Tuberculosis of the female genital organs (including tuberculosis of the kidney) / by Albert Vander Veer.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculosis of the female genital organs (including tuberculosis of the kidney) / by Albert Vander Veer. 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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    tion of which the patient is possessed; therefore, when we have a patient who suffers from pelvic disease, and all conditions, such as tumors, pelvic abscesses, etc., are to be excluded, and we have present the constitutional symptoms, such as tempera- ture, increase of pulse-rate, a hectic and anaemic appearance, all pointing to some obscure condition of the uterine appendages, we do not usually go astray in a direct exploration, and it is not surprising that we find a large number of these cases to be of the character of local or possibly general tuberculosis. Beyond a doubt tuberculosis of the ovaries is much rarer than tuberculosis of the uterus and tubes, and it is fair to infer that when infection takes place it is through the circulation more particularly. The ovary when in a condition of miliary tuber- culosis will present many raised points the size of millet-seed. When caseous tuberculosis exists the ovary will enlarge to the size of a large marble or hen’s egg. Acute peritonitis and tubercular peritonitis are sometimes caused by these tubercular nodules softening and rupturing into the peritoneal cavity. In tuberculosis of the ovaries miliary tubercles are the exception. There are two chief forms of tubercular ovarian disease de- scribed: The first, minute miliary granulations on the surface of the organ; and the second, usually caseous masses. The latter may assume the size and shape of a small apple, dense on section, and containing numerous small cysts filled with viscid fluid. Such cases present little or no normal ovarian stroma. Either form, as here described, may be grafted upon papilloma- tous tumors, or other diseased conditions of the ovary. It is very difficult to make the diagnosis between tuberculosis of the ovaries and chronic oophoritis. When it is possible to make the former diagnosis the ovaries should be removed as promptly as possible. Ovarian cysts are sometimes studded? with subperitoneal tubercles, as has been observed by a number of writers, yet removal of the cyst seems to relieve any sympathetic involve- ment. Symptoms. The primary sore, whether connected with the vulva or vaginal wall, will present at times a distinct ulcer, the *
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