Contributions to the surgical treatment of tumours of the abdomen
272 pages
English

Contributions to the surgical treatment of tumours of the abdomen

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272 pages
English
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1 06705342 1761 3 EN 1 \ rU.FCTRIf'm PRESENTED TO The University of Toronto BY '^j^'f^As^Vr^. L^-^ f Digitized by the Internet Archive in 2007 with funding from IVIicrosoft Corporation http://www.archive.org/details/contributionstosOOkeituoft — K CONTRIBUTIONS TreatmentSurgical OF Tumours of the Abdomen, Part II. Electricity in the Treatment of Tumours.Uterine BY THOMAS KEITH, M.D, LL.D. Edin., AND SKENE KEITH, F.R.C.S. Edin. EDINBURGH: OLIVER AND BOYD, TWEEDDALE COURT. LONDON : SIMPKIN, MARSHALL, HAMILTON, KENT, AND CO., LIMITED. 1889. PRINTED BY OLIVER AND BOYD, EDINBURGH. To DR GEORGES APOSTOLL Dear Sir, Willyon allozv my son atid myself to dedicate toyou the following account our first attempts to follow you in your treat-of ment uterine electricity ? It is allwe can youof tumours by offer for the kindness with whichyou received us at the various visits we have paid to your clinique. You gave us every information you put; everything at every case treated byyouour disposal; the notes forof the last years were open to us. For all these things accept ourfive hearty thanks. Since we beganyour treatment, now more than twoyears ago, we have ceased to perform any operation on the uterus by abdominal section. For myself I have always had grave doubts I wereif justified in at all.

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1
06705342
1761
3
EN
1 \ rU.FCTRIf'mPRESENTED
TO
The University of Toronto
BY
'^j^'f^As^Vr^. L^-^
fDigitized by the Internet Archive
in 2007 with funding from
IVIicrosoft Corporation
http://www.archive.org/details/contributionstosOOkeituoft—
K
CONTRIBUTIONS
TreatmentSurgical
OF
Tumours of the Abdomen,
Part II. Electricity in the Treatment of
Tumours.Uterine
BY
THOMAS KEITH, M.D, LL.D. Edin.,
AND
SKENE KEITH, F.R.C.S. Edin.
EDINBURGH:
OLIVER AND BOYD, TWEEDDALE COURT.
LONDON
: SIMPKIN, MARSHALL, HAMILTON, KENT, AND CO., LIMITED.
1889.PRINTED BY OLIVER AND BOYD, EDINBURGH.To
DR GEORGES APOSTOLL
Dear Sir,
Willyon allozv my son atid myself to dedicate toyou the
following account our first attempts to follow you in your treat-of
ment uterine electricity ? It is allwe can youof tumours by offer for
the kindness with whichyou received us at the various visits we have
paid to your clinique. You gave us every information you put;
everything at every case treated byyouour disposal; the notes forof
the last years were open to us. For all these things accept ourfive
hearty thanks.
Since we beganyour treatment, now more than twoyears ago, we
have ceased to perform any operation on the uterus by abdominal
section. For myself I have always had grave doubts I wereif
justified in at all., especially hysterectomy,performing such operations
the mortality operation is out allproportion tofor attending this of
the natural history mortality uterine tumours, and the resultsof of
it are received by the Asout all proportion to the benefits few.of
time went on, and the number operations became larger, my doubtsof
and that tooas to tvhether Iwere doing right continued to increase,
in spite the mortality with which I wascomparatively lotvof
favoured, more especially in myprivate practice. I never had any
ovariansuch doubts as to thepropriety performingovariotomy,forof if
atideven that is only reachedcysts be let alone, death is almost certain,
Hyster-aftergreat With hysterectomy it is quite different.suffering.
tumourthat itselfectomy is a hazardous operation theremoval a offor of
—hand, therarely shortens minor operation, on the otherlife. The
— itsperformance.removal the ovaries requires no surgical skillforof
andbeing simply castrationIt is a great mutilation to a woman, ;
ahvays successful inwomen are beginning this out. It is nottofind
some casesthese pagesattaining its purpose, you will find inforDEDICATION.vi
wherenarrated that were cured by electricity^ operations on the
had to give any relief.ovaries failed
aYour method thus came to me at very opportune time. You
those anxious doubts and that hadhave taken awayfrom me fears
For this I shall ever grateful to you.so long vexed me. feel
Leaving out hysterectomy, abdo7ninal surgery is comparativelyplain
sailing, now that the principle early operation in ovariotomy isof
in whatrecognised. Things are very different this respectfromfully
were twettty or twenty years ago.they five
For long, Ihad hoped f?iuch electricity in the treatmentfrom of
fibroids, but had only met with disappointment tillyour method was
a method, and belongsmade known to me. It is in everyway new it
toyou, and to other. You have worked true spirit.no in the scientific
For yearsyou laboured quietly atyour clinique, kept up at yourfive
known.own expense, and open to all, before you made your work
When it was madepublic, atid ought to have had all a warmfrom
welcome, or at least a patient hearing and honest investigation, con-
sidering the magnitude the work, it %vas received with unbeliefof
and ridicule.
In common with many, I regret the unfair treatment you have
received in this country. In spite, hou'ever, the ignorance andof
prejudice making its way, and itdisplayed, your ivork is tvery day
is impossible to resist the accumulating evidence there now is in its
favour. Thatyou will in a years see your treatment adoptedfew
all over the world Ihave little doubt ; and no one can wish you
success more heartily than I do.
Believe mc, Dear Sir,
Yours truly,
THOMAS KEITH.
Charles Street, London, W.,42
August 1889.—
INTRODUCTION.
tell, in simplest language,In the following pages we the
the story perfect or imperfect, or merely experimental—
with uterine tumour who, up to the endof every patient
electricity.of last year, submitted herself to be treated by
have followed Dr Apostoli's method to the best ofWe
we have always found him an exact andour power, and
truthful guide. It is therefore needless, with the ample
he has given, to go over the details of hisinstructions
willprocess. Those who are acquainted with his work
easily understand our ways. No attempt at classification
cases has been made. We leave every one to drawof the
his own conclusions.
Various circumstances have interfered with earlier publi-
cation. For long we had doubts as to the permanency of
the treatment in the early cases. The later work has been
more satisfactory. But now moremuch that two years
have passed, since all operations were given up for this
treatment ; and our first patient writes—and no one could
have had more haemorrhage—that she has been perfectly
well all summer, climbing hills and rowing in a boat.
Another of the early and doubtful ones, who could never
—bear a large dose of electricity, tells us, " I am now in
excellent health, without an ache or pain of any kind, and
my periods are just a show and nothing more, and give me
no discomfort whatever. I hope you have been as suc-
cessful with all your other patients as you have been with
me. But it cannot be otherwise, for I am sure that no oneVI INTRODUCTION.
could have been worse than I was with that awful haemor-
rhage." This patient's importunity had almost driven me
into doing hysterectomy for her.
The cases are narrated in the order in which they
presented themselves. Every one is given, as well as the
every dose of electricity,amount of even in one of the
dispensary cases, though only a single application was
dispensary patientsmade. In these there was much trouble
and loss of time in finding out their after-history. This
was, however, obtained in nearly every case, though it
necessitated two special journeys to Edinburgh to search
them all out.
About half of the cases that presented themselves were
sent away without any treatment, simply because the
tumours were giving little or no trouble, or they were near
where no treatmentthe menopause, was necessary. At
first we fell into the natural mistake of trying electricity on
presented any symptoms—inevery case that some, when
the tumours were almost certainly sarcomatous, and even
who was in the last stage of old cardiacin one, disease
;
still we give every one of these. We know now that the
treated are those who arecases best suffering much from
haemorrhage—the more the better,—cases in which some-
must be done cases in which, two or three years ago,thing ;
the question of operation of some kind would have been
considered by us.
single case during the last two years wasIn only a
agreedhysterectomy proposed and to. The patient was
sent by Dr Dow of Dunfermline, was 42 years of age,
grown for fifteen years. In spiteand the tumour had of
monthly losses and the size of the tumour—not far off from
in weight—she had the management of a large farm,50 lbs.
be out of doors to look after things,and was able to
summer and winter, by six o'clock in the morning, so
trouble had the huge tumour given her. Till threelittle

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