Bennett mentions an instance in a woman of seventy-five, and Davies records a similar instance. Borsini and Terrier cite instances of successful ovariotomy in patients of seventy-seven.
Carmichael performed the operation at seventy-four. Owens mentions it at eighty; and Homans at eighty-two years and four months. Dewees records a successful case of ovariotomy in a woman over sixty-seven; McNutt reports a successful instance in a patient of sixty-seven years and six months; the tumor weighed 60pounds, and there were extensive adhesions. Maury removed a monocystic ovarian tumor from a woman of seventy-four, his patient recovering. Pippingskold mentions an ovariotomy at eighty. Terrier describes double ovariotomy for fibromata in a woman of seventy-seven. Aron speaks of an operation for pilous dermoid of the ovary in a woman of seventy-five. Shepherd reports a case of recurrent proliferous cyst in a woman of sixty-three, on whom successful ovariotomy was performed twice within nine months. 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. Fowler operated successfully for strangulated umbilical hernia on a patient of sixty-eight.
Repeated Operations.--Franzolini speaks of a woman of fifty on whom he performed six celiotomies between June, 1879, and April, 1887. The first operation was for fibrocystic disease of the uterus. Since the last operation the woman had had remarkably good health, and there was every indication that well-merited recovery had been effected. The Ephemerides contains an account of a case in which cystotomy was repeated four times, and there is another record of this operation having been done five times on a man. Instances of repeated Cesarean section are mentioned on page 130.
Before leaving this subject, we mention a marvelous operation performed by Billroth on a married woman of twenty-nine, after her sixth pregnancy. This noted operator performed, synchronously, double ovariotomy and resections of portions of the bladder and ileum, for a large medullary carcinomatous growth of the ovary, with surrounding involvement. Menstruation returned three months after the operation, and in fifteen months the patient was in good health in every way, with no apparent danger of recurrence of the disease.
Self-performed Surgical Operations.--There have been instances in which surgeons and even laymen have performed considerable operations upon themselves. On the battlefield men have amputated one of their own limbs that had been shattered. In such cases there would be little pain, and premeditation would not be brought into play in the same degree as in the case of M. Clever de Maldigny, a surgeon in the Royal Guards of France, who successfully performed a lithotomy on himself before a mirror. He says that after the operation was completed the urine flowed in abundance; he dressed the wound with lint dipped in an emollient solution, and, being perfectly relieved from pain, fell into a sound sleep. On the following day, M. Maldigny says, he was as tranquil and cheerful as if he had never been a sufferer. A Dutch blacksmith and a German cooper each performed lithotomy on themselves for the intense pain caused by a stone in the bladder.
Tulpius, Walther, and the Ephemerides each report an instance of self-performed cystotomy.
The following case is probably the only instance in which the patient, suffering from vesical calculus, tried to crush and break the stone himself. J. B., a retired draper, born in 1828, while a youth of seventeen, sustained a fracture of the leg, rupture of the urethra, and laceration of the perineum, by a fall down a well, landing astride an iron bar. A permanent perineal fistula was established, but the patient was averse to any operative remedial measure. In the year 1852 he became aware of the presence of a calculus, but not until 1872 did he ask for medical assistance. He explained that he had introduced a chisel through his perineal fistula to the stone, and attempted to comminute it himself and thus remove it, and by so doing had removed about an ounce of the calculus. The physician started home for his forceps, but during the interval, while walking about in great pain, the man was relieved by the stone bursting through the perineum, falling to the floor, and breaking in two.
Including the ounce already chiselled off, the stone weighed 141/2 ounces, and was 10 5/8 inches in its long circumference. B.
recovered and lived to December, 1883, still believing that he had another piece of stone in his bladder.
In Holden's "Landmarks" we are told that the operation of dividing the Achilles tendon was first performed by an unfortunate upon himself, by means of a razor. According to Patterson, the late Mr. Symes told of a patient in North Scotland who, for incipient hip-disease, had the cautery applied at the Edinburgh Infirmary with resultant great relief. After returning home to the country he experienced considerable pain, and despite his vigorous efforts he was unable to induce any of the men to use the cautery upon him; they termed it "barbarous treatment."In desperation and fully believing in the efficacy of this treatment as the best means of permanently alleviating his pain, the crippled Scotchman heated a poker and applied the cautery himself.
