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THE

BIRMINGHAM

MEDICAL REVIEW:

A MONTHLY JOURNAL

OF

THE MEDICAL SCIENCES.

EDITED BY

DOUGLAS STANLEY, M.D. EDIN., M.R.C.P.,

AND

LEONARD GAMGEE, F.R.C.S.

VOL. IV. NEW SERIES.

VOL. LVI. OLD SERIES.

BIRMINGHAM:

PERCIVAL JONES LIMITED, 87-89, EDMUND STREET.

1904.

BOSTON MEDICAL

AUG 7 1906

LIBRARY

CATALOGUED

AUG 7 1906

E. H. B.

LIBRARY.

A PLEA FOR EXPLORATION IN SUSPECTED DISEASE OF THE OVARY,

MALIGNANT

WITH ILLUSTRATIVE CASES,

Being the Ingleby Lectures for 1904.

Delivered at the University of Birmingham, May 10th and 17th, 1904. By CHARLES J. CULLINGWORTH, M.D., F.R.C.P., Obstetric Physician to St. Thomas's Hospital, London.

LECTURE II.

IN my last lecture I spoke of the difficulty of diagnosing a case of malignant papilloma of the ovary from a case of ordinary infective, or non-malignant, papilloma, and of the desirability of making an exploratory incision in every doubtful case. And when, even after the abdomen has been opened and the parts have been exposed to view and touch, there still remains, as there will occasionally remain, a doubt as to the true nature of the disease, I advocated the completion of the operation wherever it was at all possible. I narrated in, I am afraid, somewhat wearying detail three cases which had come under my own observation, and of which the subsequent history, extending over a long series of years, was more or less fully known to me. In all three, the adoption of the measures I was advocating, though carried out under the most unpromising circumstances, had had the result of considerably prolonging life, and in one instance of apparently effecting a complete and permanent cure. In order that I may not lay myself open to the charge of recording only the more favourable cases, I am about to relate, very briefly, the particulars of a case which, though less successful in regard to the extent to which life was prolonged, nevertheless still appears to me to have justified the decision to operate.

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