Transactions Volume 34 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1893 Excerpt: ... bilobed tumour closely connected with the uterus. On June 4th the anterior portion of the tumour was found to be increasing in an upward direction; and a secondary mass was felt deep in the pelvis behind the uterus, which was slightly enlarged, with somewhat impaired mobility. Menstruation continued regular without excessive loss, the flow lasting four days. The patient was subsequently lost sight of until the following October, when she returned to the hospital looking very ill, with a history of seven weeks' amenorrhoea, accompanied by abdominal pains and rapid loss of flesh. I first saw her with Dr. Konth on November 10th, and she entered the hospital on November 12th. The following notes were then made of her condition: --" A delicate-looking, but fairly well nourished little woman, without any pelvic deformity. No evidence of heart, lung, or kidney mischief. Abdomen occupied by a firm, elastic, somewhat irregular tumour, extending highest in the left side, where its upper border reaches nearly to the costal arch. Epigastrium and both flanks resonant. Anterior to the larger tumour, a secondary mass of firmer consistence rises from the pelvis to midway between pubes and umbilicus. This latter growth overlies the uterus, which on bimanual examination is found to be considerably enlarged, lying retroverted with its fundus in the right iliac fossa, and a characteristically softened cervix pointing towards the left side of the pelvis. An ill-defined souffle is audible in the right inguinal region." No menstrual loss had occurred since August 15th. Morning sickness had been noted for some five or six weeks. Diagnosis.--Pregnancy with advanced disease of one, or possibly of both, ovaries. Operation, on November 18th, 1890.--The ordinary median incisio...