Cesarean section : necessitated and justified by hypertrophic elongation of the cervix : removal of a living female child of seven pounds weight : a paper presented to the Council by a candidate elected to fellowship of the American Gynaecological Society at the Thirteenth Annual Meeting in 1888 / by Jno. S. Coleman.

Coleman, John S.

Date:: 1888

Credit: Cesarean section : necessitated and justified by hypertrophic elongation of the cervix : removal of a living female child of seven pounds weight : a paper presented to the Council by a candidate elected to fellowship of the American Gynaecological Society at the Thirteenth Annual Meeting in 1888 / by Jno. S. Coleman. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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On p. 112, Mr. T., in discussing the diagnosis of extra- uterine pregnancy, says: “ The most important point is that the cervix is always quite open, in my cases almost admitting the finger. TJhder such circumstances, if a fetal heart is audible, the case is clear ” (italics mine). I am greatly indebted to Dr. Eugene Foster, not only for valuable assistance in the investigation of the literature of this subject, but for his kindly obtaining for me the loan from the Surgeon-General’s office, U. S. Army, of the Edinburgh Ob- stetrical Society’s Trans, for 1882 and 1883. In this volume is contained Prof. A. R. Simpson’s paper, “ Basilysis for Dystocia from Hypertrophic Elongation of the Cervix Uteri.” This patient was seen by Prof. Simpson two hours after her admis- sion into the hospital and some twelve hours after the com- mencement of labor. Page 34, par. 2 ; “ On inspection, a tumor was noticed projecting two inches from the vulva, with a transverse division in the centre; its consistence was very hard, and it was of a red color, except in some places where it was ulcerated and covered by a gray pellicle, showing that the erosion had existed for some time, and from these there was a discharge of sanguineous, purulent matter. The vulva was dis- tended by the tumor, the parts around being white and in- durated. The os just admitted two fingers, and at a full finger's length from the os the vertex of the child was felt presenting with the membranes unruptured/ the occiput was directed to the right and a little posterior to the right extremity of the trans- verse diameter (italics mine). The bones of the head felt lax.” The cervix was pushed back into the vagina and the anterior lip supported during the pains. Its tissue became somewhat softer, and the os dilated to about two inches in diameter and the lips would be about half an inch thick. During this time, the upper portion of the cervix and lower part of the uterus were becoming thinned out and in danger of rupture. On Prof. Simpson again returning, the membranes were ruptured and meconium stained liquour escaped, after which the parts were thoroughly douched with carbolized water. It being very clear that the child was dead, he determined to basilyze it so as to facilitate the delivery. The patient was anesthetized and placed in the lithotomy position, in the presence of Dr. Guido Jochner, Jr., of Munich, Dr. Anderson, of University College, London, and several of the maternity students. The house

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