Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D.
- Lawson Tait
- Date:
- 1888
Licence: Public Domain Mark
Credit: Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![definition either for extra- or intra-peritoneal effusion—and tubal pregnancy, and the confusion becomes positively amazing ; for it will be seen as wc proceed tliat for hitra-peritoneal luematocele l>y far the most connnon cause is the tubal pregnancy for wliich Dr. lunmet desires to find a differential diagnosis. This is Avliat he says upon treatment: Surgical interference has been advocated by many in its practice, and been urged as the necessary procedure at an early stage. Unquestionably cases must occur when the surgeon would be wanting in sense of duty if he did not assume the responsibility and puncture the mass. But with a large majority of cases such interference would be criminal, as it needlessly places the life of the patient in jeopardy. Here, again, what Dr. Emmet says is absoultely true about extra-peritoneal ha.'matocele, and it is absolutely untrue about intra-peritoneal effusion. I only desire to say tliat I have taken up Dr. Emmet as an example of this confusion in English writings, not because he is worse tlian otliers, but merely because his work ha23pened to be the first text l)Ook on gynaecology which cauglit my eye as I started to write this lecture. If we accept the anatomical and physical facts before alluded to as a basis, we shall find that it is not a difficult matter to reconcile a very large nundjer of discordant facts and many discrepancies in the views of various authorities ; in fact, the whole story of hematocele may be reduced from confusion into order. We shall find also that the two varieties of hicmatocele are different in their relative frequency, in their causation, in their history, and of course particularly in their relative fatality, different in their symptoms and the signs by which they may be diagnosed, and, finally, in their demand for surgical interference. Dr. Beruutz has expressed an opinion to which I have already alluded that the bloody tumour which is left as the remains of a hfcmorrhage has no right to be regarded as a specific disease apart from what has caused it. This is true, I hold, of intra-peritoneal h.Tmatocele, but not of the extra-peritoneal variety. When h.Tmorrhage into the broad ligament occurs the arrest of the luiemorrhage has already been brought about, in the vast majority of cases, by Nature's own methods, prol)ably even before the accident has been diagnosed, and therefore all we have to do with is the thrombus, and in the great bulk of cases that may be and generally is let alone. But cases do arise, as I shall tell you by- and-bye, when it becomes a serious disease, for if the sac of the broad ligament bursts into the peritoneal cavity the haemostatic pressure is relieved and bleeding goes on, the two forms of the lesion co-exist and tlie patient bleeds to death. That such an ending may occur and lias actually occurred is known by a case I shall quote as a result of this secondary rupture of the broad ligament pregnancy cyst, the primary rupture having taken ])lace](https://iiif.wellcomecollection.org/image/b21448048_0033.jp2/full/800%2C/0/default.jpg)
