The mechanical system of uterine pathology : being the Harveian lectures delivered before the Harveian Society of London, December 1877 / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: The mechanical system of uterine pathology : being the Harveian lectures delivered before the Harveian Society of London, December 1877 / by Graily Hewitt. Source: Wellcome Collection.

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    found the condition and the symptoms associated so very constantly that no room exists in my mind for doubt'on the subject. Here we meet, as r have aheady remarked, with opposing statements as to the value and frequency of the association. Thus one statement is to the effect that it is common enough to meet with cases of flexion in which there is no com- plaint and no inconvenience felt whatever. I can only say that such cases do not, at all events, present themselves in my practice. There are various ways of accounting for this discrepancy as to a matter of fact. The first remark to be made in connection with this subject is, that cases vary very much in severity, and too much has been expected in regard to uniformity of symptoms when the conditions were not uniform. There is great difference, for instance, between the degree of flexion in the two cases of retroflexion represented in Figs. 16 and 17. As regards this particular symptom, pain on locomotion, it is one which I have hardly ever found absent when the uterus is actually distorted. This symptom is plainly of importance, but it is not one which has usually been thought much of, and may have been present even to a marked degree in some of the cases, when flexion is said to have occasioned no complaint or incon- venience.' Another circumstance, before mentioned, is that, when the flexion is slight, and there is more version than flexion, the pain and inconvenience may be shght in degree. Further, it must be borne in mind that the flexed uterus is not always in the same condition. Sometimes it is much con- gested; at other times not particularly full of blood. Dr. Braxton Hicks has lately' published observations on retroflexion of the uterus, and, in accounting for the differences of opinion on the treatment of this affection, he points out the differences observable at different times in regard to the state of the uterus, as accounting for these diverse opinions. These re- marks of Dr Hicks meet, for the most part, with my concurrence. The con- gestion or engorgement is, no doubt, a condition which adds very much to the discomfort which a flexion produces, and in a case where it happened not 1 J]rit.ish Medical Journal, 1877.