Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West.

  • Charles West
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West. 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.

    6/38 (page 4)
    but a tumour was felt through the superior vaginal wall, encroaching on its cavity, and so firmly fixed as to be quite immoveable. The use of the catheter afforded much relief, and though an attempt at the reposition of the uterus failed, yet the organ two days afterwards returned to its proper position, and the patient went to the full term of her pregnancy without suffering any further inconvenience. l)r. Skae* has recorded an instance of inversion of the uterus, occurring 10 days after abortion at the 4th month of pregnancy. Considerable hemorrhage had occurred on the third day after the miscarriage, in consequence of the patient attempting to move about; but the uterus became inverted during an attack of vomiting, which was attended with a sensation of something falling down within her, and was followed by prostration of strength, bearing down, and flooding. She was seen 12 hours after the accident, when the os tincse was open to the width of two inches, and dilatable, and a tumour passed through it into the vagina. After two efforts, each continued for 15 or 20 minutes, the tumour was returned within the os uteri; but the fundus of the organ was not thoroughly reverted till the following day- The patient had since menstruated naturally, and continued well. [A somewhat similar case is related by Lisfranc, ‘Clin. Chirurg.’ iii. 380; but the inversion of the uterus, which had probably existed for five years, was not discovered until after the patient’s death.] Extra-uterine Pregnancy. Dr. Cogswellf has related a case of supposed ovarian pregnancy, in which the symptoms subsided between the 2d and 3d month, but the woman subsequently conceived and gave birth to two living children. In her second labour, it became necessary to puncture a soft tu- mour, situated between the vagina and rectum, which refilled, and, having been again tapped, continued to discharge a dark fluid, until the patient died ex- hausted, three months after delivery. The sac was found to be formed by the enlarged left ovary, which contained a pint of fluid besides some foetal hair and bones. The case described as ovarian pregnancy by Dr. Harris];, though the account given of it is very imperfect, may yet be decided not to have been an instance of extra-uterine pregnancy, but of ovarian disease, the right ovary being dropsical; hair and a portion of bone having been formed in die j interior of the left. A case of Fallopian pregnancy is related by Mr. Allport,§ which terminated j fatally by hemorrhage, consequent on rupture of the tube in the 5th mouth : of pregnancy; and another is related by Dr. 01dham|| in which the patient died from the same cause at the 3d month. The uterus was in both cases I lined with decidua. Dr. Oldham’s second case appears to have been one of interstitialpregnanoy, j the ovum having been developed in the uterine substance just behind the end of the tube. The tube was impervious, both abbve and below the supposed situation of the ovum, which appeared to have occupied a cell in the uterine substance large enough to contain a horse chesnut. Some doubt, however,is thrown on the real nature of the case, by the circumstance that the ovum, which had probably escaped through the ruptured walls of the cell, could not he found, and that the corpus luteum, though distinctly marked, was found in the ovary opposite to that side of the uterus where the supposed ovum was situated. References are given below to several cases of abdominal pregnancy.% In Northern Journal of Medicine, July, 1845. f Boston Medical Journal, July, 1845. x Southern (American) Journal, July, 1846. § Lancet, Oct. 18, 1845. || Guy’s Hospital Reports, 1845. ^| Grossi, Annales de la Chirurgle, Sept., 1845; Jobert et Dubois, Gaz. des HApitaux, July 5, 1845; Stevens, Amer. Journal of Med. Science, July, 1845; Yardley, Ibid., April, 1846; Whinery, ibid., April, 1846; Craddock, American Medical Examiner, May, 1846; Mason, ibid., Jan., 1846; Carganico, Med. Zeitung, Aug. 13, 1845; Cerise, Gaz. des H6pit., Jan. 12, 1846; McCulloch, British American Journal, Oct., 1845; Gotz, Oesterr. Med. Jahrbiich, April, 1846.