A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The enormous size attained by ovarian cysts, and the tremendous amount
of fluid drawn off from them, are shown by the old records of the days
when tapping the cyst was the only treatment. A few references will
illustrate this. In one case 1920 pints of fluid were drawn off by
66 tappings in a period of sixty-seven months. In another case 2787
pints were withdrawn by 49 tappings. In another case 9867 pounds were
withdrawn by 299 tappings. The fluid in these remarkable cases must
have been of low specific gravity, containing but little solid matter,
or the women would have sooner succumbed from the drain on the system.
The misery of the women who were slowly crowded out of existence
by these enormous tumors, or who, though with life prolonged by
tapping, were exhausted by the continuous drain, was depicted in their
countenances. The expression was called the _facies ovariana_. We do
not often see it at the present day. Wells describes it thus: “The
emaciation, the prominent or almost uncovered muscles and bones, the
expression of anxiety and suffering, the furrowed forehead, the sunken
eyes, the open, sharply defined nostrils, the long, compressed lips,
the depressed angles of the mouth, and the deep wrinkles curving around
these angles, form together a face which is strikingly characteristic.”
The natural duration of life depends upon the character of the ovarian
tumor. A dermoid may exist from childhood and give no trouble--in
fact, may not be recognized until some accident starts it into rapid
development. Even then it is of comparatively slow and limited growth,
and danger from it is due to the accidents, such as inflammation and
suppuration, to which it is especially liable.
Though the papillomatous cyst is also of slow growth when compared with
the glandular cyst, yet the danger here is due to peritoneal infection,
which very often takes place before the tumor has, by its size, begun
to annoy the woman.
The glandular cyst, however, is of rapid, continuous, unlimited growth,
and usually destroys the woman within a period of three years. Life has
been prolonged for a much longer period in some cases by palliative
treatment and tapping. On the other hand, life may at any time be cut
short by the occurrence of some accident, such as rupture or torsion of
the pedicle.
_Symptoms of the Accidents that occur in Ovarian Cysts._--The symptoms
of inflammation are pain and tenderness over the surface of the tumor.
The tenderness is often limited to a local area which marks the
position of an intestinal adhesion.
When suppuration takes place, the symptoms indicative of the presence
of pus appear--elevated temperature, rapid and feeble pulse,
exhaustion, and emaciation.
_Symptoms of Torsion of the Pedicle._--There are no characteristic
symptoms of slow or chronic torsion, unless, perhaps, retardation of
the growth of the tumor appears as a result of the interference with
the circulation.
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