The Philadelphia practice of midwifery / By Charles D. Meigs.

  • Charles Delucena Meigs
Date:
1838
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Licence: Public Domain Mark

Credit: The Philadelphia practice of midwifery / By Charles D. Meigs. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    I am ready to admit that it might happen that a tonic contraction of an inverted uterus should come on at once, and last so long as to prevent the employment of the plan that I suggest; but 1 think it probable that it would always be practicable to return it, in any case where it had not been inverted more than four or five hours, by waiting for the moment of its greatest relaxation, and then first indenting the fundus, and afterwards pushing it steadily upwards through the os uteri, and so into the abdomen again. I have recently seen a lady whose womb was inverted about two years ago, at her confinement. I am informed that she then had a very profuse hemorrhage, and was thought to be in extreme danger. She gradually got better, however, but remained subject to frequent attacks of hemorrhage, by which her strength became greatly reduced. At length a physician whom she called in made an examination, and found the womb inverted. In this case the womb hangs into the vagina, and is, I think, turned completely inside out; it is not much larger than the healthy non-gravid womb—does not appear to be very sensible on pressure, but bleeds very easily. By careful regulation of the diet, strict attention to her bowels, and the use of astringent injections, under the care of her physician, Dr Mcehring, the hemorrhagic tendencies have of late been happily counteracted and she is acquiring a more decided state of health. She goes freely now about the house, and even about the city. This I regard as a very consolatory case, as it furnishes ground to hope for the escape of our patients with life, even where the inversion is incurable. It has been stated that when the womb is only half inverted, the woman is liable to greater pain and danger than where it is turned completely inside out, in conse- quence of the strangulation of the part that is griped by the OS uteri. It is thought by some persons good prac- tice in such cases to make the inversion com])lete. I am unable to speak of this point from any experimental knowledge that I possess, yet I feel ready to admit that the probabilities of recovery would be greater with a complete than with an incomplete inversion.