Modern abdominal surgery : the Bradshaw lecture delivered at the Royal College of Surgeons of England, December 18th, 1890 : with an appendix on the castration of women / by Sir T. Spencer Wells.

Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Modern abdominal surgery : the Bradshaw lecture delivered at the Royal College of Surgeons of England, December 18th, 1890 : with an appendix on the castration of women / by Sir T. Spencer Wells. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    as well as after the first operation. The temperature remained almost normal; there was no sickness, very little pain, and when I removed the stitches on the seventh day the wound had healed completely, and, so far as anyone could see, recovery was com- plete. She left London twenty-six days after operation.^ I went to Paris last July to see an American lady, seventy- five years of age, in consultation with Dr. Faure Miller and Dr. Bouilly. All the facts pointed to recent rupture of an old- standing cyst of the right ovary. There was a great deal of free fluid in the peritoneal cavity, and a large solid tumour, certainly not uterine. The necessity for immediate relief was urgent, and with the kind assistance of Dr. Bouilly, on July 25 I made an exploratory incision. A large pailful of turbid fluid escaped from the peritoneal cavity, and then we found an enor- mous mass of papilloma. It converted the thickened omentum into a large tumour, and covered the peritoneum of the abdomen and pelvis with such a dense layer of sprouting growth that it was quite impossible to ascertain or do anything more. I had scarcely a doubt that drainage would have been a fatal mistake, and closed the wound. I heard that Dr. Bouilly removed the sutures on August l,and 'found everything healed, and says she could not have done better had she been twenty years of age.' I had a very satisfactory report of her condition a few days ago. There had been no fluid formed since the operation.^ It is very curious that simply removing fluid by tapping- does not appear to have any such beneficial result as incision, either in cases of tubercular peritonitis, or in cases of papilloma of the peritoneum, whether these have followed bursting of an ovarian cyst or have originated from some other cause. The fact of the extraordinary recovery of patients whose peri- toneum seemed to be in a hopeless condition, and their remain- ing many years after the incision in good health, was noticed by Mr. Thornton in 1881. I have been greatly surprised at several such cases in my own practice, and Dr. Keith Las met with others. The extremely important practical question of drainage can- not be discussed without some thoughtful consideration of Dr. ' January 1801.—I hear from Mr. Cutfield, wlio succeeded ]\Ir. Mason, that the patient has gone on well since her return home. 2 March 18D1.—This lady died last month, no lluid having collected.