89



left her bed, and sat by tlie fireside. She strongly objected to
having the operation performed, nor could I, in her present emaciated
and enfeebled state, press it upon her ; though I had no doubt that,
if she bore the operation, she would derive much temporary relief.
The amelioration of her symptoms was but of very short duration.
The diarrhoea returned, and with it increased irritability of stomach.
She suffered considerable pain, particularly in the right side, where
tenderness was experienced. Such palliative means as appeared
admissible were assiduously administered ; but she sunk on the night
of the 7th of January.
Sectio cadaveris. — The integuments were reduced to their utmost
tenuity, and were in many parts so closely adherent to the sac of
the tumour, that the thickened peritoneum seemed to split into two
layers, in the attempt to remove them. ^Then the tumour came
into view, it appeared to occupy the whole space of the abdomeu,
forcing the ribs up, so as to give the chest a bell-Kke form. (Eig. 3a.)
The adhesion of the cyst was chiefly confined to its anterior part ;
and a slight evidence of recent peritonitis was found in the right
lumbar space. When the tumour was removed, it was found to be
appended to one ovary alone, which was considered the right; though
from the twisted position of the uterus, I was not quite convinced
that it was. The other ovary was small and dwindled. The tumour




Kg. 32 represents the ovarian tumour when tlie integuments had been
removed.
90



ON ABDOMINAL TUMOURS.
did not adhere to any of the viscera, except partially to tlie omen-
tum; which came into sight on opening the integuments, spread
over a small extent of the apper part of the tumour.
