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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![tlierefore it is that some of my operations for ectopic gestation at the full time liave been abdominal sections, and some have not been. Therefore it is also that the opening in this case should be made not central but well to one side. This curious lifting of the peritoneum may of course be interrupted by a secondary rupture of the sac into the peritoneum, and we may find—probably sliall—that many of the minor varia- tions which are quite well established, such as invasions of the intestines by the placenta, are due to the same cause. AVe may also find, what I have already indicated as a probability, that direct primary rupture into the peritoneum of a tubal pregnancy of the twelftli week, may end neither in the death of the mother nor in that of the child, but that it may go on developing in the peritoneum. I regard this as very unlikely, and as yet wholly unproven. The lifting of the peritoneum also explains the intimate association which the fcotal sac always has with the posterior wall of the uterus. What was, on my part, originally a pure speculation concerning tlie methods of origin of the relations of the ]ieritoneum and their details, has been elevated into a series of indisputable facts by the fortunate experience by Dr. Berry Hart, of Edinburgh, of two 1)odies which contained ectopic pregnancies. The bodies were frozen and sections made, and these have been so carefully and elaboraely described by Dr. Hart and Mr. Carter that I cannot do l^etter than reproduce their original observations. I must acknowledge at the same time my indebtedness to these gentlemen, and to the proprietors of the Edinhurgh Medical Journal for permission to reproduce an admirable illustration Avhich will assist my readers greatly in understanding the description of the parts. The first specimen had advanced to between the fourth and fifth month. Dr. Hart saw the patient for the first time in the Buchanan Ward of the Eoyal Infirmary, and found her with a tumour the size of a cocoanut in the site of the right broad ligament, and reaching from the right iliac margin to the region of the recto-vaginal space, which bulged down markedly. The uterus was displaced to the left side of a two months' pregnancy. From the history of five months' amenorrhoea, and the occasional attacks of fainting and pain during that time, there was no difficulty in coming to the conclusion that we had here to deal with an extra-uterine gestation developing between the layers of the broad ligament. Two days after, the patient collapsed markedly, evidently from rupture of the sac and loss of blood. Eight hours afterwards, when she had somewhat rallied, an exploratory abdom- inal incision was made to see if anything could be done. Blood poured out whenever the peritoneum was opened, and on passino- the fingers in, rupture deep down through the posterior lamina of](https://iiif.wellcomecollection.org/image/b21448048_0090.jp2/full/800%2C/0/default.jpg)
