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Morand speaks of an ovarian cyst from which, in ten months, 427 pounds of fluid were withdrawn. There are old records of tubal cysts weighing over 100 pounds. Normand speaks of an ovary degenerating into a scirrhous mass weighing 55 pounds. Among recent operations Briddon describes the removal of an ovarian cyst which weighed 152 pounds, death resulting.
She was supposed to have dropsy of the abdomen, and among other treatments was the use of a speculum and caustic applications for inflammation of the womb. The escape of watery fluid for two days was considered evidence of the rupture of an ovarian cyst. At the end of two days, severe pains set in, and a warm hip-bath and an opiate were ordered.
The tumor was three feet high, covered the breasts, extended to the knees, and weighed 146 pounds. Kelly speaks of a cyst weighing 116 pounds; Keith one of 89 1/2 pounds; Gregory, 80 pounds; Boerstler, 65 pounds; Bixby, 70 pounds; and Alston a tumor of 70 pounds removed in the second operation of ovariotomy. Dayot reports the removal of an enormous ovarian cyst from a girl of seventeen.
"Then this tumor, if it should really prove to be one, may be of a malignant character." "That is possible. But I trust to find only a simple cyst, or, at the worst, an adipose or fibrous tumor easy of removal, though I am sorry it is in the neck. I never like to cut in among the large blood-vessels and tendons of that region." At twelve o'clock Doctor Hillhouse made the promised visit.
Delicate hairs may also be found projecting from the epithelial lining of the cyst. Faulty coalescence of the cutaneous covering of the back occurs most frequently over the lower sacral vertebræ, giving rise to small congenital recesses, known as post-anal dimples and coccygeal sinuses. These recesses are lined with skin, which is furnished with hairs, sebaceous and sweat glands.
Wells mentions an ovarian cyst in a woman of sixty-five, from which 72 pints of fluid were removed. Hawkins describes the case of a musician, M. Rochard, who at the age of one hundred and seven was successfully operated on for strangulated hernia of upward of thirty hours' duration. The wound healed by first intention, and the man was well in two weeks.
Moreover, under certain conditions, it becomes quiescent, incloses itself in a delicate case or cyst, and then divides into two, four, or more portions, which are eventually set free and swim about as active Colpodoe. But this creature is an unmistakable animal, and full-sized Colpodoe may be fed as easily as one feeds chickens.
When inflamed, it may be impossible to dissect out the cyst, and the wall should be destroyed with carbolic acid, the resulting wound being treated by the open method. #Moles.# The term mole is applied to a pigmented, and usually hairy, patch of skin, present at or appearing shortly after birth. The colour varies from brown to black, according to the amount of melanin pigment present.
In consistence they are firm and elastic, or fluctuating, and are incorporated with the overlying skin, but movable on the deeper structures. The orifice of the partly blocked sebaceous follicle is sometimes visible, and the contents of the cyst can be squeezed through the opening. The wall of the cyst is composed of a connective-tissue capsule lined by stratified squamous epithelium.
#Diagnosis.# A cold abscess is to be diagnosed from a syphilitic gumma, a cyst, and from lipoma and other soft tumours. The differential diagnosis of these affections will be considered later; it is often made easier by recognising the presence of a lesion that is likely to cause a cold abscess, such as tuberculous disease of the spine or of the sacro-iliac joint.
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