Ovarian tumors : their pathology, diagnosis, and treatment, especially by ovariotomy / by E. Randolph Peaslee.

Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Ovarian tumors : their pathology, diagnosis, and treatment, especially by ovariotomy / by E. Randolph Peaslee. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    required. I shall speak first of the general treatment, and then of the treatment demanded by the various symptoms and conditions as they arise. SECTION- I. GENERAL TEEATMENT AFTER OVARIOTOMY. 1. The dressings already mentioned are changed as required, two or three times in the twenty-four hours, perfect cleanliness being insisted on; warmth is applied till reaction is secured, and a comfortable temperature is afterward maintained. The catheter is introduced once in six hours (oftener if the patient demands it) for from forty-eight to ninety-six hours (five or six days—Dr. Clay), according to the symptoms, after which time, efforts at micturition are allowed. Quiet of body and mind is to be insisted on for the first five days, and opiates enough are to be administered to secure this object and overcome pain, and no more. The hypodermic injection of morphia, immediately after the operation, adds much to the depressing effect of the operation, and should be, as a rule, discountenanced. ]^o one but the physician and necessary attendants should be admitted to the apartment during the first three days, even in the most favorable cases. The sutures are to be partly or wholly re- moved, if there be no tympanites, on the fourth day; the clamp becomes detached from the fourth to the tenth day. 2. The temperature of the room being 70° to even 80° dur- ing the operation, may be kept at about 65° after reaction is established. And the ventilation of the apartment should be perfect. Mr. Wells's patients, even in the winter months, were found lying with the window open, but the curtain down and the bed protected by a screen. 3. Yery little nourishment is to be given the first seventy- two hours. I prefer to continue the milk-porridge, used before the operation (p. 398). I. B. Brown gives barley-water, or iced milk, or weak broths, and sometimes ale and a mutton- chop on the third day. Mr. Wells and Dr. Keith give barley- water mainly, but the latter gives no food at all till after flatus passes per anum / only a little cold water, or a few sips of very hot water. He gives soup-and-brandy enemas in the feeblest