OVA RIAN CYSTS.
The electrolytic treatment of ovarian cysts has been described and practically tested in particular by Fieber, Von Ehrenstein. Ultzmann, Semeleder, and Muncie, and to the latter we are indebted for an elaborate analysis' of the recorded cases and for the deductions which have rele gated the practice to its proper sphere in surgical gynecology. Semeleder has proved himself one of the most enthusiastic of the advotates of the method, and, were it not that there is a safer method of treatment for these cysts, the cases which he has recorded would justify its general ac ceptance. In his papers' to which we have had access he has reported twenty-seven cases, seventeen of which were completely cured. Similar results, however, have never been obtained by other operators, at least they have not published, for Von Ehrenstein has never substantiated his claim, that of several hundred ovarian cysts subjected to electrolysis nearly fifty were cured. In Mund6's monograph fifty-one cases are col lected and analyzed with the following results: Cures, twenty-five; per manent improvement, three; teniporary improvement, four; negative re sult, six; peritonitis with recovery, four; deaths, nine. While no one will question the possibility of curing ovarian cysts by snbjecting them to electrolysis, the question to-day is as to whether the method has advan tages over ovariotomy when considered in the light of possible dangers and of mortality. When MundCs analysis was made he was able to draw the following comparison between the two methods: " Notwithstanding these undoubted cures the percentage of success of oophoro-electrolysis (55 per cent.) compares unfavorably with that of ovariotomy (70 to 80
per cent.); Spencer Wells 78 per cent.—in 1876 as high as 91 per cent.; and so also do the deaths by electrolysis (17.6 per cent.) nearly equal those following ovariotomy in recent years (20 to 30 per cent, to 22 per cent.), and far exceeding those occurring in the last series of fifty-five cases of Spencer Wells." In the nine years which have elapsed since these comparative statistics were given the mortality rate from ovariotomy when performed with the requisite precautions has sunk so low that it has become an operation which per se carries with it scarcely any risk at all, except in the highly unfavorable cases in which a priori no better result could be predicated from electrolysis. While resort to the method, therefore, cannot by any means be considered unjustifiable, it is none the less true that but few operators of today would sanction it in preference to ovariotomy.
The technique of electrolysis as applied to ovarian cysts does not differ from that usual in other instances where it is resorted to. Semeleder favors steel needles and punctures with the positive pole, applying the negative at some distant part of the cyst. In the instances which he treated the Aumber of seances requisite was from six to one hundred and three, and the treatment extended over from one to nine months. Those who care to test the method, therefore, must supply themselves before hand with a plentiful stock of patience.