Removal of large fibro-cystic tumour of the uterus : recovery / by J. Knowsley Thornton.

  • Thornton, J. Knowsley.
Date:
[1878?]
Catalogue details

Licence: Public Domain Mark

Credit: Removal of large fibro-cystic tumour of the uterus : recovery / by J. Knowsley Thornton. 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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    in a septic condition directly to the wound by the very dressing which we use to avoid septicity. The patient was placed in bed at five minutes after eleven, one hour and thirty-five minutes from the time she lay down on the operating-table. She was much collapsed, cold, and blue; axillary tem- perature 97'8°; but she rallied rapidly, and at 9 p.m. was very comfortable, perspiring well; temperature 100-8°, pulse 120, respirations 20. During the first two days progress was satisfactory: pulse quiet and of fair strength; flatus passed well, and there was plenty of urine. Menstrua- tion commenced on the second day, and in the afternoon, fifty-four hours after the operation, temperature began to rise and the pulse varied from 108 to 120; at 9 p.m. the temperature was 103'4o, but as she was perspiring well and there was no unfavourable symptom except the restlessness, and as I did not wish to check the menstrual flow, I did not put on the ice-water cap, as I generally do with such a tempera- ture. At four the next morning she had a slight rigor, the temperature remaining over 103°. In the middle of the day the pulse was again 120, respiration shallow and rapid, so the ice-water cap was put on, with the temperature at 104°. It at once began to fall, with a proportionate decrease in the rate of pulse and respiration. On the evening of the sixth day the temperature was normal, and the cap was removed; but at 8.30 p.m. on the seventh day it was 102°, and the cap was put on again and kept on till the ninth day, when it was finally removed. During this time I dressed the wound daily under the spray, and was somewhat anxious as to its asepticity, as the gauze about the clamp had a sour smell, and I was afraid some cause of putrefaction in the clamp-hinge might have escaped the carbolic acid when the clamp was cleaned. On the third day I detected a con- siderable quantity of fluid in the recto-vaginal pouch, which bulged much in the vagina, and I have no doubt that the reabsorption of this bloody serum was the cause of the high temperature, and I regard the case as an example of the fever described by Billroth and attributed to reabsorption