Licence: Public Domain Mark
Credit: On ovarian dropsy : with cases of ovariotomy / by Thomas Keith. 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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![small cysts. Tlic uterus was very movable, and perlia])s smaller than natural. I was quite satisfied that no more of the attaeliment of the tumour could liave been removed than had been done, and it appears to me that the diagnosis of such a rare and unfortunate case is impossible. These are all the cases in which up to the present time I have performed this operation, and with the successful cases amongst them, I have had the good fortune to break the line of unsuccess that has, since Mr Lizars's case, in 1823, hitherto followed the opera- tion of ovariotomy amongst us. Never having seen a single case cured, but having seen many die under all other modes of treatment, T have now confidence in this operation. I have given it a fair trial, for I have not selected favourable eases as I have heard it reported. On the contrary, I have declined no case that has presented itself, however advanced the disease, or however reduced the strength of the patient. But I have refused to operate in many eases, in which life not being seriously threatened, I neither considered the patient warranted in submitting to, nor myself justified in undertaking, such a serious proceeding. With one exception, in which the patient's health was only beginning to give way, all were extreme cases of multilocular ovarian disease. The weight of the tumours was beyond the average ; one was by far the largest ever removed with success. Adhesions were present in all of the cases, and in five of them were very formidable and extensive; and in four-, the time occupied by the operation was between an hour and a half and two hours and a half. Into the many as yet undecided questions, in connexion with ovariotomy and its after-treatment, I do not, from my limited ex- perience, feel warranted in expressing an opinion ; but it has seemed to me better to narrate my cases simply as they occurred. At pre- sent, for instance, Mr Clay's tables appear to show that there is a smaller mortality in leaving the pedicle of the tumour within the abdomen than in securing it externally ; while the more recent ex- perience of the most successful London operators would seem to indicate that, in hospital-practice, there is a larger amount of suc- cess than in private operations. Now, we would certainly expect the opposite of this to be true. In a year or two, statistics will doubtless decide all these and other questions in connexion witli this subject. I would merely add, that, after ha^nng carefully studied in the originals every case of this operation I could find narrated, it appears to me, that what has been written on ovario- tomy by Mr Spencer Wells of the Samaritan Hospital is most satisfactory and trustworthy. No one has done more than Mr Wells to improve the operation and to simplify its after-treatment; and it gives me pleasure to acknowledge that when I commenced these operations I took him for my guide. There is no operation that has had so much evil spoken of it as ovariotomy. No surgical proceeding ever brought forward for the](https://iiif.wellcomecollection.org/image/b21951925_0016.jp2/full/800%2C/0/default.jpg)
