Illustrations of some modes of death after ovariotomy / by John D. Malcolm.

  • Malcolm, John David.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Illustrations of some modes of death after ovariotomy / by John D. Malcolm. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/36 (page 6)
    drained tlie peritoneal cavity through the median incision, taking great care to keep apart the dressings and the dis- charges of the two wounds. When put to bed the patient was very weak. The temperature quickly rose to 10T8°, and then tended downwards. The pulse rose to 140 and continued fast. In other respects the condition was not unsatisfactory for the first two days; flatus passed freely from the rectum, and on the second day the bowels moved spontaneously. The discharge from the wounds was scanty and odourless. Early in the morning of the third day flatus did not escape at all freely when the rectal tube was inserted, and there were colicky pains on the right side. In the afternoon of this day the groin wound became very offensive, the temperature was 101 *4°, and the pulse 144. In the evening the bowels again moved sponta- neously, and the temperature fell to 100°. On the fourth morning the temperature was 100'8°, the pulse was 130, and there was occasional vomiting with slight distension of the abdomen, which latter diminished after the bowels were again moved by three small (5]) doses of sulphate of magnesia. After this very little flatus escaped from the bowel. Towards evening the distension increased, vomiting was frequent, the urine became scanty, the tem- perature rose to lOS’S0, and the patient died very early on the fifth day after the operation. The discharge from the drainage-tube was clear, scanty, and odourless to the last. At the autopsy, which Mr. Stephen Paget kindly made for me, there was very little fluid in the pelvis, and no sign of general peritonitis. The small intestine was adherent, near its lower end, to the stump of the pedicle on the right broad ligament. The bowel was acutely bent, and completely occluded at the point of adhesion, but otherwise healthy. Suppurative peritonitis had spread from the groin wound, but the neighbouring coils had become adherent, so that the inflammatory action was strictly localised. It was found to be impossible to sepa- rate the piece of cyst wall from the bowel.