Coeliotomy for myoma of the uterus : hysteromyomectomy : infection by Bacterium coli commune / by Hunter Robb and Albert A. Ghriskey.

  • Robb, Hunter, 1863-1940.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Coeliotomy for myoma of the uterus : hysteromyomectomy : infection by Bacterium coli commune / by Hunter Robb and Albert A. Ghriskey. 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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    anything by the mouth. When the tube was inserted, 10 per cent, iodoform gauze was used in the tube instead of the ordinary sterilized gauze. The tube was dressed again the next day, at 3.35 p. m., 21 h hours after the first dressing, or 51 £ hours after the operation. The cotton over the tube was scarcely moistened; the plug in the tube was moist and discolored with blood. Five pledgets of cotton were used to clean the tube. The usual cultures were made. The condition of the patient at this time seemed somewhat better ; the abdomen not so distended, and the nausea diminished; but the pulse was still quick, 150. The temperature on this day fluctuated considerably; the mouth temperature was as low as 98.8°, and at the same time the rectal temperature was 102.6°. The usual stimulants were continued, and rectal enemas used to induce the bowels to move. She also complained this day of con- siderable pain in the lower portion of the abdomen, and also of some pain in the epigastric region. After the bowels were slightly moved, this was very much diminished. The vomiting increased in amount, and occurred at more frequent intervals. The next day the tube was dressed at 3.40 p. m., 24 hours after the second dressing. The usual cultures were made. Cultures from the first dressing now showed better, and numerous colon bacilli were recognised, and not staphylococcus pyogenes albus, as at first surmised. The notes taken at this time were: Dressing over tube dry, plug in lower portion of tube wet with slightly col- ored bloody fluid. Tube cleaned with four pledgets of cotton; tube raised and turned. Abdomen much distended. Great ten- dency to stupor, nausea not so frequent, but there were one or two bad attacks. Pulse to-day full, regular and quick. Usual stimulants given hypodermically and by mouth, as she could retain them. The temperature on this day, by the mouth, 98.5° in the morning, to 103.3° at 3.55 a. m.; and by the rectum, the temperature in the morning was 104.6°, and at 3.55 a. m. was 104.3°, at which time she died in collapse on the 4th day. Autopsy of case made five hours after death. The following notes were recorded at the autopsy performed in the Pathological Laboratory. The autopsy is necessarily imper- fect, owing to the conditions under which it was made. Anatomical Diagnosis. Diphtheritic enteritis. Oedema of the lungs. Peritonitis. Operation wound of abdominal walls. Hys-