Diseases of the ovaries : their diagnosis and treatment / by T. Spencer Wells.

  • Wells, Spencer, 1818-1897.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the ovaries : their diagnosis and treatment / by T. Spencer Wells. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    the thickness of the layer of fat, to the amount of oedema, to the thickness of the peritoneum or of the cyst, to the quantity and character of the fluid, and to the amount of tympanitic distension of the intestines. In itself, it offers no assistance in diagnosis, because a thin-walled ovarian cyst, filled with limpid fluid, with a moderately tense and thin abdominal wall, would give a more quick and decided wave than a moderate quantity of ascitic fluid beneath an abdominal wall thickened by fat or subcutaneous oedema. The characteristic peculiarity of the fluctuation in ascites is that it varies with the position of the patient, and is only perceived in the parts where the fluid gravitates towards the abdominal wall; while in ovarian dropsy its situation does not vary with position, but is per- ceived wherever fluid is to be discovered by III. Percussion. The two following diagrams represent the situation of clear and dull sounds obtained by percussion in typical cases of ascites and ovarian disease, the patient lying flat and evenly on her back. The dark parts of the abdomen are dull, the rest clear. In ascites, the stomach and intestines are above and in front; the fluid behind and on either side. In ovarian dropsy the fluid is in front, extending in different degrees to either side, and pushing the stomach and intestines upwards and backwards, just as a gravid uterus does. The figure to the right of the page, indeed, would represent either a gravid uterus near the full period of pregnancy, or an ovarian cyst of about the size of such a uterus, and situated centrally, as II.