Tuberculosis of the female genitalia and peritoneum / John B. Murphy.

  • John Benjamin Murphy
Date:
[1903]
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculosis of the female genitalia and peritoneum / John B. Murphy. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    casionally there is a pronounced remission of symptoms even to apparent cure. As a matter of fact, the disease reappears as an acute tuberculosis of other organs. This type of remission was forcefully illustrated in the following case: Miss H., aged 16. Seen in consultation April 9, 1901, suffer- ing from a severe acute attack of tuberculous peritonitis, with considerable abdominal effusion, local nodules of exces- sive resistance and tenderness; infiltration and thickening of the pelvic peritoneum shown by practical examination; morn- ing temperature 101, evening 103; sweats and hectic, great depression. These symptoms had been present with increasing severity for ten days. Operation was advised and declined. During the three weeks following the patient made great im- provement; the vomiting ceased, the pain, temperature and effusion disappeared; the patient's general appearance was materially improved and the surgeon was severely criticised for suggesting the operation. Five weeks from the onset of the attack the patient began to complain of severe headache, nausea, and the temperature suddenly rose to 104. In twelve hours she was delirious and in seventeen unconscious. She remained in that state until she died, at the end of the third day, with all the manifestations of a tuberculous meningitis with effusion. Vierordt (1891) reported a case of spontaneous cure as a curiosity. Henoch (1897) says medical treatment is useless, and was not very sanguine as to operation. Pribram (1898) mentions some spontaneous cures. Kussmaul (1899) witnessed complete recovery in a case with enormous ascites, and several recoveries in cases of milder type. In considering prognosis, the possibility of s]3on- taneous cure must be taken into account. A cure so complete that not the least vestige of the original dis- ease may be left. Several such are now recorded, Al- terthum alone mentioning three. Yeit looks on cases of peritonitis with ascites and granular dissemination over the peritoneum as undergoing healing. Gatti, in his experiments on animals, found that the fibrous form of tuberculosis healed readity, while the caseous