On surgical diseases of women / by I. Baker Brown.

  • Isaac Baker Brown
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On surgical diseases of women / by I. Baker Brown. Source: Wellcome Collection.

    160/468 (page 112)
    recovering the normal tonicity and status of the parts, be unsuccessful; or should the diseased condition have been pre- viously neglected until no longer amenable to medical treat- ment, then we may seek a cure by surgical means. The measure I propose resembles in principle the one I have adopted for prolapse of the anterior and posterior walls of the vagina; viz., mechanically curing the displacement by con- tracting the relaxed, loose mucous canal. With this object I suggest the removal of a portion of mucous membrane pos- teriorly and laterally, and the introduction of sutures after the same plan as in the other operations. The denudation should be most freely carried out poste- riorly (Plate 8), and tapered up on each side towards the fourchetfce; the whole bared surface having a crescentic or horse-shoe shape, adapted to admit of free dilatation in any subsequent labour. The general plan of treatment laid down applies as well to the incomplete as to the complete form of prolapsus uteri; but the operative proceeding is seldom called for in the former, unless it has been long neglected and the vagina much stretched. On this and other points connected with the treatment pro- posed for the radical cure of prolapse of the womb, the excel- lent article by Dr. Savage in the Lancet (vol. I., 1858, p. 164) may be advantageously referred to. But at the time he wrote it, that gentleman had somewhat mistaken my opinion and mode of practice, and, in reviewing the several sorts of incision employed by different surgeons, he inadvertently described mine as narrower than was the case, and to illus- trate this adduced a diagram of mine, given, not to show the operation for prolapsus uteri, but that for cystocele. It is incumbent upon me to notice the error Dr. West has fallen into, respecting the principle and nature of the opera- tion I adopt for the cure of prolapsus uteri. In his Lectures on the Diseases of Women, 1856, p. 187, that physician inti- mates that I adopted Dr. Fricke's operation in a modified form, according to which the prime object was to contract the vulva. This is wrong; for the operations I first carried out