COCILLANA—THE BARK OF AN UNDETERMINED SPECIES OF GUAREA.NATURAL ORDER—MELIACEÆ; HABITAT, BOLIVIA. Read in the Section on Materia Medica and Pharmacy, at the Forty-fourth Annual Meeting of the American Medical Association

F. G. RYAN
1894 Journal of the American Medical Association (JAMA)  
ovaries were bound down in massive exudates from which the Doctor literally dug them out. Every element in the tube and ovary was diseased ; perisalpinx, musculature and endosalpinx all had widespread pathologic conditions. Con¬ siderable pus was found in the pelvis. The abdominal cavity was thoroughly irrigated and the wound closed with silk¬ worm gut. Drainage was used. Recovery was good. Eight months after the operation she is nursing and is practically well. The reasons which justified and
more » ... hich justified and demanded laparotomy in this case were exactly what Dr. Waite and myself had repeatedly observed during our four months' treatment of the patient viz : periodic exacerbations of pelvic peritonitis, pain, gonorrhea, pelvic exudates, rise of temperature, con¬ stant suffering and incapacity for labor and the downward course of the patient. Case 27.-Removal of the tubes and ovaries for a general myoma of the uterus. The patient had had a tumor the size of a cocoanut for three years with severe hemorrhage for one year. She had three children. She recovered from the operation and has had one hemorrhage since, so far as re¬ ported, in six months. Ten months after the operation I saw her. She appears perfectly well, and says she is now healthy and hemorrhage has almost entirely stopped. Dr. Waite ligated the upper end of the uterine artery, which accounts for the almost complete arrest of bleeding. Case 28.-Laparotomy for chronic salpingitis and ovaritis. Age 36. She was ill seven years and a neurotic wreck. The
doi:10.1001/jama.1894.02420820006001a fatcat:k2kxnmpahjdf7ksdwai4rh5a2y