The results of all the operations for the extirpation of diseased ovaria, by the large incision, from September 12, 1842, to the present time : to which is appended an essay on the diagnosis, prognosis, and treatment of ovarian diseases / by Charles Clay.

  • Clay, Charles, 1801-1893.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: The results of all the operations for the extirpation of diseased ovaria, by the large incision, from September 12, 1842, to the present time : to which is appended an essay on the diagnosis, prognosis, and treatment of ovarian diseases / by Charles Clay. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    othersj and I trust will be tlie means of offering relief to the almost hopeless cases we occasionally meet with, where extirpation cannot be thought of. CASE ELEVENTH. PeetiotiS Histobt.—Mrs. S., of Tyldesley Banks, Lancashire, aged 51, long subject to irregular menstruation; bowels generally confined; the left side of the abdomen more tumefied than the right; tumour to the touch of the cystic character ; has noticed the enlargement five or six years ; frequent pains in the abdomen, chiefly on the left side; size of the abdomen equal to that of mature pregnancy ; uterus, per vagiuum, perfectly healthy ; countenance good; low spirited; no cough; tumour very movable ; fluctuation distinct; sleep disturbed; recumbent position uneasy; when lying on the right side a dragging sensation in the groin; recollects pain and swelling in the ab- domen, after lifting a heavy weight, some years ago, chiefly on the left side. Digestion impaired; often troubled with flatulence; has never applied ban- dages ; subject to leucorrhoeal discharges ; occupied only as a housewife ; sta- ture tall; has never been tapped; married ; has had only one child, twenty- nine years ago. Present Condition.—Tapped the sac January 10th, 1846; removed 221b3. of dark cofiee-coloured thick fluid; ordered the inspissated ox gall, grs. x. night and morning, with the view of emptying the bowels well before extirpa- tion, and to allay intestinal flatus, which that remedy does most efi'ectually. January 14th, 1846, 11 o'clock a.m., extirpated the sac in presence of Sir Ar- nold Knight, Drs. Watson, and Lewis, of Liverpool, Dr. Radford, and Mr. Winterbottom. Pulse before operation 90, soft. The incision from umbilicus to pubes; the sac, with some four pints of freshly secreted fluid ( since tap- ping), about 61bs in all. which, added to the former 221bs, presenting a total weight of 281bs ; pedicle as predicted on the left side, and of moderate thick- ness ; no adhesions ; the tumour, one large thick-walled cyst, without solid matter; temperature of the room during operation, from 70® to 74''; pulse, im- mediately after, 90, soft; blood lost not two ounces; bore the operation with great fortitude ; gave a draught with three-fourths of a grain of mur : morphine. PEOGEESS OF THE CASE. Two o'clock (three hours after the operation).—Temperature of the room 70°; pulse 94, soft; tongue moist and clean; no haemorrhage ; skin warm and moist; felt considerable pain at the pedicle (left groin) ; no cough ; no shivering ; no movement of the bowels ; passed no urine (the bladder having been well emptied before operation) ; no thirst; no flatus ; respiration calm; no disposition to sleep; no sickness; bowels perfectly free from tenderness : ordered thin gruel and tea with softened bread in it. Six o'clock, p.m. ( seven hours after operation).—Temperature 68° ; pulse 96—98, firm but soft; no haemorrhage; tongue moist and clean; general sur- face warm, with copious perspiration; pain at the pedicle much less; no cough; no shivering ; no motions ; passed gviii. of urine hj her own efibrts ; no thirst; no flatus ; respiration calm. The morphine had produced one hour and a half of sound sleep ; no tenderness ; no sickness. Ordered one grain of calomel; diet as before. Eleven o'clock, p.m.—Temperature 68 ; pulse 86, soft; no haemorrhage ;