Diseases of the ovaries : their diagnosis and treatment . cyst, dating from the birth of her third child sixyears before. Increase in size was slow for the first four years,but more rapid during the last two years. She had been subjectto prolapsus uteri before the confinement, and it became morecomplete afterwards, being at the time of admission irreducible,and complicated by vaginal cystocele and rectocele. She hadbeen greatly distressed by the abdominal distension, and hadkept her bed for six months before admission. The cata-menia had been regular as to time and quantity ever since thebirth
Diseases of the ovaries : their diagnosis and treatment . cyst, dating from the birth of her third child sixyears before. Increase in size was slow for the first four years,but more rapid during the last two years. She had been subjectto prolapsus uteri before the confinement, and it became morecomplete afterwards, being at the time of admission irreducible,and complicated by vaginal cystocele and rectocele. She hadbeen greatly distressed by the abdominal distension, and hadkept her bed for six months before admission. The cata-menia had been regular as to time and quantity ever since thebirth of the last child. The annexed cut, from a photographby Dr. Wright, gives a good idea of the size of the girth at the umbilicus was fifty-four inches, and the distance CASE LIII. JAN. 19, 1863. 139 from ensiform cartilage to symphysis pubis thirty-six inches;while from one anterior-superior spinous process of the ilium tothe other it was forty inches. I tapped her on December 30,and removed twenty-two pints of clear highly albuminous A movable multilocular cyst remained. The uterus was theneasily returned. She was feeble for a few days after the tapping,and the fluid began to reform rapidly, but she soon regainedstrength. On the 18th of January the measurements were—girth thirty-five inches, instead of fifty-four; perpendicularseventeen inches, in place of thirty-six; and anterior seventeeninches, in place of forty. Ovariotomy was performed on January 19, 1863. Mr. Clovergave chloroform. Dr. Marion Sims of New York, Mr. Macilwain,&c., were present. Owing to the extreme looseness of the inte-guments, I made the first incision by transfixing a fold of skin,thus making an opening six inches long, down from one inch 140 CASES OF OVARIOTOMY. below the umbilicus. The peritoneum was opened, as usual, ona director. Some loose but extensive adhesions were separatedby the hand. The chief sac was tapped, emptied, and with-drawn ; but a mass of secondary cysts, as la
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