Cases of ovariotomy : with a table of sixty-five cases / by Thomas Keith.

  • Thomas Keith
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Cases of ovariotomy : with a table of sixty-five cases / by Thomas Keith. Source: Wellcome Collection.

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    operation was fixed upon—it again gave way. The symptoms were more severe than on the former occasion: there was more pain, and, if possible, a more copious eruption. In ten days the fluid had again become absorbed, and she was able to be out of bed. She was now extremely reduced. Ovariotomy wTas performed on the 11th of December, the cyst having already partially filled. The large cyst was emptied, and as it was carefully drawn forward, it gave way at its upper part, where the ruptures had taken place. There were two small open¬ ings covered over with a thick layer of recent lymph, and some very slight intestinal adhesion. Tire surface of the cyst was intensely vascular; the omentum and intestines of a bright rose colour, showing signs of recent inflammation. The cyst was freely opened. It contained some thick albuminous fluid. The hand was then passed through it, and the semi-solid portion, which weighed seven pounds, was broken up. The part which occupied Douglas’s space was easily turned out; it was nowhere adherent in the pelvis. The pedicle was so short that there was just room to apply the clamp, the angle of the uterus being brought into the wound. The symptoms for some days after the operation were the same as after the ruptures, without the eruption. Some distention, with hardness of the abdomen and a rather high temperature, caused some apprehension for a few days that the chronic peritonitis, which existed at the time of the operation, was going on. These symp¬ toms soon disappeared, and she went home to Montrose four weeks after operation. Case LI.—Multilocular Ovarian Tumour. Ichthyosis. Both Ovaries removed. Recovery. Mrs H., aged forty, came to me for ovariotomy in the end of December 1866, at the recommendation of Professor Dyce of Aberdeen. The tumour was detected in September 1863. She was first tapped in July 1864, when four months advanced in her second pregnancy. Three gallons and a quarter of fluid were then removed. She went on to the full time, and for thirteen months no perceptible increase took place, till she gave up nursing. She was a second time tapped by Dr Dyce in October 1865, when three gallons and a half were removed, and the solid portion of the tumour was found to have increased. Two months afterwards, when she came to me, her girth was forty-four inches. The wall was still flaccid, and there was coarse crepitus almost all over the abdomen. The uterus was high, central, and movable, and there was no evidence of any local difficulty. The general condition, however, did not seem to be a favourable one for ovariotomy. She had had ichthyosis from her childhood. She was thin, fragile-looking, and somewhat anaemic. She never perspired, and her hands and feet felt like horn. She was always
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