On artificial dilatation of the os and cervix uteri by fluid pressure from above : a reply to Drs. Keiller of Edinburgh, and Arnott and Barnes of London / by Horatio R. Storer, M.D.

  • Storer, Horatio Robinson, 1830-1922.
Date:
1863
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Licence: Public Domain Mark

Credit: On artificial dilatation of the os and cervix uteri by fluid pressure from above : a reply to Drs. Keiller of Edinburgh, and Arnott and Barnes of London / by Horatio R. Storer, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    remained imcffaced, and not from above it; an operation of entirely different nature, based upon an entirely different principle, and no more to be claimed by Arnott than those of Braun and Briinniug- hausen. Having thus stated all the facts in the case, it will be seen that, putting aside the measures of Hiiter and Braun for inducing prema- ture labor by dilatation of the vagina as entirely foreign to the sub- ject, it is to Arnott and Gariel that belongs the credit of first sug- gesting the possibility of dilating the cervix uteri by fluid pressure directly applied to that canal, in these instances from below; that in dilating the uterus by fluid pressure from above, although my in- strument was already prepared for the purpose, Keiller really antici- pated me by a few days in actual pr^etice; that we both immediate- ly made our discovery known to medical friends and thus to the profession, and that our respective publications in print were made on the same day, in Philadelphia and Edinburgh. As regards pri- ority of publication, however, Mr. Murray certainly forestalled us both, his case being the first thus recorded. Personally, I do not hesitate thus far to yield the credit to Dr. Keiller, merely claiming for myself independent conception and suggestion. To Dr. Barnes belongs the merit of forcibly presenting the subject to the profes- sion at a later date, of endeavoring by modification of our instru- ments to perfect one for practice, and of adopting my proposal of water as the dilating medium. So far, as regards our several claims to the original proposal of dilatation of the cervix by pressure from above. I have referred to the value of water as compared with air for the dilating medium. This to my mind is practically as important as the idea of the dila- tation itself, for it is a question that may often directly involve the life of the patient. Cases are already on record of sudden death from admission of air into the cavity of the uterus, especially to- wards the close of pregnancy and during labor. I need only refer to those instanced by John Eeid,* Simpson,! May,:]: Barry,§ Depaul, Gardner, Dalton and others; and whether we are to suppose the fatal result produced by the passage of air into the abdominal cavi- ty through an abnormally patent Fallopian tube, or its forcible in- jection thither by the uterine contractions, or are to accept the more probable alternative, as suggested by the younger Legallois in 1829, by Ollivier in 1833, and more recently byRcid, Simpson, Cormack.|| and McOlintock,! that the air is forced directly into the circulation through the uterine sinuses, and so kills by inducing paralysis of the heart from overdistension, or asphyxia from more gradually increas ♦ Pliysiologicnl Kcscarclics, ]iS48, p. .578. t Obstetric Works, i., p. 719, ii., p. 74; Edinburgh Medical Journal, Sept., 18C1, p. 289. t Britisli Mwikiil .Joiiriiiil, June, 1857. 5 Prov. Mcflicnl nnd SiirKir.'il .Toiimal, Nov., 1850. II London Journal of Medicine, Vol. ii., p. 950. S Mediuil I'ross, March, 1852, p. 147.