Identifier: tumoursinnocentm1911blan (find matches)
Title: Tumours, innocent and malignant; their clinical characters and appropriate treatment
Year: 1911 (1910s)
Authors: Bland-Sutton, John, Sir, 1855-1936
Subjects: Neoplasms
Publisher: New York : Funk
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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theparts contain much blood. In the case of ovarian tumourswith twisted pedicles, not in communication with the outerair directly or indirectly, micro-organisms rarely gain accessto them. It is therefore erroneous to describe as gangrene thechanges observed in cysts with torsioned pedicles. This isfurther illustrated by the circumstance that small ovariantumours may be completely twisted from their pedicles andsubsequently shrink. Were the changes in the cyst gan-grenous in character, general infection of the peritoneum anddeath would be the inevitable consequences. Burden Sanderson, in his article on the Pathology ofInflammation, refers to the peculiar plan of emasculatinganimals known as bistournage. In this method no instrumentis used; the testicle is freed from its association with thedartos, then twisted on the spermatic cord as on an axis, four AXIAL ROTATION 533 or five times, the whole manipulation being performed withprodigious rapidity. If the animal is killed afterwards and
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Fig. 279.—Ovarian dermoid containing hair and grease which had twisted its pedicle many times. * The stiimp of the Fallopian tube. the arteries are injected, it is found that no blood enters thespermatic artery beyond the twisted part of the cord. Con-sequently, while the surrounding parts receive their natural 534 TUMOURS OF THE OVABY supply of blood from the piidic artery and preserve theirvitality, the testicle itself is irretrievably condemned to death..We have in the above method practically a crucial experiment,which demonstrates that when a testicle is deprived of bloodin consequence of axial rotation it necroses and finallyatrophies. A perusal of the records of cases described as gangrenouscysts indicates that the reporters have regarded the deep lividhue of such cysts as evidence of gangrene, and that othershave confounded suppurating with gangrenous cysts. Rotation of an ovarian cyst, when it gives rise to suchsevere changes as have just been considered, may be describedas

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