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.

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    The after history of this patient was in many respects similar to that of the first case, only it was prolonged for thirty-five days. She quickly recovered from the opera- tion, and her condition gave no cause for anxiety during the first week, the highest temperature and pulse being 101'8° and 116 respectively. Urine was secreted abun- dantly, and soon became clear. Flatus passed downwards early, and there was no distension. The drainage-tube discharged between six and seven ounces of fluid in the twenty-four hours. A frequent cough seemed to be causing the tube to irritate the peritoneum, and I therefore removed it on the fourth day. On the sixth day the cough was much better, and expectoration was easier ; the temperature was 99°, and the pulse 84 in the morning. During the second week the bowels were opened daily, or every second day, by enema or by laxative medicine. There was now, however, some distension in the lower abdomen, the edges of the wound became red, and the temperature varied between 99‘6° and lOl'G0, the pulse being between 86 and 100. The wound had healed by first intention, except superficially where the skin edges had not been exactly apposed, especially at the part where the drainage-tube had been fixed and over the bladder opening. On the sixteenth day the wound was completely healed and free from all signs of irritation. During the night between the sixteenth and seventeenth days no flatus passed from the anus, the patient suffered much pain, her abdomen became greatly distended, the temperature rose to 103°, and the pulse to 116. A turpentine enema caused a slight movement of the bowels and a free passage of flatus, with great relief of pain and diminution of the distension. The tempe- rature fell by the following evening to 100‘2°, and the pulse to 96. From this time there was frequent difficulty from retention of flatus, and the abdomen gradually in- creased in size, but the temperature was only once recorded above 1()1'2° for a few hours, on the twenty-fifth day, when it rose to 103° in the vagina. On the twenty-fourth day vomiting set in, and was at first very occasional, but