Clinical lecture on the flexions of the uterus : with a report of the ovarian and other diseases admitted into Prudhoe Ward, Middlesex Hospital, in the year ending July, 1864 / by John Hall Davis.

  • Davis, John Hall.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lecture on the flexions of the uterus : with a report of the ovarian and other diseases admitted into Prudhoe Ward, Middlesex Hospital, in the year ending July, 1864 / by John Hall Davis. Source: Wellcome Collection.

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    Mary Randall, at the above date, July 15, was then admitted under my care at the Middlesex Hospital. Her girth around navel was now 57 inches. I found her emaciated, very sallow, eyes sunken, features sharp, deeply furrowed. She had nausea and vomiting, bilious diarrhcea ; urine scanty, turbid. Abdominal walls tense, oedematous ; cuta- neous veins moderately large ; dull pain over whole of abdomen ; ribs very prominent; mammary veins turgid. Pulse 104, small, wiry ; respiration 28. Treatment.—Diuretics, and sedatives of sickness, as effervescing salines, hydrocyanic acid, ice to suck, were given, and subcutaneous injections of morphia resorted to for pain and restless nights, with much relief. At the same time I directed a laxative enemata to be administered as required. Stimulants, as sherry, brandy, were also given as needed. I judged it unsafe to tap her until rallied somewhat. July 21.—Girth of abdomen 59^ inches. Urine 1,017; no albumen. Pulse 96 ; respiration 24. July 23.—She being rallied, I requested Mr. De Morgan to perform paracentesis, and he removed seven pints of chocolate- coloured fluid, which being thick, came away slowly ; two or three pints more drained off in the night. July 24.—-Febrile disturbance ; pulse 100. July 26.—Pulse 120, small; respiration 36, heaving. Tongue dry, chapped ; thirst extreme ; skin dry, hot. July 27.—She gradually sunk, and died at 6*30 a.m. Necropsy.—The lungs were (Edematous, but crepitated. Heart- valves normal. Abdomen filled with a lobulated tumour, which extended from the pelvis to the cartilages of the ribs. The intestines were situated above and behind it. The liver, although of large size, lay entirely beneath the ribs. The tumour was adherent to the anterior ab- dominal wall over a very large space ; but the adhesions were slight, and easily torn through. The peritoneal cavity contained some turbid brown fluid mixed with blood; this was oozing freely from a puncture in the tumour corresponding to the trocar wound in the abdominal walls. Posteriorly, the upper part of rectum and descending colon were
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