Forty cases of ovariotomy / by Thomas Keith.

  • Thomas Keith
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Forty cases of ovariotomy / by Thomas Keith. Source: Wellcome Collection.

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    hours, completely exhausting her. Though she took stimulants freely, she never fairly rallied, scarcely spoke after the operation, and died in thirty-two hours. The tumour was nearly solid, and weighed 11 pounds. There were 60 pounds of ascitic fluid, which formed a complete jelly on cooling. The following remarks, appended by Mr Spencer Wells to his twenty-fourth case of ovariotomy, are so applicable to the above case that I quote them entire:—u Is it right to perform such an operation as ovariotomy in unfavourable cases ? It may be said that by doing so the surgeon not only risks his own reputation, but lowers the operation he performs in the estimation of the profession, and fhu& lessens the number of favourable cases who might be willing to undergo it, were it not known that one in two, three, or four who do submit to it die. It is quite clear that a surgeon, who will only operate on very favourable cases, ought to show far better returns than one who consents to stake his own reputation, in order to give a dying patient a small chance of recovery; and. it may possibly be right to follow the more prudent course. But in a case where the poor woman says, as many have said to me, 11 suffer from a disease which must kill me.. I cannot live very long. My life must be a life of suffering. If you operate, I know the risk I run, but I may be cured, and return to my husband and children, and 1 would rather die than live as I am.’ In such a case as this, I do not envy the feelings of a man who, unless he saw the case was absolutely hopeless, would let any consideration for the general character of surgery, or for his own reputation as a successful operator, induce him to refuse the prayer of the poor dying creature who placed her life in his hands.” Case XXIX.—Nearly Unilocular Ovarian Tumour. Pelvic Adhesions. Death four days after Ovariotomy. Mrs D., thirty-two years of age, was sent to me, in the spring of 1864, by Dr Kilgour, of Aberdeen, to consider the question of ovari¬ otomy. The patient was a remarkably delicate, phthisical-looking woman, and had always had indifferent health. The tumour was small, not extending much above the umbilicus. It was unilocular, and there was no evidence of parietal attachments. The uterus lay very far back, and low down in the pelvis. The cervix was movable, but the body of the uterus was quite lost in the cyst; indeed it seemed to form part of it. She had got cold on her way by sea, and when I saw her she had a slight pleuritic attack, with some effusion. There was also some subcrepitant rale here and there through the right lung, especially below the clavicle. She had a good deal of cough, without much expectoration. The right side of the chest was contracted, and there was a history of old pleuritic attacks. Under these circumstances, I recommended no interference, and she returned home. Her health improved during the summer, and no increase of size took place. In the following spring, however, she
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