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.

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    ring-pessary to which is attached a curved stern surmounted by an oblong cushion or pessary. A hinge at the origin of the stem allows its inclination to be varied, while a screw at its other extremity, renders it possible to vary its length, and consequently to regulate the pressure in an upward direction which the instrument exercises.] Inversion of the uterus. Mr. Crosse’s essay already referred to, contains a most interesting collection of facts illustrating the somewhat obscure subject of chronic inversion of the uterus, after parturition, or occurring in the un¬ impregnated state in consequence of the presence of uterine polypus, or of the influence of other similar causes. Dr. Oldham* describes and delineates a pre¬ paration of partial inversion of the uterus produced by a polypus which grew from the right side of the fundus uteri, and several most instructive diagrams and plates illustrative of this occurrence are given in Mr. Crosse’s essay. Dr. Oldham’s remark is doubtless correct, when he says that the inversion is the result of the action of the womb in its efforts to expel the polypus rather than of the mere weight of the body. Dr. Meigsj- makes mention of two cases in which he believes that an inverted uterus became spontaneously restored to its natural condition. In one case the uterus was ascertained to be inverted five weeks after delivery, in the other this state had persisted for more than two years after the birth of the patient’s child, notwithstanding which, both the women subsequently became pregnant. [It is easier, however, to conceive that even an experienced man should commit an error of diagnosis, than to under¬ stand how any efforts of nature could cure a chronic inversion of the womb.] Mr. Crosse, Dr. Esselman, M. Velpeau, and Dr. M‘Clintock relate cases in which the inverted uterus was removed, and all the patients recovered with the exception of the woman operated on by M. Velpeau, who died of perito¬ nitis, which supervened almost immediately after the operation. The person whose history is recorded by Dr. M'Clintock, is the fifth on whom Dr. Johnson of Dublin, has successfully operated. Two of his cases are related in vol. iii of the Dublin Hospital Reports ; the outline of two others is given in Dr. M4Clintock’s paper, besides the particulars of the one already referred to, and the history of another woman whose health was too bad to allow of the operation being performed, and who died nine months after the occurrence of the accident, worn out by hemorrhage and mucous discharge from the uterus. M. Tessiert adduces cases in proof of the existence of dropsy and tympany of the unimpregnated uterus, in reply to the assertions of MM. Stolz and Naegele, that such diseases are impossible. Their denial of the possibility of such occurrences in the unimpregnated state was founded on the fact of the lining of the membrane of the uterus being mucous, not serous, on its tissue being incapable of any distension, such as the occurrence of these diseases must imply, on the absence of any cause adequate to close the cervix, and on the non-existence of any authentic observations of physometra, or hydrometra. Besides detailing observations by various writers in support of his opinion, M. Tessier relates the particulars of an indubitable and very interesting case of tympanites uteri that came under his own notice. Inflammation and ulceration of the os and cervix uteri. In a series of papers, which have since been republished in a separate form. Dr. H. Bennet§ gives the results of a series of observations on this subject, made at the Hopital St. Louis, and other hospitals of Paris. He treats, first, of the affection as it oc¬ curs in women who have never borne children ; then in those who have been * Guy’s Hospital Reports, new series, vol. ii, pp. 105-36. t Op. cit. p. 183. + Gaz. Med. Jan. 5, 1844. j In the Lancet during the spring of 1845, and under the title of A Practical Treatise on Inflamma¬ tion, Ulceration, &c. of the Neck of the Uterus.