The Dublin practice of midwifery / By Henry Maunsell, M. D., with notes and additions by Chandler R. Gilman.

  • Henry Maunsell
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: The Dublin practice of midwifery / By Henry Maunsell, M. D., with notes and additions by Chandler R. Gilman. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    part by muscular fibres, forming a species of sphinc- ter. At about an inch from the orifice (which is its narrowest part), the vessels are collected into a cavernous erectile tissue, denominated the plexus retiformis. The internal surface is lined with mu- cous membrane, which, in the young subject, is ar- ranged into transverse folds or rugae : it has also many orifices of mucous glands. The superior ex- tremity of the vagina passes up nearly an inch above the os uteri, before its mucous membrane is reflected upon the cervix; this reflection takes place higher behind than before, so that the poste- rior lip projects more into the canal than the ante- rior. The anterior wall is connected firmly with the urethra below ; and above, by looser cellular substance, with the back of the bladder; this wall in its undisturbed state measures about three inches. The posterior wall (longer) is united to the rectum below : above, it is covered by peritoneum, which forms a cul de sac separating it from the intestine. [This anatomical fact, that at its upper and poste- rior part the w all of the vagina is in immediate con- tact with the peritoneum, should be kept distinctly before the mind, whenever we attempt to introduce instruments, or perform any operation in the vagina. This upper and posterior part is, so to speak, the weak spot in the canal ; any injury inflicted here will, very probably, be followed by peritonitis, and any laceration at this spot, where it is very likely to happen, is almost certain death to the patient. This spot should therefore always be carefully avoided by the operator.]