Fibrous tumor of the uterus : excessive hæmorrhage; removal by excision / by B. Fordyce Barker.

  • Barker, B. Fordyce.
Date:
[1857?]
Catalogue details

Licence: Public Domain Mark

Credit: Fibrous tumor of the uterus : excessive hæmorrhage; removal by excision / by B. Fordyce Barker. 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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    uterus. Neither does the case bear any resemblance to those reported by Dr. Atlee, of Philadelphia, either as regards the motive for operating, or the plan of operative proceedure. Mr. Grimsdale, Surgeon to the Lying-in Hospital, Liverpool, in an article On arti- ficial enucleation of Uterine Fibroid Tumor, published in the Janu- ary number of the Liverpool Medico-Chirurgical Journal, and quoted in the last number of BraitAwaite's Retrospect, gives the following conditions as necessary to justify the operation for enucleation. 1. There must be present some symptom, as haemorrhage, intracta- ble, and of so serious a nature as, if allowed to continue, would almost inevitably sooner or later destroy life. So long as the tumor is quiescent, attended by no formidable symptom, it would manifestly be highly improper to propose any interference, that might of itself seriously compromise the patient's safety ; but in the presence of frequent and exhausting hemorrhages, inevitably fatal in their tendencies, it becomes a question of anxious interest, to both surgeon and patient, whether or not any operation can afford a fair prospect for relief. 2. The tumor should be a single one, as may be generally known by its globular form. On this point I wish to correct a misconception I believe to be prevalent, viz : as to the infrequency of single fibrous tumors of the uterus. Most writers on these subjects vary in general terms, or lead their readers to infer that it is quite the exception to find a solitary tumor of this kind; in the great majority of cases, say they, these tumors are plural, or even in considerable numbers. Now in opposi- tion to this, Mr. Pollock's records of post mortem examinations, at St. George's Hospital, show that in more than one-half of his cases the tumors were single. 3. The tumor should be surrounded by hypertrophied uterine tissue. When such is the case, we can always by auscultation detect an uterine bruit more or less loud, and I should be unwilling to ope- rate unless this was present. 4. The more the tumor bulges inward towards the uterine cavity the better. 5. A time should be chosen, if possible, at which the system shall somewhat have rallied from the eflfects of the antecedent hajm- orrhages. ♦ These conditions all existed in the present case, and were equally applicable to the operation performed. I should mention that the hypertrophy of the uterus has in a great