Report of the in-patient department for diseases of women for the year 1889 / by Charles J. Cullingworth.

  • Charles James Cullingworth
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the in-patient department for diseases of women for the year 1889 / by Charles J. Cullingworth. 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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    20th to 23rd.—Temperature varied from 99° to lOO^0, patient looking and feeling much better. 24th.—Between 5 a.m and 6 a.m. patient had another severe and sudden attack of pain and swelling in the lower part of the abdomen, accompanied with excessive pallor and vomiting, but with no rise of temperature. The attack seemed to be brought on by emotional excitement, due to a tragedy in a neighbouring music hall, late on the previous evening, the principal victim of which was a person known to the patient. The occurrence became known in the ward during the night, the murdered man having been brought into the hospital, and much excitement prevailing both inside and outside the hospital. 25th.—Better, but still very ill. No vomiting since yester- day morning. Temp. 99’4° to 100'4°. Tenderness and resist- ance most marked on the left side, not on the right as hereto- fore. [The operation of abdominal section had been con- templated on the occasion of the previous attack, but the patient rallied so quickly that it was postponed. The occur- rence of a fourth attack, however, reopened the question; the consent of herself and her husband, therefore, having been obtained, it was decided to perform the operation on the 27th.] It was evident that the patient, whose condition was almost certainly due to repeated intra-peritoneal haemor- rhages, was in constant danger of the haemox-rhage recurring. 27th.—Patient much better; pain less; anaemia less ex- treme. Temp. 99’4°. [The opinion was expressed that the case would prove to be one of intra-peritoneal haematocele, pro- bably complicated with and originating in a haemato-salpinx.] Abdominal section (2 p.m.).—Abdominal wall loaded with fat. On reaching parietal peritoneum and making a small opening in it some dark fluid blood immediately welled up. The peritoneal incision was now made of equal length with the external wound. The omentum was exposed by the upper inch of the incision; the lower part opened directly into a cyst-like cavity, shut off from the upper part of the peritoneal cavity by a wall, consisting of firm blood-clot and omentum; and containing blood, partly liquid and partly in the form of soft dark clot, to the extent of 30 fl. oz. After removing some of the blood the uterus was felt, of normal size, to the left of
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