Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

  • Bedford Gunning S., 1806-1870.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the diseases of women and children / by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    DOUBLE ENCYSTED OVARIAN DROPSY. its proper position, whilst the protrusion from the vulva consisted m an inversion of the mucous membrane of the vagina.] This, gentlemen, is a case of double encysted ovarian dropsy, the first that has presented itself at this Clinique, although we have had ten examples of simple ova- rian disease during the present session. Here, both ovaries are affected, and you perceive in what way the two tumors meet each other. Thej come in contact at about the mesial line, and as I place the cubital por tion of my hand at the point of junction, you recognize a distinct fissur* marking the line of separation. As I have so repeatedly, during the winter, called your attention to the causes, symptoms, pathology, and treatment of ovarian growths, I shall for the present limit myself to one or two observations respecting the inversion of the mucous mem- brane of the vagina. This is not of common occurrence, but when it takes place it becomes a question of great moment not to confound it with other protrusions, such, for example, as the womb, bladder, a poly- pus, etc. It might too, under certain circumstances, be mistaken for the “ bag of waters ” during labor. A point of interest in the present case is as to the cause of the inversion. What has produced it ? My ex- planation is as follows : This patient in the first place is extremely feeble and relaxed, the mucous membrane of the vagina participating in a large degree in this relaxation ; she has been laboring under habitual constipa- tion ; on making a vaginal examination and carrying my finger upward and backward, I distinctly felt a soft fluctuating tumor resting in the tri- angular space or cul-de-sac, which is bounded anteriorly by the posterior surface of the womb, and posteriorly by the anterior surface of the rectum. The tumor is unquestionably the depending portion of one of the en- larged ovaries; and the soft fluctuating sensation imparted to the finger is the result of the fluid contained within this organ. Three influences, therefore, have contributed to the inversion of the vaginal mucous membrane: 1st. The relaxation of the vagina; 2d. The habitual con- stipation, and consequent straining in attempting defecation; 3d. The pressure from above, increased at every effort at defec-ation, of the de- pending ovary. The case before you is well calculated to excite your sympathy; here is a poor woman in feeble health, affected with a formidable disease, and yet compelled to seek her living by her own labor. Poverty, indeed, is no crime, but it is a trying inconvenience. [Here the patient exclaimed, “ Yes! doctor, dear, it is inconvenient with this load of sickness upon me—^but the Lord has afflicted me because I am a sinner, and 1 am content, and will bear my sufferings with all the strength I can.”] What an example is this poor woman to the discon- tented and dissatisfied of the earth! She is tranquil in mind, and sub- missive under her severe distress. Causes.—These are the predisposing and exciting—the former comdst in frequent labors, long-continued discharges ^om the vagina, drains of any description on the sysft'.ra ; in a word, any influence calculated te
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