A theoretical and practical treatise on midwifery, including the diseases of pregnancy and parturition / by P. Cazeaux ; rev. and annotated by S. Tarnier.

  • Cazeux, Pierre, 1808-1862.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: A theoretical and practical treatise on midwifery, including the diseases of pregnancy and parturition / by P. Cazeaux ; rev. and annotated by S. Tarnier. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    They consist of a cutaneous and a mucous layer, between which is a fibrous partition, a continuation of the superficial fascia of the perineum. Between this aponeurosis and the internal surface of the integument, is found a very thick layer of cellulo-adipose tissue, filling up a peculiar pouch hitherto unknown to anatomists until discovered by M. Broca. [This pouch is constituted by a membranous sac situated between the skin and the superficial aponeurosis: its bottom is directed towards the fourchette, where it becomes blended with the fascia superficialis of the parts on each side of the anus. It has a long and narrow neck, which is directed toward the external inguinal 4'ing, and receives into its opening a portion of the fibres of the round ligament. Its cavity is filled with cellulo-adipose tissue, varying in quantity with the embonpoint of the individual. The pouch forms of itself the greater part of the thickness of the labia majora. The fibres of which the pouch is composed are derived chiefly from the fascia superficialis of the thigh and abdomen, but some proceed directly from the spine of the pubis; the most external are attached to the rami of the pubes and ischia, whilst the most internal unite and become blended with the suspensory ligament of the clitoris. According to M. Broca, this sac is the analogue of the dartos of the male ; M. Sappey, however, believes that it is comparable only to the suspensory ligament of the scrotum and penis. The microscope proves it to be composed of interlaced fibres of elastic tissue. The arteries of the labia majora are derived from the perineal artery, itself a branch of the internal pudic or of the external pudic or epigastric. The veins for the most part accompany the arteries, some, however, pass back- ward and form a plexus, which communicates with the bulb and vaginal veins. These veins, which are very numerous, often become dilated during pregnancy. The nerves proceed from the genito-crural branch of the lumbar plexus, and from the perineal branch of the internal pudic nerve. The lymphatics all pass into the inguinal glands.] 2. The nymphce, or labia interna, are broug'ht into view, by separating the external lips, under the form of twTo mucous folds, resembling the comb of a young cock. Contracted behind, where they are continuous, with the internal face of the labia externa, they spread out in front as they con- verge towards each other. These lips scarcely descend to the middle of the external ones, but they mount up in front as high as the clitoris, where they bifurcate; the inferior branch of this bifurcation is lost in the clitoris; but the other surmounts it, joins its fellow of the opposite side, and forms above this body a little fold in the shape of a hood, called the prepuce of the clitoris. At birth, the nymphse project beyond the external lips, but at puberty they are concealed by the latter. Again, they become visible in child-bearing women; rather, however, by the separation of the labia majora than by their own prominence. Further, their dimensions are very variable in different individuals, and in various climates ; thus, in certain countries of Africa, they,are very long, and constitute the famous apron of the Hottentots. Besides, as Velpeau has remarked, these parts are so extensible that, under the influence of continual tractions, they may become very much elongated. I have met wi'.h a young female, in my own practice, who was afflicted with an ex-