Four cases of oöphorectomy : with remarks / by Joseph Taber Johnson.

  • Johnson, Joseph Taber, 1846-1921.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Four cases of oöphorectomy : with remarks / by Joseph Taber Johnson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    I saw a skillful and experienced gynecologist remove the uterine appendages last spring from a patient who had been many years a great sufferer. He had urged the operation at a consultation two years previously, and again after the ex- piration of another year of ineffectual treatment and con- tinued agony. Finally objections were withdrawn and the operation agreed to, after all other hopes of relief had de- parted and her strength was well-nigh exhausted. The operation lasted fully an hour and a half, the adhe- sions were strong and numerous, the tubes were enlarged to the size of the small intestine, and for a time were mistaken for intestine. The patient died, I am informed, of peritonitis and internal hemorrhage from torn surfaces on the fifth day. The probabilities are all in favor of the recovery of this patient if she had been operated on two or three years sooner, and she would have been saved untold misery in either event. Tait operates early, and finds few adhesions. The time consumed in most of his oophorectomies is from ten to twenty minutes, and the patients all, or nearly all, recover. Two deaths in one hundred and eight cases, according to his latest reports ! Is not this the great secret of his success ? Ilis pa- tients are yet in good condition, but surely tending, he thinks, toward a fatal issue. In some instances he removed the ap- pendages where the myoma was no larger than an orange or fetal head, and had yet produced none of the effects of press- ure and displacement, but was rapidly growing and causing great loss of blood, and likely in time to cause death. While I do not venture to make suggestions to this So- ciety, as to any special points or symptoms which would render earlier operations more justifiable, I think I may ex- press the hope that some authoritative means may be soon developed and published whereby we may be able to operate earlier, before the patient drifts into that exhausted and bed- ridden condition, after years of unrelieved suffering, when strong and numerous adhesions add so largely to the diffi- culties and dangers of the operation.