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On Ovarian and Uterine Tumours, Their Diagnosis and Treatment
Thomas Spencer Wells
No preview available - 2015
abdominal tumour abdominal wall adherent adhesions albumen appearance ascites ascitic fluid become bladder blood broad ligament cancer canula cells colloid colour condition contained contents cyst wall cystic death degeneration dermoid dermoid cyst diagnosis dilated discharge distended enlarged epithelial epithelium escape examination Fallopian tube fatty felt fibrous tissue fluctuation followed formation glands Graafian follicles growth hydatids inches incision intestine kidney large cyst layer left ovary ligature malignant mass membrane months mortality multilocular cysts nodules nuclei omentum opening operation ovarian cyst ovarian disease ovarian dropsy ovarian fluids ovarian tumour ovariotomy ovum pain patient pedicle pelvis percussion peritoneal cavity peritoneum pints portion pregnancy pressure puncture quantity rectum removed renal right side Rokitansky rupture Samaritan Hospital secondary cysts seen serous serum simple cysts solid sometimes stroma structure substance surface surgeon symptoms tapping thick tion trocar tympanitic umbilicus urine uterine uterus vagina vascular veins vesicles vessels woman wound
Page 492 - One appeared to be central, and a little above the umbilicus ; the other to the right side, under the anterior superior spinous process of the ilium. They were then each about the size of a goose egg. Increase had been slow at first, and no alteration in dress had been called for till a year ago ; during the past two months increase had been very rapid.' The abdomen was enormously distended, measuring fifty-six inches in girth at the level of the umbilicus, nineteen inches from the ensiform cartilage...
Page 90 - ... requirement for the modern practice of successful special surgery is a patient brought to the highest state of resistance to microbic infection and made as clean as possible. The power of resistance of each individual cannot be learned from the pulse or temperature, but we can estimate it to a limited extent from the history of the case and the general condition of the patient. In many cases we try by proper alimentation and treatment to increase the individual power of resistance before operation....
Page 186 - As soon as the external opening was made the intestines rushed out upon the table, and so completely was the abdomen filled by the tumor that they could not be replaced during the operation, which was terminated in about twenty-five minutes.
Page 186 - In five days I visited her, and much to my astonishment found her engaged in making up her bed. I gave her particular caution for the future, and in twenty-five days she returned home as she came, in good health, which she continues to enjoy.
Page 182 - If it be proposed indeed to make such a wound in the belly as will admit only two fingers or so, and then to tap the bag, and draw it out, so as to bring its root or peduncle close to the wound of the belly, that the surgeon may cut it without introducing his hand; surely, in a case otherwise so desperate, it might be advisable to do it, could we beforehand know that the circumstances would admit of such treatment.
Page 26 - The two tumors in question were examined directly after their removal by Dr. Ritchie, who pointed out to me in each of them a number of small cysts, which were evidently enlarged Graafian follicles. Knowing the great and long familiarity which Dr. Woodham Webb has had with the ova of various species of animals since his researches in conjunction with Barry, I asked him to examine some of the cysts in order to ascertain whether they did or did .not contain ova, knowing that on this point no higher...
Page 252 - The size of an ovarian tumour does not of itself affect the result ; but size and solidity together, by affecting the length of the incision necessary for the removal, appear to be of some importance. A short incision is much more favourable than a long one. The probable result of ovariotomy can be estimated with far greater accuracy by a knowledge of the general condition of the patient than by the size and condition of the tumour.
Page 49 - In these cases the place of the ovary on either, or on both sides, is occupied by a nodulated mass of uniformly hard, heavy, white, and fibrous tissue. The mass appears to be generally of oval form, and may be three or more inches in diameter. Its toughness exceeds that of even the firmest fibrous tumor, and its component fibres, though too slender to be measured, are peculiarly hard, compact, closely and irregularly woven.
Page 26 - ... years old, were growths in excess of true ovarian structure. The multilocular character was produced by clusters of ovisacs of various sizes. Ova with the other natural contents were to be found in all the small sacs. The fibrous coats of the larger sacs were thickened, and had many other secondary sacs developed in them. The interior was lined with epithelium, which in some instances had, by parthenogenetic enlargement and successive buddings of the cells, given rise to bunches of grape-like...
Page 230 - English operators in their classical works ; and only after having attained the same results should we venture to practically put into force our own ideas, in order to improve upon these. I had the good fortune to see Spencer Wells operate upon two complicated cases, and from them, as well as from oral communication with this remarkable man, I learned much. I constantly follow his precepts, knowing that he has long since thoroughly thought out and tested all that can happen to myself. I shall willingly...