The antiseptic method in relation to drainage of the peritoneum in abdominal surgery / by J. Knowsley Thornton.

  • Thornton, John Knowsley.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The antiseptic method in relation to drainage of the peritoneum in abdominal surgery / by J. Knowsley Thornton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    have mentioned that, when I took out the tube, my colleague Mr. Doran and myself could distinctly see the intestines, injected and reddened, rolling about in the abdominal cavity. I will next record the last case in which I have drained, as a striking contrast. The patient was a single woman of 35, with an enormous multilocular tumour. She came in with well-marked symptoms of mischief in the cyst, which had been tapped some months previously, though only a small quantity ot fluid was then obtained. She was jaundiced, and had a rapid, weak pulse ; morning temperature generally over gg'o, afternoon and evening from ioi‘4 to I02’0. The operation was a difficult one, the cysts (there were three or four much of a size) all contained a mixture of ovarian fluid and a brown clot-like mate- rial (fibrinogen?), with a distinctly unpleasant odour. I had to break up the septa and pump this material out with my hand; much of it necessarily flowed over the wound, and though I was careful in washing it away, and cleaning my hands as often as possible-, I could not feel any confidence that I did not intro- duce causes of putrefaction into the peritoneum. Extensive and very vascular adhesions had to be separated, and both ligatures and cautery were used to control the haemorrhage. The peritoneum also poured out serum freely, and I therefore decided to put in a tube in spite of very careful cleansing of the abdominal cavity. At the evening dressing the temperature was 99^4 ; pulse 116, very feeble ; respiration shallow, 30; there was a little pale serum on the dressings, and 2$ oz. almost pure fluid blood, from sponge and tube. Second dressing next morning, temperature ioo'o, pulse 120, respiration 26 ; no discharge on dressings, only about