Ovarian tumors : their pathology, diagnosis, and treatment, especially by ovariotomy / by E. Randolph Peaslee.

  • Peaslee, E. R. (Edmund Randolph), 1814-1878.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Ovarian tumors : their pathology, diagnosis, and treatment, especially by ovariotomy / by E. Randolph Peaslee. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    be suffering from morning-sickness; and, after a considerable development of the breasts, a milky fluid is sometimes secreted. There is also a feeling of weight and fulness in the pelvis. If amenorrhcea exists with these symptoms, the suspicion of preg- nancy is, of course, increased; and only a physical exploration can demonstrate the true state of the case. 2. When the tumor rises above the pelvis—the patient now first detecting its presence—a new train of symptoms is inaugu- rated. Frequent micturition is very common from pressure forward upon the bladder; and, until the tumor rises above the umbilicus, one side of the abdomen is seen to be fuller than the other, though the tumor can by pressure usually be moved to the opposite side. ]Sfow also diminished action of the kidneys results as the tumor presses indirectly upon them and the ure- ters. Pain in the iliac regions or the back occurs from tension of the Fallopian tubes and the broad ligaments. Suppression of the menses is rare till after the commencement of the third stage. But a feeling of fulness and a dragging pain in the back is very common. 3. Still extending upward toward the epigastrium, the tu- mor at last presses upon the stomach and other portions of the alimentary canal, the diaphragm, and the heart—thus inter- fering with digestion and respiration,* and producing palpita- tion. And now, if not before, the general health rapidly fails. The kidneys are congested from pressure, and derangement of menstruation supervenes in this stage. Emaciation, at first of the face, neck, and upper extremities, becomes decided; a pecu- liar expression of countenance is seen; the menses cease; slight efforts produce dyspnoea; the enlarged abdomen is symmetri- cal on the two sides; the cutaneous veins of the abdomen are enlarged, and often the lower extremities (at least that of the affected side) are cedematous, though even a large tumor may not produce oedema if there be no adhesions in the pelvis, while a small one often produces this effect if such adhesions exist. Ascites also more rarely supervenes, and sometimes entire retention of urine ensues. 1 It is an interesting fact that dyspnoea from an ovarian cyst does not produce tuberculosis; and that anaemia thus caused does not produce disease with fibrinous exudations (Kiwisch, p. 41).