Contributions to the surgical treatment of tumours of the abdomen / by Thomas Keith, M.D., LL.D. Edin.

  • Thomas Keith
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the surgical treatment of tumours of the abdomen / by Thomas Keith, M.D., LL.D. Edin. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    tumour. These often grow to an enormous size, far larger often than any ovarian tumour. I have seen one that would not be less than two hundred pounds weight. Sometimes large quantities of red serum can be removed with much relief, and I have several times been able by this means to carry patients over the menopause, when the necessity for further puncturing ceases. These tumours seem to open up the broad ligaments more than the ordinary hard tumour, and some that I have removed have had very extensive pelvic attachments. These tumours are much reduced by free purgation. 4. In cases of large bleeding fibroids of any age, provided that the patients are not approaching fifty years of age, and provided that the lives are practically useless, and that further experience in the operation shall show that the mortality of hysterectomy is likely to diminish. 5. In certain cases of tumours surrounded by free fluid, the result of peritonitis, provided that the fluid shows a tendency to re-accumulate after two or three punctures. My own experience in such cases is, that after one, two, or three punctures, the fluid does not collect, and it often disappears of itself without any interference. It must not be forgotten, however, that the long continued irritation of the peritoneum by very large tumours is apt to be followed by degenera- tion of the surfaces of a sarcomatous and cancerous character. On this point the microscopic examination of the fluid gives positive evidence which will settle the question of interfer- ence in any way. These embrace every form of case in which I have yet ventured to interfere by operation. In every case once begun, the operation was completed, sometimes with great difficulty. Indeed, there is no operation that tries one so much as the removal of a large, badly adherent uterine fibroid. All but one, were cases of supra-vaginal hysterectomy. Nearly all were under observation for some years—some for many
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