Diagnosis and Surgical Treatment of Abdominal Tumours

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Churchill, 1885 - Abdomen - 216 pages
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Page 13 - ... 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 46 - 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 119 - There is no proof that tapping an ovarian cyst is more dangerous during pregnancy than at any other time ; and if there be a large single cyst, tapping will afford immediate relief to distension at a very slight risk to the mother, and lead to the natural termination of pregnancy in the birth of a living child, if proper precautions be taken to prevent the escape of ovarian fluid into the peritoneal cavity, and the entrance of air into this cavity, and into the cavity of the cyst.
Page 44 - 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 admissible to do it, could we beforehand know that the circumstances would admit of such treatment.
Page 119 - In cases of multilocular cyst, tapping can be of little use ; the rule, therefore, should be to remove the tumour in an early period of pregnancy ; and if an ovarian cyst should burst during pregnancy at any period, removal of the cyst, and complete cleansing of the peritoneal cavity, may save the life of the mother, and pregnancy may go on to the full term.
Page 37 - ... which the patient is not saved by the operation. But such cases as those just alluded to must be very rare exceptions to the large majority in which ovariotomy becomes the subject of consultation. There is generally as much time for discussion as in the parallel case of lithotomy in the male adult. And in both cases, the responsibility of operating with the full knowledge that if the patient be not saved by the operation he or she is killed by it, must be fairly faced.
Page 209 - It has finally become a recognised means of treatment in certain forms of localised and chronic peritonitis, especially when purulent collections have formed. The author would urge the adoption of this principle in treatment in connection with acute and diffused forms of peritonitis.
Page 46 - 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 116 - What should be done when a pregnant uterus is discovered during some stage of ovariotomy ? Let it alone But supposing the operator has penetrated the uterus or wounded it? If any conclusion can be drawn from the case in which I made this mistake, and emptied the uterus, and two other cases, in which the same mistake was made by other surgeons who did not empty the uterus, but closed the puncture in its wnlls by wire sutures, and both patients died after aborting, while mine recovered, it would seem...
Page 47 - I enlarged it two inches, and even then nothing came forth but a little thin, yellowish serum, so I ventured to lay it open about two inches more. I was not a little startled after so large an aperture to find only a glutinous substance bung up this orifice.

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