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.

    425/468 (page 361)
    from below, of extra-mural pediculated or non-pediculated uterine growths—which, are all of them very different pro- cedures, and have all of them, with the exception of the first, been attended with a much lower degree of mortality. It should not be confounded, moreover, with three other operations which it might seem to more closely resemble, namely—with the removal, by gastrotomy, of pediculated uterine fibroids; nor with the attempt at enucleation, after gastrotomy of interstitial uterine growths, allowing the matrix to remain in situ ; nor with removal of the organ through an abdominal incision after its attachments have been divided by dissection from the vagina—each of which operations is probably intrinsically more fatal; the latter, indeed, almost necessarily so. Nor—and here I quite agree with Dr. Storer— should the operation by simple abdominal section be thought so very different from the ordinary operation for extirpation of an ovary, save as concerns the greater difficulty of its performance, the greater courage it requires in the surgeon, and the greater necessity of careful preparatory and after-treatment. We learn from Dr. Storer that the removal of the uterus by abdominal section, for malignant disease, was proposed by Weisberg, in 1 787, and again by Gutberlat, in 1814; neither of them, however, seeming to have attempted it in practice. Dr. Sfcorer finds that there have hitherto been put upon record but five successful cases of extirpation of the uterus by purely abdominal section; one of them British, by Clay, of Manchester; one of them French, by Koeberle, of Strasburg; and three American, one of which was by Kimball, of Lowell, and the other two by Burkham, of the same city. They were all five non-malignant tumours. To these suc- cessful cases Dr. Storer adds a sixth. From returns of all the cases Dr. Storer could collect, he found that this operation had been performed twenty-four times.,—six times with success, and eighteen times with a fatal result, or with a per-centage of recoveries of one in four, or twenty-five per cent. I shall hereafter relate my case, which I have previously published in the Obstetrical Transactions,