The Journal of Surgery, Gynecology and Obstetrics (Volume 31)

9780217353236: The Journal of Surgery, Gynecology and Obstetrics (Volume 31)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1909. Excerpt: ... of pregnancy, and attempted to induce an abortion by the use of some article appertaining to the female toilette--possibly a hat pin. Her efforts were followed by a flow of blood and severe pains, and she considered that her purpose had been accomplished. As, however, the flow continued to an alarming extent, and she realized that she had become quite ill, she called in my friend, who, on makmg a careful examination, detected a mass in her pelvis, which on operation proved to be a ruptured ectopic pregnancy. So frequently is ectopic pregnancy mistaken for an early abortion that I would advise that every case of abortion be subjected to a careful and painstaking bimanual examination as the only method of preventing embarrassing and perhaps fatal mistakes. Unfortunately, the ability to make an accurate bimanual examination can only be acquired by diligent and persistent practice; and in the event that the attendant does not possess sufficient experience in this line of work to give him the necessary confidence in his findings, it becomes his duty to call in some one who can give him the information he desires. It is important to note that a serious rupture may occur and objective symptoms may be entirely absent. In such cases we have to place our entire reliance on the subjective symptoms and history of the case; and it is well to note at this point that these are most frequently sufficiently clear to indicate quite exactly the nature of the complaint, and one of most value in arriving at diagnosis. Treatment of Perityphlitis.--Klauber (Med. Klin.) advises immediate, and, wherever possible, radical operation in every stage of appendicitis. He claims that by this means he has reduced the mortality of the cases in his hands from 39 per cent, in 1905 to 12 per...

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