Cases of ovariotomy / by Thomas Keith.

  • Thomas Keith
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Cases of ovariotomy / by Thomas Keith. Source: Wellcome Collection.

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    thick, and there was much fat over the peritoneum. The large cyst was emptied, and, along with some secondary cysts that occupied the pelvis, drawn out, after freeing it from some recent parietal adhesion, from a loop of intestine above the umbilicus, and from some older and firmer adhesions towards the right side. The pedicle was about an inch and a-half in length. It was retained outside with some pull upon the uterus, a double ligature having been first applied, in case it should be necessary to remove the clamp and allow the pedicle to subside into the abdomen. The intestines were distended and red, and filled up the pelvis so much that I did not get the cavity sponged so carefully as usual. After tying two or three bleeding vessels the wound was closed by deep and superficial silk sutures. She looked very ill on being placed in bed • the heart’s action was feeble and the breathing quick. Several opiate enemas were necessary in the afternoon to relieve pain and quiet restlessness. For the first three days there was severe vomiting and considerable distention, and the first dressings were soaked with red, somewhat fetid, serum. There was no perspiration, and the urine was scanty ; but the pulse did not rise above 112. She gave us all not a little anxiety till the fourth day. After that she recovered well, and when taken down stairs by the end of the third week the wound was firmly cicatrized. She has since returned to the West Indies. Case XL1I.— Case of Tubercular Peritonitis. Exploratory Incision. Recovery. Mrs Main, from Glasgow, aged thirty-two, was sent to me in the spring of 1866, as a fit subject for ovariotomy. First signs of ill health came on four years ago, when, the catamenia being pre¬ sent, she took severe pain in the left iliac region. There was sudden suppression of the menses, and she was confined to bed for four weeks. Two or three months after she began to go about again she felt a tumour above the pubes about the size of two hands, which she could move about from one side to the other. She gradually increased in size, and underwent much treatment, by blisters, mer¬ cury, and various diuretics and purgatives, without getting any relief. For the last two years her general health has been fairly good. Latterly she has lost flesh, and has suffered more from distention and the weight of the tumour, but does not think she has increased in size for some time past. She was unwell when I saw her, and the first examination was hurried. She measured forty-four inches. The abdomen was full and well arched, and the flanks were not more bulged than they usually are in cases of large ovarian tumours. It was observed that there was clear sound on percussion midway between the umbilicus and ensiform cartilage, but this was supposed to be due to a piece of adherent intestine, as there was a protrusion on cough¬ ing about the size of an egg just above the umbilicus. The right B
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