A short account of a case of disease of the appendix caeci, cured by operation, with suggestions as to the propriety of adopting a similar method of proceeding in certain cases of peritonitis / [Read before Med. Soc. London., Sept. 25th, 1848].

  • Henry Hancock
Date:
1848
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Licence: Public Domain Mark

Credit: A short account of a case of disease of the appendix caeci, cured by operation, with suggestions as to the propriety of adopting a similar method of proceeding in certain cases of peritonitis / [Read before Med. Soc. London., Sept. 25th, 1848]. Source: Wellcome Collection.

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    17th.—Much worse than when we last saw her. Her countenance anxious; nose pinched; pulse intermittent and running ; sickness very troublesome ; tongue brown in the centre; had obtained no sleep although thirty minims of the solution of bimeconate of morphia had been given every three hours; skin cold and clammy; complained of great pain, and fits of shivering which were most violent, and from their frequency had prevented her sleeping; bowels scarcely relieved by enema. The blistered surface having healed up, a more decided examination could be made. The cord-like swelling, already alluded to, was more apparent, but too close to the spine of the ilium to be an inguinal hernia; there was also thickening and hardness extending outwards towards the ilium, where she complained most of pain. As she was evidently sinking, and the previous treatment had been of no avail, I proposed to make an incision from the spine of the ilium to the inner side of the internal abdominal ring over the hardened spot, so that if it were intestine or omentum it could be freed—or if, as we thought more probable, matter had collected in the right iliac fossa, it could be let out, and thus give our patient a chance of recovery. This having been agreed to by Dr. Chowne and Mr. Diamond, who attended the case with me through¬ out, the patient was put under the influence of chloroform, and an incision, about four inches long, made inwards from the spine of the ilium above Poupart’s ligament, but as close to it as possible. Upon opening into the abdomen a quantity of excessively offensive turbid serum with fibrinous flocculi poured out, mixed with air globules and also patches of false membrane. She was directed to be turned on her side that the discharge might freely escape, a poultice to be applied and to take an opiate.