The results of all the operations for the extirpation of diseased ovaria, by the large incision, from September 12, 1842, to the present time. : To which is appended an essay on the diagnosis, prognosis, and treatment of ovarian diseases. / By Charles Clay, M.D.

  • Charles Clay
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: The results of all the operations for the extirpation of diseased ovaria, by the large incision, from September 12, 1842, to the present time. : To which is appended an essay on the diagnosis, prognosis, and treatment of ovarian diseases. / By Charles Clay, M.D. Source: Wellcome Collection.

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    mass of facts and information on diagnosis and treatment, which they are little prepared to receive ! This, I feel assured, will be the greatest punish¬ ment that I can inflict. It is indeed a fortunate circumstance that this bold operation (for it is cer¬ tainly unequalled in surgery) cannot be accomplished alone, or performed in holes and corners ; every operation performed by me having been sanctioned by the presence of professional men of the highest standing and respectability, and of those not a few (not only from my own immediate neighbourhood, but also from considerable distances) who were actuated by the purest love for their profession, and noblest desire for its proper improvement and advance¬ ment ! Would that we had more like them! I will now allow the cases to speak for themselves, feeling confident that a discerning and impartial profession will acquit me of every charge which my de¬ tractors have advanced against me, and attribute to the true cause the envy and malice of men who ought to know and act differently. Case 1st.—Published in Med. Times, Vol. 7th, 1842. Mrs. Wheeler. June 10th, 1842. iEt. 46. Had enjoyed tolerable health until within the last three or four years, when the abdominal enlargement commenced, and gradually increased to its present size—being equal to one of the last month of utero-gestation. Had borne eight children, experienced one miscarriage, and was twenty-three years of age at the period of her first labour. The present swelling might have existed longer, but did not attract her attention until the year 1839. She never considered herself pregnant, as menstruation continued regular. In the beginning of 1840 the enlargement increased more rapidly, but without affecting the menstruation. Prom first to last she experienced no pain; the sensation being more that of a weight or incumbrance, than any other. Does not distinctly remember on which side the enlargement commenced, but imagines on the left. Her bowels are gene¬ rally confined ; never recollects receiving any external injury; and never followed any occupation but that of attending her house affairs. Had always rapidly recovered after her confinements. On examining, per vaginam, I as¬ certained that prolapsus vaginae existed ; which must have been of long con¬ tinuance, as the protruded parts had lost their natural colour, and were hard and dry, not unlike the skin of a fish to the touch. The pelvic cavity was filled with a tumour, so completely, that its extent could not be ascertained, nor could it be moved in the slightest degree by the finger. The tumour ap¬ peared to be distinct from the uterus; that organ being completely forced out of the pelvic cavity, with the exception of the os uteri, which was flat¬ tened, and pressed firmly against the upper posterior edge of the pubis. Ex¬ ternally the abdomen was equal in size to the ninth month of pregnancy, and uneven on the surface, with hard protuberances here and there. Pluctuation could not be detected in any part, except immediately above the pubis ; and even there very indistinctly. The conclusion arrived at was that a large tumour occupied both pelvic and abdominal cavities ; that it was ovarian, and originated from the right side, reasoning from the history of the case, though the left side was most completely occupied. The tumour was moveable under the integuments in the abdominal, but not in the pelvic cavity, and possessed apparently few adhesions, except the original attachment or pedicle.