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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    could not feel any part of the uterus above the brim. On internal examination, I found the cavity of the pelvis occupied by a large tumour, resembling the head of a child, which had descended within nearly an inch of the vaginal orifice. ‘The cervix uteri had very nearly disap- peared, and the os internum was soft and slightly open. Although the ballottement of the uterus was quite imprac- ticable, I felt certain of the fact of pregnancy, and testified accordingly, but my opinion as to the vitality of the ovum was very guarded. Four days after this visit, a slight hemorrhage ensued, which was followed by pains, and the expulsion of a still-born and decomposed six months’ child. Again, the gravid uterus, instead of rising out of the pelvis at the fourth month, may lie completely without the os externum. In one instance of this kind, I succeeded both in returning the uterus within the pelvis, and retain- ing it there by means of a very large globular pessary, until the natural elevation had taken place. Soon after conception takes place, the os uteri acquires a degree of softness and fullness which it did not pre- viously possess. The flatness and roundness of the uterine lips and their final disappearance leaving a mere circular depression, together with the descent of the inferior segment of the uterus, (the orifice being directed back- wards opposite the second sacra] vertebra, whilst the fundus inclines forward,) are strongly characteristic of pregnancy. ‘The shortening of the vagina both in the early and the latter weeks, and its elongation in the middle period are also presumptive of the same state. In primi- pare the uterine orifice is closed almost from the time of conception to the period of labour; but, as Dr. Rigby has observed, such is its irregularity and knotty state in women who have had many children, that “it is gene-