down in the pelvic basin was found a adherent fluctuating tumour of the left ovary about the size of a large peeled cocoanut. With great difficulty the adhesions were separated, the pedicle ligatured and tumour removed. The operation was brought to a close in the usual way. That evening temperature rose to a 102?; abdomen was enormously distended, and the patient very thirsty and restless. The following morning labour pains set in, and she was delivered of a 8th month child. In the evening her temperature rose to 107?, and she died 27 hours after operation. No autopsy allowed. lower
firmly
Case No. 2.?K.F., Hindu, 16, unmarried, nullipara. Admitted with an abdominal tumour, rising from the pelvic basin and reaching to the liver, oblique in direction, hard and resisting, said to be 8 months in duration, menses regular ; cervix soft and drawn up under the pubic arcli and pointing backwards with the sound in position, the uterus is movable laterally, and lies in front of a hard solid mass which extends well down into Douglas's pouch, pushing the posterior vaginal wall forward. Diagnosed as a solid tumour of Under proper antiseptic prethe right ovar}". cautions, abdominal section was performed. A large fluid cyst of the right ovary was removed, the patient making an excellent though tardy
THREE CASES
fIN
OP
ABDOMINAL
THE MATERNITY
SECTION
HOSPITAL, TKlVAN-
DRUM. By Surgn.-Lt.-Col. W. P. Esmonde Durbar
White, i.m.s.,
Physician, Trivandrum.
Case No. 1.?A. L., Christian, Yl-para. Adhospital 11 months ago for a tumour about the size of an orange in Douglas's pouch, having a small nodule of the thickness ot a goose quill 011 its left. Diagnosed as a solid Was advised operatumour of the left ovary. tion, but was unwilling. Re-admitted on the 11th August 1897. She was now 8 months pregnant, having conceived some time after leaving hospital. She came in with the follow-
mitted into
ing symptoms
recovery. Case No. 3.?A. A., Christian, 29, IV-para. Previous to admission was treated for chronic cervical endometritis. Examination revealed a ?'hard pelvic tumour rising to a level with the umbilicus, 6 months in duration, cervix points to the front. Uterus retroverted and to the left. Replacing the organ in position, it was found to move freely, lying in front of a solid tumour, occupying Douglas's pouch as well. Diagnosed solid tumour of right ovary, probably a as malignant from rapidity of growth. Abdominal section revealed a fluid tumour of the right side. The patient made an excellent and rapid recovery. The above cases, the notes of which have been kindly taken for me by Assistant-Surgeon John Goudy, who assisted me in the operation, are interesting. In the first case, the question arises as I operated to what was the best treatment. it the the best chance. woman believing gave The second
:?
so
a
case
is
interesting from the fact of an so large ovarian
girl having
young umbilicus, dyspncea, tumour. 102? F. On exaand vomiting. Temperature, The third case is interesting as being an ordimination, cervix found drawn up and jammed ovarian one when a malignant tumour was nary against the symphisis pubis; vagina barely indicated. admitting the passage of the examining fingers, clearly All the cases here desciibed were operated on being narrowed by a hard resisting tumour, Labour in the usual manner, the abdominal cavity being fixed in Douglas's pouch. immovably about, but very little being done to sponge washed natuvales vias impossible, thought being per Intense
pain
below the
dpminal section was performed under the usual or rub the peritoneum. The last case was comantiseptic precautions. The gravid uterus was plicated by a superficial abscess in the incision bodily lifted out of the abdominal cavity, and clearly due to the use of a non .antiseptised needle.;
firmly
Case No. 2.?K.F., Hindu, 16, unmarried, nullipara. Admitted with an abdominal tumour, rising from the pelvic basin and reaching to the liver, oblique in direction, hard and resisting, said to be 8 months in duration, menses regular ; cervix soft and drawn up under the pubic arcli and pointing backwards with the sound in position, the uterus is movable laterally, and lies in front of a hard solid mass which extends well down into Douglas's pouch, pushing the posterior vaginal wall forward. Diagnosed as a solid tumour of Under proper antiseptic prethe right ovar}". cautions, abdominal section was performed. A large fluid cyst of the right ovary was removed, the patient making an excellent though tardy
THREE CASES
fIN
OP
ABDOMINAL
THE MATERNITY
SECTION
HOSPITAL, TKlVAN-
DRUM. By Surgn.-Lt.-Col. W. P. Esmonde Durbar
White, i.m.s.,
Physician, Trivandrum.
Case No. 1.?A. L., Christian, Yl-para. Adhospital 11 months ago for a tumour about the size of an orange in Douglas's pouch, having a small nodule of the thickness ot a goose quill 011 its left. Diagnosed as a solid Was advised operatumour of the left ovary. tion, but was unwilling. Re-admitted on the 11th August 1897. She was now 8 months pregnant, having conceived some time after leaving hospital. She came in with the follow-
mitted into
ing symptoms
recovery. Case No. 3.?A. A., Christian, 29, IV-para. Previous to admission was treated for chronic cervical endometritis. Examination revealed a ?'hard pelvic tumour rising to a level with the umbilicus, 6 months in duration, cervix points to the front. Uterus retroverted and to the left. Replacing the organ in position, it was found to move freely, lying in front of a solid tumour, occupying Douglas's pouch as well. Diagnosed solid tumour of right ovary, probably a as malignant from rapidity of growth. Abdominal section revealed a fluid tumour of the right side. The patient made an excellent and rapid recovery. The above cases, the notes of which have been kindly taken for me by Assistant-Surgeon John Goudy, who assisted me in the operation, are interesting. In the first case, the question arises as I operated to what was the best treatment. it the the best chance. woman believing gave The second
:?
so
a
case
is
interesting from the fact of an so large ovarian
girl having
young umbilicus, dyspncea, tumour. 102? F. On exaand vomiting. Temperature, The third case is interesting as being an ordimination, cervix found drawn up and jammed ovarian one when a malignant tumour was nary against the symphisis pubis; vagina barely indicated. admitting the passage of the examining fingers, clearly All the cases here desciibed were operated on being narrowed by a hard resisting tumour, Labour in the usual manner, the abdominal cavity being fixed in Douglas's pouch. immovably about, but very little being done to sponge washed natuvales vias impossible, thought being per Intense
pain
below the
dpminal section was performed under the usual or rub the peritoneum. The last case was comantiseptic precautions. The gravid uterus was plicated by a superficial abscess in the incision bodily lifted out of the abdominal cavity, and clearly due to the use of a non .antiseptised needle.;
