A case of complete inversion of the uterus, nearly of twelve years' duration, successfully treated / by W. Tyler Smith.

  • Smith, W. Tyler (William Tyler), 1815-1873.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: A case of complete inversion of the uterus, nearly of twelve years' duration, successfully treated / by W. Tyler Smith. Source: Wellcome Collection.

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    when we desire a polypus to pass, by the use of sponge- tents, and other, means. In the same way, from a priori reasoning, and from what I observed in the preceding case, I believe that the necessary development may be gradually im¬ parted to the os and cervix, in cases of inversion, so as cer¬ tainly to admit the return of the organ. In the case under consideration, nothing could have been more rigid and un¬ promising than the os and cervix uteri; hut in obedience to the force and stimulus exerted, chiefly by the air-pessary, the fundus and body of the uterus was converted into a wedge or tent, which by constant pressure dilated and developed the narrow ring which had so long fixed the uterus in its inverted position. At the same time, the pressure diminished the size of the body and fundus, and in this way promoted the re-inversion, and the arrest of the haemorrhage. I should entertain little doubt of the possi¬ bility of replacing the uterus in any case of inversion, by similar means, and so far from the uterus being considered one of the most difficult and obstinate, it ought to he held as one of the most manageable organs of the body, in any matter relating to growth or form. The plan of treatment by air or fluid pressure must at least deserve a trial in all future cases, when we consider that the alternatives are, death from loss of blood, or the extirpation of the uterus, with its attendant risks. Besides the employment of the air-pessary in the vagina, to effect reinversion of the uterus in the case described, I have used it with good effect for the arrest of haemorrhage, in cases of menorrhagia resisting ordinary remedies, and to keep the uterus replaced in cases of retroversion. I have no doubt the same means would prove serviceable, in cases of flooding from fibrous tumour of the uterus ; or from polypus, when the state of the os uteri does not admit of operation. It offers a better kind of tampon than any hitherto used, in cases of flooding during abortion, and in placenta praevia, before the dilatation of the os uteri. I have also used the air-pessary before the time of labour, in a case of high deformity of the pelvis from mollities ossium, with con-