Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14581666110)

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library



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erine solid tumour, apparently one with the uterus,and therefore indistinguishable from a fibroid. If it be freein the peritoneal cavity, and movable apart from the uterus,it will be indistinguishable from a solid tumour of the ovary.The correct diagnosis could in neither case be made withoutan exploratory incision; and if the patients health be suffer-ing, this will be the proper treatment. The treatment of extra-uterine gestation after thedeath of the child.—It is possible for a patient to retain adead ectopic child for years without her health suffering. Thechild may remain practically unchanged, or calcareous saltsmay be deposited in its membranes and its skin, so that itbecomes enclosed in a more or less complete calcareous shell, 858 DISEASES OF WOMEN. and becomes what is called a lithopgedion (Fig. 249). Ineither case the patient may go for an indefinite time ingood health, suffering only from the increased size of thebelly. So long as she is in this state there is no need to
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Fig. 249.—Lithopaedion. (After Bland Sutton, from a specimen in the Museum ot theRoyal College of Surgeons.) do anything. A moderate increase in the waist measure-ment is not a sufficient reason for an operation involvingmuch immediate suffering, some risk to life, and possibleulterior ill-effects. When operation is indicated.—Usually, at a variable timeafter the death of the child, suppuration begins. This ismarked by fever, pain, and, if these symptoms continue,wasting. As soon as this process has begun it is time tointerfere. Wait only long enough to be sure that the febrilesymptoms are not due to some other cause. If you wait ECTOPIC AND COMPLICATED PREGNANCY. 859 longer than this, the continuance of suppuration will reducethe patients strength, and no greater safety in the operationwill be attained. The operative removal of an extra-uterine foetus at thisstage is not usually a difficult operation, nor should it be adangerous one. But there are several important points yetto b