On some of the most important diseases of women : with other papers / prefatory essay by R. Ferguson.

  • Robert Gooch
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: On some of the most important diseases of women : with other papers / prefatory essay by R. Ferguson. Source: Wellcome Collection.

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

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    ]38 III. The following case, of which the result was similar, occurred at St. Bartholomew's Hospital in the year 1828. The patient was a poor woman about forty years of age, who had been delivered by the forceps about six months before, on which occasion a tumour was found in the vagina. When I saw her first, she was in the following state: she had a large tumour, which, when she was in the upright postui-e, protruded externally, but could easily be re- turned. It was as large as the head of a new-born infant, and was attached by a stalk, nearly as thick as the wrist, to the usual seat of the cervix uteri, but I could not feel the orifice of the uterus. The tumour was of a pale flesh colour, had a knotty surface, and felt firm. The patient had a profuse coloui-less discharge, but she had no haemorrhages, and had for some time ceased to menstruate. The ligature was applied round what was supposed to be the stalk of the tumour: it occasioned little pain when it was first applied, but towards evening it became so severe as to resemble labour. It was relieved by an opiate, so that she passed a comfortable night; but the next day the pain increased, extending up the loins, and down the limbs. The ligature was tightened every day with a re- currence of pain, which required an opiate : the tumour became livid and the discharge foetid. On the seventh day a violent hfemorrhage came on, which occasioned death-like faintings and cold sweats. The hfemorrhage was arrested by a local astringent, and the fainting relieved by brandy and ammonia, but she continued to have much, pain with vomiting, and at length died on the fifteenth day after the operation. On opening the body, the uterus was found of its natural size and structure; the tumour grew from the orifice of the uterus all around so as to be continuous -ndth the cervix, and so as to cover the aperture of the uterus, and to make it impossible to say where the neck of the uterus ended, and the stalk of the tumour began. The ligature had been applied so liigh as to include the projecting neck of the uterus: the posterior part of it had occa- sioned tdceration into the cavity of the peritoneum, in which there was an aperture of about an inch in extent: the inner structure of the tumour was similar to the fleshy tubercle; there was no inflam- mation of the peritoneum. The danger of including the uterus in the ligature may, I think, always be avoided by the following rules: 1st. Instead of aiming at passing the hgature as high as possible on the stalk, to pass it as