Identifier: transactionsofso7189sout (find matches)
Title: Transactions of the Southern Surgical and Gynecological Association
Year: 1894 (1890s)
Authors: Southern Surgical and Gynecological Association (U.S.)
Subjects: Surgery Gynecology Surgery Genital Diseases, Female
Publisher: (S.l.) : The Association
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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a perfectly clear fluid, a mucoid secretion, character-izing this form of biliary obstruction. After emptying thismy finger detected a large stone firmly impacted deep in thecystic duct. I experienced considerable difficulty in remov-ing it. It is well known that the walls of the gall-bladderand its ducts are thin and friable, and hence the utmost deli-cacy of manipulation must be observed when the duct isstretched by an impacted stone. It is very easy to push itthrough the thin tissue of the duct. Various forceps havebeen invented for the removal of stones under these circum-stances, some with padded blades for crushing the stone fromthe outside of the duct. With two fingers introduced withinthe abdomen and the index finger of the other hand withinthe gall-bladder, I succeeded in dislodging this large stonewithout injury to the duct, and removed it. (See illus-tration.) The further steps of the operation consisted in sew-ing the incised gall-bladder to the parietal peritoneum of the
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L. S. MCMURTRY. 319 incision, introducing a rubber tube into the gall-gladder andclosing the incision (except at the central point, where thetube was placed) in the usual manner. In this way the gall-bladder is drained through the abdominal wall. Before theoperation was concluded bile began pouring out throughthe gall-bladder. The patients convalescence was uninter-rupted, being entirely afebrile and requiring no opiumor other anodyne. The tube remained in the gall-bladderuntil the discharge ceased, and the bile followed the normalchannel. The opening closed altogether during the fifthweek. The patient was entirely and immediately relieved ofpain, and is now quite restored to vigorous health. Case. III. Suppurative Salpingitis and Peritonitis.—L. J.,aged twenty-five, referred by Dr. P. F.-Barbour, had suf-fered for several months from pelvic inflammation. The his-tory and symptoms leave no doubt as to the infection beingdue to gonorrhoea. For seven weeks prior to admission tothe inf

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