The Cleveland Medical Gazette, Vol. 1, No. 3, January 1886Various
History
The Cleveland Medical Gazette, Vol. 1, No. 3, January 1886
Various
Medicine -- Periodicals; Surgery -- Periodicals
The subsequent history of the cure was as favorable as could be desired.
The wound united very readily. The temperature never rose above 103°,
and was only at that point for a few hours; most of the time was 100° to
101.5°. Two weeks after the operation temperature was normal, a point it
had not reached since her admission, and probably not for some time
previous.
Patient was examined September 8; the tumor was found to be considerably
diminished in size, and tenderness almost entirely disappeared. She had
apparently gained in weight, and expressed herself as feeling well. She
was discharged from the hospital September 9. On the tenth of October
she again presented herself, according to agreement, and was examined by
Dr. Scott, Dr. Allen and myself. The tumor had entirely disappeared,
only a slight thickening of the tissues remaining, the uterus had
resumed its normal position, and the patient, to all appearances, was as
well as ever.
I have reported this case as one of extra-uterine pregnancy, and yet it
will be seen by the report that the existence of that condition was not
demonstrated at the operation, but it seems to me that the history of
the case, both prior and subsequent to the operation, demonstrates
pretty conclusively that it could be nothing else. Both the gentlemen
who saw the case before operation were of the opinion that everything
could be excluded except a collection of fluid, disease of the coecum
and extra-uterine pregnancy, and to my mind (and the gentlemen who were
called in consultation have expressed themselves in the same manner) the
operation and the result of it excludes everything except the last
mentioned condition. It may be said that in the treatment of the case
less severe measures should first have been tried; that the electric
current should have been employed before resorting to an operation. This
subject was fully discussed, and the decision against the employment of
electricity was unanimous, from the fact that the most favorable time
for its employment had passed and the time had arrived when any further
delay was dangerous. Then the danger from an exploratory incision is so
small that it seemed to be more than counterbalanced by the knowledge
that would be obtained by it. If an exploratory incision was made we
would then be better able to tell what we had to deal with, and would
also be in a position to deal with whatever was found in the most
effectual manner, and it was thought that the most certain means of cure
should be employed first and the patient not be subjected to the danger
of delay in order that less certain methods might first be tried; also
the high temperature seemed to render any delay more dangerous. The
incision described was employed because it seemed that the tumor could
be more easily reached and removed by means of it than by means of the
central one. When, however, the mass was reached it was found to be so
firmly attached to the cœcum by strong adhesions that it was absolutely
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