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.

    18/22 page 18
    there was foetid discharge round the clamp. As this was much depressed and some pain felt, it was removed next day, and the slough cut away. The stump of the pedicle sunk at once far in¬ wards, and there was pain in the left iliac region. On the ninth and tenth days, she was flushed and looked yellow, had a dry tongue and quick pulse. The urine also became ammoniacal and concen¬ trated. This condition, which was suggestive of septicaemia, passed off with profuse perspiration. After this she improved rapidly, and left the Home for Dunse twenty-three days after operation. Case XXXIII.—Double Ovarian Tumour. Pelvic Adhesions. Ovariotomy. Recovery. In July last, Dr Gordon, of Old Aberdeen, took me to see Mrs K., set. 42, who had been under his observation for about four years with ovarian disease. She had been a healthy woman, and had had only one daughter, now twenty years of age. She was fair complexioned, and her appearance, though somewhat ansemie, was still healthy. She was emaciated about the arms and chest, and had a remarkably dry skin. The abdomen was covered with a slight eczematous eruption. The girth at the umbilical level was 40 J inches, and from ensiform cartilage to pubis 19^- inches. Percussion was clear in right, dull in left lumbar region. The dulness of the tumour extended 2-| inches above the ensiform car¬ tilage, and the liver was much displaced upwards. The uterus was not very movable, the cervix was elongated and large, and the whole organ felt heavy. The roof of the vagina felt soft, but the examination was somewhat hurried, and the diagnosis I gave was, u single unattached cyst of left ovary.” After this she came to town for operation, and on again examin¬ ing the condition of the tumour in the pelvis, it was observed that there was some depression of the right side of the vagina. When the patient lay on her back the roof of the vagina was soft, when she was turned on her face the roof of the vagina became tense, and rose from the finger. It seemed, therefore, very probable that some pelvic adhesion existed. Ovariotomy was performed on the 16th of August, with the assistance of Dr Carruthers, of Cramond, and Dr James Carmichael. A large thin-walled eyst, containing 35 lbs. of fluid, was easily removed through an incision 3 inches in length. The pedicle, which was long and thick, was secured by a clamp. On putting down my fingers to examine the state of the right ovary, I came upon a second tumour, about the size of a newly-born child’s head, fixed in the pelvis. The body of the uterus was seen to be very large, and closely connected with this second cyst. The incision was extended, and after a little manipu¬ lation I found that the pedicle was adherent to the side and back of the uterus. This was separated, and the ovary itself, apparently quite healthy, was seen lying close to the uterus. The other attachments to the side of the pelvis were then torn, the cyst tapped and drawn upwards, and I was able to free it from all its
    digitised image 1
    digitised image 2
    digitised image 3