On surgical diseases of women / by I. Baker Brown.

  • Isaac Baker Brown
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On surgical diseases of women / by I. Baker Brown. Source: Wellcome Collection.

    309/468 (page 253)
    lasting twenty-four hours. Ordered bark and acid. She gradually got stronger, and lost no more blood ; and on Nov. 27th she menstruated, there being only a normal amount of discharge. Dec. 10th. She left the Home ; her general health is very good, and she can get about with comfort. The tumour can still be felt, but exceedingly diminished in size, and causes her no inconvenience. Feb. 1861. This patient is now in good health, has a healthy complexion, and is increased in flesh. At the last menstrual period she only used three napkins. Case IV.—Fibrous tumour : Operation: Death.—J. M., set. 46, un- married, admitted into the London Surgical Home. Has suffered from a fibrous tumour of the uterus for twelve years, which has gradually increased, and is now the size of a six months foetal head : it causes great uneasiness and pain in her back, frequent desire to micturate, and an inability to sit up for a long time together. On examination, I found the hymen almost imperforate, and the os and cervix uteri not altered from their normal character. Nov. 19th. I operated, in the presence of Dr. Hall Davis, Mr. Charles Mann, and Mr. Philip Harper, dividing the os and cervix uteri ; and found a fibrous tumour embedded in the left side of the uterus down to the os internum. I then cut through the capsule of the tumour, gouged out a piece from its centre, and broke it down on each side of the opening thus made. I next plugged the vagina with oiled lint. There was very little bleeding. Nov. 20th. Has had some cold shivers and pain in the abdomen. Twelve leeches were applied to the abdomen, and a powder of hyd. c. cret. and pulv. Doveri given. 21st. At ten and four o'clock a shiver. At 2 p.m. gave three grains of quinine, which dose was repeated at night, and in the night. Pulse 120. 22nd. Passed a good night, without opiates ; the pain of abdomen gone. Pulse 120, but soft. From this time symptoms of pyaemia became apparent, purulent effusion occurred within the pleura, and the patient died on the tenth day after the operation. A post- mortem examination was made, and diffused purulent infiltration discovered. Bemarks.—The fatal termination of this case is attributable to the several stages of the operation having been performed together, and to the con- sequent absorption of pus by some of the recently cut surfaces. Case V.—Fibrous tumour.—A. B., aet. 37, married ; mother of one child ; admitted into the London Surgical Home October 14th, 1859. Had an attack of profuse flooding in May last, and four others since that time, pro- ducing great debility and anaemia. On examination, a portion of a fibrous tumour, of the size of an orange, was seen projecting through the os uteri, and found to be adherent to its anterior lip, but it had no pedicle. On Dec. 1st, I detached the tumour from the os by a pair of scissors, but in a day witnessed its reappearance : and although I cut a portion off on the 5th, yet on the 15th it was again protruding into the vagina, and called for further excision. On the 29th, another large portion was removed. After each operation, the patient suffered much sickness and depression, with loss ©f appetite. January 12th, 1860. I removed several pieces from the morbid mass which then filled up the vagina. Feb. 2nd. Excised three more pieces. March 29th. Cut off a portion as large as a hen's egg ; and on April 5th, two large pieces, the size of the fist, for the morbid growth then protruded even through the vagina. On April 24th, I removed large quantities again. She was very weak after this operation, and soon after left the institution ; but a few weeks subsequently I removed another large piece at her lodgings. From