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Excerpt from Ovarian Tumors, and Remarks on Abdominal Surgery With the Result of 50 Cases We meet sometimes with adhesion of the bladder at that point as a complication with ovarian cyst. Again, there are cases on record where an ovarian cyst became adherent to the umbilicus and formed a fistulous opening and a spontaneous cure took place. How to diagnose tumors and cysts of the kidney: I have already spoken to you in a previous lecture; do not forget that tumors of the kidneys will enlarge from the posterior to the anterior part above and they push the intestine in front. The colon here is always in front and can be filled with air and be distended thereby and recognized. In the cyst of the broad ligament the fluid is always as clear as spring water, contains no albumen and a manual examination per rectum under chloroform will detect two ovaries. These are the cysts that are cured by tapping. Now this drawing represents a side view of an abdomen affected with a multilocular cyst, and this is a portrait of the characteristic feature (facies ovariana, after Wells.) The time of one hour is too short to go into details about everything, but to do you and the subject justice I have prepared these tables you see hanging upon the walls which you may study for yourselves. See tables, pages 10, 11 and 12. Here you have the differential diagnosis of a mono cyst, a poly cyst and a dermold cyst. Then here the chemical consistence of the fluids of an ovarian cyst, cyst of the broad ligament, amniotic fluid and ascitic fluid. And here what the microscope reveals. All this will give you a pretty good idea of the difficulties we may encounter and what is necessary to make a correct diagnosis. In conclusion I will say to you again: Be systematic in all your doings, only by following and carrying out a certain system can we expect to come any ways near to perfection. Let me repeat then: First take the symptoms into consideration, the history of the case, the expression of the face and neck, the activity of the kidneys, the sympathetic affections of the mammae; then the local signs; then the rational signs as detected by the patient; then the physical local signs; exploration, such as inspection, measurements, palpitation, percussion, auscultation, change of position, vaginal touch, trocar, microscope; and last of all exploratory incision. Second; Ask yourselves the following questions, so beautifully illustrated by the late Dr. Peaslee, and answer each and every one of them positively, viz: Is there actually an enlargement within the cavity? Is there fluctuation, indicating an accumulation of fluid within the abdomen, or a solid tumor? "Mesenteric fibroma or fibro-plastic." Is the fluctuation due to ascites? Does the cause of the enlargement arise in the pelvis? Is not the tumor a pregnant tumor? Is there not still an enlargement of the uterus though it be not gravid? "Haematometra, hydrometra, uterine hypertrophy, fibroma, carcinoma of fundus, uterine fibro cysts." And to what is the fluctuation due? Serous cyst of the broad ligament, encysted dropsy of peritoneum, dropsy of fallopian tubes, renal cyst hepatic cyst, pelvic abscess, splenic abscess, etc." In our next lecture we will take up the treatment, or rather when and now to operate, and I will demonstrate to you my method of operating. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com"

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Author: Edward Borck
Number of Pages: 30 pages
Published Date: 27 Sep 2015
Publisher: Forgotten Books
Publication Country: United States
Language: English
ISBN: 9781330106709
Download Link: Click Here
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