The practice of medicine and surgery : applied to the diseases and accidents incident to women / by W.H. Byford and Henry T. Byford.

  • Byford, W. H. (William Heath), 1817-1890.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The practice of medicine and surgery : applied to the diseases and accidents incident to women / by W.H. Byford and Henry T. Byford. Source: Wellcome Collection.

    772/852 (page 760)
    We will often meet with cases that have been neglected until pres- sure has impaired the nutritive functions to such an extent that the recuperative powers of the patient have been greatly reduced. In some of these cases we may improve the general condition of the pa- tient by tapping the tumor and restoring nutrition by proper meas- ures. This should be attempted when there is a cyst from which we can reasonably expect to draw off a large quantity of fluid. If, however, the distension is caused by the growth of a multilocular tumor, with only small or moderately sized cysts, we should risk the operation without loss of time or addition of the risk of a fruitless tapping. When the tumor is not large, or has been reduced by tapping, we should resort to tonics, abundant and nutritious diet, and surround the patient with the best hygienic conditions possible until her health is sufficiently restored to enable her to sustain the effects of the opera- tion. Th ere are mental conditions which increase the hazard of an opera- tion. When a patient is very greatly depressed on account of bereave- ment, or other causes of intense grief, the indications should be very urgent to justify the immediate removal of the tumor; indeed, if it is possible, we should allow sufficient time for reaction from such a state of depression. I feel sure that I lost one patient because I could not pay sufficient attention to this condition. Courage on the part of the patient is an important item in assuring success in ovariotomy, and we should inspire the patient with hope by every possible means. The most favorable view of her case should be presented to her, and every means taken to help her to expect recovery, instead of leaving doubt in her mind. The menstrual cycle affords a time when the operation is more promising, and I think there is no doubt that we should operate as soon as the menstrual flow has subsided, if possible. The time of year in this climate is not a matter of so much import- ance as in warmer latitudes. I would rather operate in the warm than in the cold season, as ven- tilation can be secured much more easily at such times than during the inclemency of the winter season. If we can command the time, without serious inconvenience to the patient in reference to the size of the tumor, it would be better to select a period between the two extremes of temperature. The best place for the operation, if the patient has a comfortable home, is at her private residence instead of a hospital, unless it is one in which isolation and good ventilation can both be commanded. A well-organized special hospital, in consequence of the good atten- tion always at hand, is probably the next best place. When the patient