A text book of treatment : (alphabetically arranged) / by Willaim Calwell, John Campbell, Robert Campbell ; edited by R.J. Ferguson.
- Calwell, William.
- Date:
- 1908
Licence: Public Domain Mark
Credit: A text book of treatment : (alphabetically arranged) / by Willaim Calwell, John Campbell, Robert Campbell ; edited by R.J. Ferguson. Source: Wellcome Collection.
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![DECIDUOMA MALIGNUM 4] also be performed with the fingers and a pair of stout blunt-pointed scissors. The patient is to be anesthetised, placed across the bed in the lithotomy position, washed, douched, and catheterised. The left hand is to be introduced into the vagina, and the fore and middle fingers of it put round the neck from behind. The blunt hook is now to be passed along the hand and turned so that the hook lies over the neck (Fig. 21). By a series of twisting and traction movements the spinal column is broken and the soft structures torn through. The arms are now to be drawn down and the trunk delivered by traction on them. The head is to be extracted last. This may be done by introducing the hand into the uterus and getting two fingers into the mouth. By the aid of an assistant pressing on the fundus, it may be thus delivered. If any difficulty in extraction be experienced, the hand should be retained in the uterus, and, under its guidance, the scalp is to be caught with a strong vulsellum. The hand is now to be withdrawn, and the head pulled down into the cervix while an assistant ' makes pressure upon it from above. While it is being thus held, the head is to be perforated, the brain washed out, and the head extracted with the craniotomy forceps. (See CRANIOTOMY.) If a decapitating hook be not available, the fingers are to be put round the neck as before, and the scissors passed along them. The neck is then to be cut through by successive snips of the scissors, the mother’s tissues being protected from injury by the fingers. It may be necessary to crush the head after perforation and evacuation, if the pelvis be very narrow. DECIDUOMA MALIGNUM (Chorion-epithelioma).—Synonym : Syncytioma malignum.—The onset of Chorion-epithelioma is closely connected with changes occurring in association with pregnancy. It may affect the uterus or, in the case of tubal pregnancy, the Fallopian tube. It is especially prone to follow the expulsion or removal of an hydatid mole, and then arises in portions of the chorionic villi which remain embedded in the endometrium. The growth invades and destroys the uterine tissue in the same way as a malignant growth does. Fragments of the growth readily gain entrance to veins and get carried in the bloodstream to distant parts of the body, where they form secondary deposits. Profuse uterine hemorrhages, rigors, rise of temperature, and great emaciation are the most prominent symptoms. The disease runs a rapid and fatal course. Operation affords a fair chance of recovery, and is to be undertaken even when the disease is advanced. The recently observed connection between the presence of lutein cysts in the ovaries and hydatid mole raises the question as to](https://iiif.wellcomecollection.org/image/b3273329x_0055.jp2/full/800%2C/0/default.jpg)
