Volume 1

Facts and cases in obstetric medicine, with observations on some of the most important diseases incidental to females / By John T. Ingleby.

  • Ingleby, J. T. (John Thomas), 1794-1845.
Date:
1836
Catalogue details

Licence: Public Domain Mark

Credit: Facts and cases in obstetric medicine, with observations on some of the most important diseases incidental to females / By John T. Ingleby. Source: Wellcome Collection.

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    lins thinks the uterine orifice will always allow this to be done, except the laceration arises from violence. The escape of the child within the abdominal cavity is not only highly dangerous, but becomes increasingly so, and surely: we are warranted in incurring a trifling risk to remove a cer- tain and great peril. Dr. Ryan* alludes very pertinently to the fact of the uterus not contracting after the rupture, and from this urges the propriety of passing of the hand with rather more than usual perseverance. The chance of effecting this will of course be lessened when the injury is confined to the body and fundus. In two post-mortem examinations the uterus was found in very different states, the rent being very little contracted in one of the cases, and very greatly so in the other. We must not be de- ferred from dilating the orifice by a trifling resistance, which will frequently yield to perseverance ; and although violence is never allowable, I am persuaded that the dila- tation may be accomplished under somewhat adverse cir- cumstances. ‘The earlier the operation is undertaken the better, a few minutes hesitation may be fatal. The prac-. titioner, however, may not be on the spot, and collapse may have set in ere his assistance is obtained. In sucha case, desirable as a speedy delivery is, unless the head lies within reach of the forceps or perforator, it may be necessary to wait until the patient is somewhat recruited. Unsafe as it is to act during a formidable exhaustion, delay will be inadmissible when signs of reaction appear. By waiting we may perhaps encounter a very formidable resistance, the contraction of the rent being regulated not only by its precise situation and the period which may have intervened from the injury, but also by the state of the vital energies. ‘That a firmly contracted uterus and * Manual, p. 51].