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Updated: May 27, 2025
I concluded that further delay to a free opening was useless; consequently with the patient lying on his right side, and near the edge of the bed, I made an opening one inch long in the lower portion of the abscess, for I now considered it one, near the spot where the needle of the aspirator and the trocar had been previously introduced.
This being ineffectual, recourse may be had to tapping, taking care that the trocar is not plunged sufficiently deep to wound the intestines. The place for the operation is directly on the 'linea alba', or middle line of the belly, and about midway between the pubis and the navel. The whole of the intestinal fluid may be suffered to escape.
It is not advisable to pasture cattle on rank growths of clover that are wet with dew or a light rain. Bloating can be quickly relieved by puncturing the wall of the paunch with the trocar and cannula. The operation is quite simple and is not followed by bad results. The trocar is then withdrawn from the cannula.
I then introduced a trocar and canula, and drew off fifty ounces of pus, slightly tinged with blood. I re-adjusted the compresses and bandage over the sinus, hoping that a part of it at least would become obliterated before it became necessary to open it more freely. Feb. 15th, 5 P. M., pulse 112, temp. 102.5.
A very practical and fairly successful method of treatment consists in the aspiration of a quantity of synovia and injecting tincture of iodin. Cadiot recommends the drainage of synovia with a suitable trocar and cannula and injecting a mixture consisting of tincture of iodin, one part, to two parts of sterile water, to which is added a small quantity of potassium iodid.
Calomel, aloes, and digitalis are recommended when the effusion period approaches in order to increase the elimination of fluid, and lessen its entrance into the body cavity. If the amount of effusion is large, puncture of the thoracic cavity with a trocar and cannula may be practised. This operation should be performed carefully, and all possible precautions used against infection of the wound.
Attempts had been made six and two years before to tap this woman, but only a few drops of blood followed several thrusts of a large trocar. A diagnosis was made of multilocular ovarian cyst or edematous myoma of the uterus, and on the morning of December 7, 1890, an operation was performed.
If gas forms, the trocar and cannula should be used. A drench of from one to two pounds of Epsom or Glauber's salts should be given. Sheep may be given from four to six ounces of Epsom or Glauber's salts. We should endeavor to stimulate the movement of the paunch by pressure on the flank with the hand, throwing cold water on the wall of the abdomen and by hypodermic injections of strychnine.
The adhesions were separated and the cyst tapped with a large trocar, and then the septa between the cysts were broken down with the fingers. The pedicle was rather small and was tied in the usual way, and the tumor was removed. Its seat of origin was the left ovary. The right ovary and the uterus were healthy, but poorly developed.
The applications of the trocar became more frequent: the summer, if summer it could be called, was "mouldering away;" and winter, with all its danger to an invalid, was drawing on apace. Nothing seemed hopeful but removal to a warmer climate. Aix in Provence was at first thought of, but the idea was abandoned on account of the difficulties of the journey.
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