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Updated: June 25, 2025
The cord of the fourth child was so short that it had to be ligated in the vagina. The children were all females and of about the same size, making a total weight of 8 pounds. The mother rallied quickly and got on well. Trustworthy records of sextuplets are, of course, extremely scarce. There are few catalogued at Washington, and but two authentic cases are on record in the United States.
On questioning her, it was found that she had formerly masturbated; later she had sexual intercourse several times with a young man, but after his death she commenced self-abuse again, which brought on the present enlargement. The clitoris was ligated and came away without leaving disfigurement.
Buhring relates the history of a case somewhat analogous to viability of anencephalous monsters. It was a bicephalous child that lived thirty-two hours after he had ligated one of its heads. A stroke of the knife bad severed the larynx and removed the whole mass of the cerebrum, leaving the inner aspect and base of the skull exposed.
Tricomi reports eight cases in which he had extirpated the spleen for various morbid conditions, with a fortunate issue in all but one. In one case he ligated the splenic artery. In The Lancet there is an account of three recent excisions of the spleen for injury at St. Thomas Hospital in London, and it is added that they are among the first of this kind in Great Britain.
The old Amsterdam authority, Tulpius, has recorded a case in which a piece of lung of about three fingers' breadth protruded through a large wound of the lung under the left nipple. This wound received no medical attention for forty-eight hours, when the protruding portion of lung was thought to be dead, and was ligated and cut off; it weighed about three ounces.
"'Alas for the too temporary support of my stimulant! It failed me at the last moment. My sight was not clear nor my hand steady as I tied the small arteries which had been cut during the operation. One of these, ligated imperfectly, commenced bleeding soon after I left the house.
Albucasis describes an operation for enlarged clitoris, Chabert ligated one, and Riedlin gives an instance of an enlarged clitoris, in which there appeared a tumor synchronous with the menstrual epoch.
In the Philosophical Transactions there is a report of a man who was wounded in the spleen by a large hunting-knife. Fergusson found the spleen hanging from the wound and ligated it. It separated in ten days and the patient recovered. Williams reports a stab-wound of the spleen in a negro of twenty-one.
Attention must be directed towards the condition with which the phlebitis is associated. Ligation of the vein on the cardiac side of the thrombus with a view to preventing embolism is seldom feasible in the peripheral veins, although, as will be pointed out later, the jugular vein is ligated with this object in cases of phlebitis of the transverse sinus.
Adhesions were found almost everywhere the most difficult to manage being those of the liver and diaphragm. The broad ligaments and Fallopian tubes were ligated on either side, the tumor turned out, the thick, heavy pedicle transfixed and ligated, and the enormous growth cut away. After operation the woman was immediately placed on platform scales, and it was found that she had lost 93 1/2 pounds.
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