Ovarian tumors, and remarks on abdominal surgery : with the result of 50 cases / by Edward Borck.

  • Mathias Adolph Edward Borck
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Ovarian tumors, and remarks on abdominal surgery : with the result of 50 cases / by Edward Borck. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    •22— 0 obtain the opinion of some one else. I know that some of such refused patients have been operated upon by others and they have died. If others present themselves with tumors in the lust stage, with broken-down con- stitutions and with the chances all against them, I give them no encour- agement whatsoever and they will of their own accord seek other advice. The favorable cases, of course, 1 encourage, but I never urge the opera- ation. I leave that to the patient to do. Again I see a patient where a certain something *(call it if you will, the faculty of presaging) tells me that the result will or may be fatal; then 1 had rather not have the patient. I must feel that my-patient will survive, and so must she—there must be the utmost confidence on both sides. lam never anxious for a case; lam never anxious to o])crate for the sake of the operation. On the other hand I would not refuse a case, even the most desperate one, if the operation offered the only, even the slighest chance of saving her life. Moral duty would commend the surgeon to run any amount of risk. I will relate a case which I saw in Illinois some time ago, one of ovarian cyst in the last stage, complicated with extra-uterine pregnancy. The woman suffered dreadfully, she was a pitiful object to look at and certainly doomed to death. Had I been prepared I would have operated at once as she was willing; the next day was Sunday and she would not be operated upon on that day. It was put off until Monday morning; but the patient did not live until then. Sunday the tumor broke through the vagina, and she died at once. In such a case I think it would have been perfectly justifiable, at least to try and give relief. My intention was to relate all my cases in detail, but I think now that such is not necessary; for, even after one has gone through the labor of ])repariug a long list of cases and their histories, very few will read them, far,less study them. We are well enough supplied with the reports of iso- lated successful cases. You can hardly take up a journal, Avherever pub- lished, that does not contain the report of a case. They are of no value in a statistical sense, but it speaks well for the American profession that there are men, even in the smallest towns capable of performing any operation and ready to do their duty. In the near future this Avill be con- sidered a minor operation. It is reasonable to suppose that w'herever there are successful cases there may also have been failures. How few of those isolated fatal cases do we see reported? I have seen many operations abroad and at home. Of the home cases in which I have seen others operate the majority died. Not a single one of these fatal cases has been reported up to the present time. Well, my friends may say I picked my cases, I would call it a judicious selection or discrimination betw'een cases and recommend all who begin to do the same. One thing my friends cannot say: that I hide my fatal cases. Every one of my fatal cases has been published at once and in detail, and I will publish every other case I happen to lose in the future, for the benefit of all. I keep full records of all my cases, and some day, when their number has doubled I may have them published. Since 1878 I have seen and examined on an average about twenty-five cases per year for abdominal enlargement, and in not a single instance have I made an exploratory incisionforthepurpo.se of making a diagnosis, though it is justifiable in very doubtful cases, and as a nile, safe. 1 do not believe in the practice of opening every woman’s abdomen be- cause it is easier to make a diagnosis. I prefer the more difficult manner— without the knife; but whenever I might be in doubt and should have to resort 1o an explor-atory incision, it w'ould be with the distinct under- standing to go on with liu‘ operation at once if such were indicated. t
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