Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

    22/50 (page 20)
    nate case of menorrhagia. [His recommendation of the remedy appears, how¬ ever, to be founded on the results obtained in a single case.] Discharges vicarious of menstruation, Sfc. M. Fourget* relates the history of a patient aged 17, who having menstruated regularly for a year, had on one oc¬ casion hemorrhage from the skin of the face, the conjunctiva, and the mucous membrane of the mouth, vicarious of the natural function. This anomaly, however, occurred but once, the menses reappearing on the next occasion by the natural channel. Professor v. d’Outrepontf met with a woman who having for some years menstruated regularly injured her arm while menstruating. Ever since that occurrence, discharge of blood has taken place from this wound synchronously with the natural menstrual flux, and ceasing as that did when the patient became pregnant. MM. von Muynck and KluyskensJ detail the history of a woman whose menses having become scanty and attended with in¬ disposition at each period, at length ceased at the age 52, but were imme¬ diately succeeded by a discharge of blood from the left nipple, which con¬ tinued to return with regularity every month, until the patient’s death at the age of 57|. M, le Conte§ relates a singular case in which a negress, aged 70, who had not menstruated for 20 years, began to do so after being struck by lightning, and had continued to menstruate regularly at the time of his re¬ port, twelve months afterwards. DISEASES OF THE UTERUS. Means of investigating them. Various modifications of the speculum have been proposed by Dr. Warden, Mr. Smith, Dr. Dixou, and Mr. Moss.|| Dr. Warden has suggestedthe application of the reflective prism to specula for ex¬ amining the ear, vagina, or other closed passages of the body. His very in¬ genious contrivance cannot be understood without minute description. He suggests moreover^ a change in the ordinary cylindrical speculum which he conceives would secure most of the advantages to be obtained by the more complex instrument. This modification consists in the removal of an oblique slice from the end of the speculum, which would allow of a lateral view of the vaginal walls, and prevent that puckering of the mucous membrane, when it is introduced or withdrawn, by which a distinct view is often so much impeded. Mr. Smith’s speculum is almost the same as Dubois’ modification of Recamier’s speculum, who had an aperture made in the cylinder for the purpose of de¬ tecting small vesico-vaginal fistulse. Dr. Dixon’s and Mr. Moss’ specula so closely resemble each other, that in reality they are the same instrument. They consist of wire rods inserted at one end into a ring, and terminating at the other in probe-pointed extremities ; and furnished with a plug of polished wood, grooved so as to receive the wires Dr. Dixon’s speculum is furnished with a contrivance for expanding it, which does not appear to exist in that invented by Mr. Moss. [These instruments may be serviceable in some opera¬ tions on the vagina, but as specula their value must be very small.] Dr. Simpson** suggests the employment of sponge tents to dilate the os uteri in order to allow of the introduction of the finger to ascertain the state of the cavity in cases of uterine disease; [but it may be doubted whether the uterus would often tolerate their presence, and likewise whether under ordi¬ nary circumstances such a dilatation of the os uteri as he speaks of, would be likely to result from their employment.] Displacement of the uterus. Prolapsus uteri. Dr. Chaumetft describes a modification of DiefFenbach’s operation for the cure of prolapsus, which he * Gaz. des Hopitaux, Sept. 24, 1344. f Neue Zeitschr. f. Geburtsk. Bd. xvi, Heft i. j Oest. Med. Wochenschr. Dec. 14, 1844. § New York Journal of Med. Nov. 1844. || Medical Gazette, May 24, 1844; Ibid. July 5, 1844 ; Boston Med. and Surg. Journal, March 1844; Dublin Medical Press, April 16, 1845. Lond. and Edinb. Monthly Journ. Dec. 1844. ** Ibid. Aug. 1844. +-|- Bull, de l’Acad, Roy. de Med. Mars 15, 1845, p. 442.