Report of the in-patient department for diseases of women for the year 1890 / by Charles J. Cullingworth.

  • Charles James Cullingworth
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Report of the in-patient department for diseases of women for the year 1890 / by Charles J. Cullingworth. 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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    7 p.m., and again at 11 p.m., a drachm of magnesium sul- phate was given in solution and retained. At midnight a soap and water enema was tried once more. It brought away some flatus but very little ftecal matter. 13th.—The vomiting continued, and the abdomen was still much distended. A seidlitz powder was given, but returned immediately. Morphia was injected at intervals. 14th.—The vomiting and distension continuing, two punctures of the distended bowel were made with the hypo- dermic needle through the abdominal wall, but with no result. The temperature was normal and subnormal, and the pulse 94 to 120. 16th.—The symptoms remaining unrelieved, an ounce of castor-oil was given at 3.30 p.m. on the 16th, followed in an hour and a half by a copious enema of soap and water, mixed with glycerine. In ten minutes the enema returned, with a good deal of liquid faecal matter. After this, liquid motions were passed frequently. 18th.—No vomiting since noon on the 17th. A fair amount of liquid nourishment taken. General aspect of patient improved. Sutures removed ; no suppuration ; pad stained with sero-sanguinolent fluid without odour. 20th.—Moved into the large ward. At 11.30 p.m. patient complained of some abdominal pain, and morphia was admi- nistered subcutaneously. Edges of wound gaping. At 4 a.m. on the 21st she became seriously collapsed ; stercoraceous vomiting occurred, and she died at 8.30 a.m., eleven days after the operation. There had been no rise of temperature except at 4 p.m. on the afternoon of the 20th, when it reached 101'6°. Autopsy.—Body of a fairly-nourished woman. Linear incision in mid-line between umbilicus and pubes. Edges gaping, unhealthy looking. On further examination it was found that there was general peritonitis. The coils of intes- tine were glued together by exudation, and there was a considerable quantity of badly-smelling semi-purulent fluid in the cavity. These signs were most intense in the pelvis, but were quite marked everywhere. In the right side of the pelvic fossa was the stump of the uterine appendages (?) with ligature around. The uterus was adherent to the back
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