OVARIOTOMY. 
PATIENT, 67% YEARS—WEIGHT OF 
TUMOR, 60 POUNDS—EXTEN- ’ 
SIVE ADHESIONS— 
RECOVERY. 
BY 
W. F. McNUTT, M.D., L R.C.P., Ed., Etc., Etc. / 
Professor of Principles' and Practice of Medicine, Med. Dept., Uni- 
versity of California. 
Reprinted from the Western Lancet, January, 1880. OVARIOTOMY. 
Now that ovariotomy is recognized as one of 
the legitimate surgical operations, it is neither 
necessary nor desirable to report every case, any 
more than it would, for instance, be considered 
necessary to report every amputation of the 
thigh There must always be. however, cases 
with special features, the reports of which will 
be both interesting and instructive, and which 
will have a tendency to extend the benefits of 
ovariotomy to those who are at present deemed 
beyond the reach of aid bv this operation. My 
object in reporting the present case is to encour- 
age those who operate for this disease to extend 
the benefits of this operation to many upon 
whom ovariotomy is ppt at present considered 
justifiable. 4 
The special features which invest this case 
with interest are the great age of the patient, 
namely years, the enormous size of the 
tumor, namely GO pounds, the extensive adhe- 
sions of the cyst to the whole abdominal walls, 
iliac fossae and omentum, and the rapid and un- 
interrupted recovery of the patient under such 
circumstances. 
I was called October 2d, by Dr. A. G. Anthony, 
to Oakland, to see Mrs. Y. Dr. Anthony stated 
to me that Mrs. Y. had a very large ovarian tu- 
mor, and that he and Dr. P. Wheeler had 
already tapped it twice, and that it had filled 
rapidly after each tapping, and her strength was 
failing very fast. They had taken thirty pounds 
the first tapping and twenty the second. 
Mrs. Y. gives the following history of herself: 
Is years old; never weighed over 90 pounds; 
wa3 born in Upper Canada; moved to Buffalo 
when a child; was married when 17 years old, 
and moved to Galena, 111 ; has had twelve chil- 
dren and three miscarriages; the last child when 5 
47 years old. She first felt the tumor about 
three years ago (before coming to this coast); 
has been here about one year. She had been 
examined by many physicians in the East, all of 
whom discouraged the idea of an operation on 
account of her advanced age and the probability 
of extensive adhesions. 
I was asked to see the case with a view of 
making some suggestions that might prolong 
her life. I could only concur in the opinion of 
Drs. Anthony and Wheeler that she could not 
expect to live more than a few weeks, and that 
tapping was seemingly not improving her con- 
dition. I stated to her that ovariotomy offered 
the only possible hope for prolonging her life, 
but that in view of her advanced age and the 
condition of the tumor, I could not offer her 
much encouragement; that I would, however, 
undertake the operation if she was willing to 
take such chances. She not only readily con- 
sented to it, but expressed a desire for the oper- 
ation. With the efficient and kindly assistance 6 
of Drs. Anthony, Clinton Cushing and Wheeler, 
of Oakland, and Drs. W. H. Mays and McQues- 
ten, of San Francisco, I removed the tumor on 
October 4th. The adhesions were separated 
entirely by the fingers without the use of instru- 
ments. There was no vessel tied or hemostatic 
forceps used. The stump, which was of fair 
length, was transfixed with a carbolized silk lig- 
ature, tied in two portions, and dropped into the 
cavity. The Lister method was carefully ob- 
served, supervised by Dr. Mays, and the “Weir 
Atomizer” used. The cavity was kept open 
until all oozing ceased,when it was hermetically 
closed by silver sutures. I closed the cavity 
upon the principle that the proper time to estab- 
lish drainage is when drainage becomes neces- 
sary. The carbolized absorbent cotton was 
used instead of sponges. The incision healed 
by first intension. There was no hemorrhage 
or effusion into the cavity, nor was there peri- 
tonitis or tympanites. There was no vomiting 
or unpleasant symptom following the adminis- 7 
tration of the ether. I gave her twenty drops 
of laudanum one hour, and some brandy imme- 
diately before administering the ether. (I have, 
for the past yeai’, made it a practice to give 
opium one hour or two previous to the adminis- 
tration of ether, and find that it greatly lessens 
the shock and nervous prostration following a 
surgical operation. Its beneficial effects seem 
to be due to the fact that it lessens the dread 
and nervous condition which a patient exhibits 
previous to being operated upon.) The patient 
was left in the care of her family physician, Dr. 
A. Gr. Anthony, to whose constant and untiring 
watchfulness she certainly owes her life. With 
the exception of a few doses of opium and qui- 
nine there was no medicine administered. 
Of the cases of ovariotomy recorded to which 
I have had access, 1 find only one at so advanced 
an age, namely by Spencer Wells, age 68, weight 
of tumor 25 pounds.