. American gynaecological and obstetrical in region mentioned forthree or four days, but he did not give up work until the day pre-ceding the doctors visit. Happening to have at this time anoperative case at Elk Rapids, I was asked to see the case, and,fully prepared to operate if necessary, drove in company with thedoctor twelve miles to the patients house. During the twenty-four hours since the doctors visit the condition of the patient hadmarkedly improved. The bowels had moved freely from thecathartics administered, the abdomen was flat, the temperatureand pulse normal. There was
. American gynaecological and obstetrical in region mentioned forthree or four days, but he did not give up work until the day pre-ceding the doctors visit. Happening to have at this time anoperative case at Elk Rapids, I was asked to see the case, and,fully prepared to operate if necessary, drove in company with thedoctor twelve miles to the patients house. During the twenty-four hours since the doctors visit the condition of the patient hadmarkedly improved. The bowels had moved freely from thecathartics administered, the abdomen was flat, the temperatureand pulse normal. There was, however, an area of decided dul- The Chicago Gyncecological Society. 375 ness in the region of the appendix, and a rectal examinationshowed decided tenderness in the left pelvis. Because of the dis-tance of the patient from medical aid, and the severity of the pre-vious symptoms, an operation was advised and accepted. Asaseptic an operation as possible was performed in the midst of themost undesirable surroundings and in a poorly lighted Gangrenous Appendix Vermiformis. The abdomen was opened with a three-inch incision parallel, toPouparts ligament. The presenting bowels as well as the adja-cent peritonaeum were found to be deeply injected. The appendixwas found deeply situated in the pelvis, and upon breaking up theslight adhesions surrounding oozed up into the abdominalincision. As the appendix was drawn out of the incision uponthe abdominal walls two fcecal concretions popped out of a gan-grenous area which was on the point of rupturing. Pus escapedfreely from this opening. The base of the appendix was ligatedwith silk and the organ removed. The stump was covered withpeiitonaeum and dropped. The abdominal cavity was washed outwith large quantities of boiled, strained water and a gauze drain 376 Transactions of Societies. inserted. The incision was partially closed with interrupted silk-worm gut sutures. In a letter recently received from Dr. Gauntlett it is
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Keywords: ., bo, bookcentury1800, booksubjectgynecology, booksubjectobstetrics
