The practice of surgery . salpingitis also may bechronic or acute. When it is acute,the secretions escape usually throughthe fimbriated end of the tube,which is open frequently in acute T-. ^^. rr,, ^, 1 forms. Chronic salpingitis is con- Fig. 204.—The T-tube. g ^ -^-u- ^ i\ ? fined withm a closed tube. The diagnosis of tuberculous salpingitis is almost impossible of differ-entiation clinically from other forms of salpingitis, though in typicalcases of chronic tuberculous salpingitis one finds loss of weight, a hectictemperature, a rapid pulse, frequent amenorrhea, an abdomen li
The practice of surgery . salpingitis also may bechronic or acute. When it is acute,the secretions escape usually throughthe fimbriated end of the tube,which is open frequently in acute T-. ^^. rr,, ^, 1 forms. Chronic salpingitis is con- Fig. 204.—The T-tube. g ^ -^-u- ^ i\ ? fined withm a closed tube. The diagnosis of tuberculous salpingitis is almost impossible of differ-entiation clinically from other forms of salpingitis, though in typicalcases of chronic tuberculous salpingitis one finds loss of weight, a hectictemperature, a rapid pulse, frequent amenorrhea, an abdomen little ifat all sensitive to pressure, sometimes ascites; and one looks for a historyof tuberculosis and the involvement of other abdominal organs. The treatment of all these pelvic infections is divided into medicaland operative treatment. I shall not discuss the former further thanto say that it consists in improved hygiene, an out-of-doors life, rest,carefvil feeding, tonics, ichthyol suppositories (an extremely useful. SALPINGITIS 325 measure), hot packs, hot douches, tampons, and, in the hands of somephysicians, pclvic massage. The operative treatment of acute salpingitis presents questions forcareful judgment. The answer to the question, when to operate, is notso easy as we found it in the case of acute appendicitis. We can laydown no rule that an inflamed tube should be removed at once, as weshould say of an acutely inflamed appendix. An acutely inflamed tuberarely threatens life immediately. The inflammatory process is relativelyslow, and the formation of protecting adhesions is almost certain. Ina great majority of these cases rest, douching, and cold applications willrelieve the symptoms and localize the process, so that a delayed oper-ation, if any, may be anticipated. Rarely one sees fulminating peri-tonitis from an acutely inflamed tube. On the other hand, with the subsidence of acute symptoms and withthe establishment of a chronic salpingitis one finds often that
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
