existed between the two. She was pale and thin, with a feeble circulation, but her general health was still good. She took her food well, slept well, and was able to take carriage exercise without fatigue. After this she went to the country, and I saw her again on her retiu'n to town in the beginning of November. Her general health continued good, but the turaom- had increased in all directions,— especially above. The cyst, filling the epigastric space, was larger and more tense and prominent. The ensiform cartilage now pointed directly upwards. The ribs were more bulged outwards, especially laterally, and the measurement over the lower end of tlie steriaum was two inches greater than at the umbilicus. My attention was now directed to the state of the spine, for the whole of the lumbar and three lower dorsal vertebras were very prominent, rendering the curvature of the back so gi-eat, that with the bulged condition of the ribs she was quite barrel-shaped. In hopes of getting some information as to the connexions of the Tipper part of the tumour, I tapped the upper cyst at its lower margin, on the 12th November, midway between the umbilicus and ensiform cartilage. A large trocar was used, but after a few ounces of very glutinous fluid escaped, the stream stopped and no more could be obtained, though on passing in a probe it was evident the cyst was of considerable size. Soon after, pain came on, and in the course of an hour I found her with a pale anxious countenance, thoracic breathing, and a very rapid pulse, suffering fii-om intense pain and tenderness, with vomiting, all over the upper portion of the abdomen. Large opiates and fomentations relieved this, but for some days her condition gave rise to not a little anxiety. All