A case of complete inversion of the uterus : with remarks upon the modern treatment of chronic inversion / Clifton E. Wing.
- Wing, Clifton E. (Clifton Ellis)
- Date:
- [1879?]
Licence: Public Domain Mark
Credit: A case of complete inversion of the uterus : with remarks upon the modern treatment of chronic inversion / Clifton E. Wing. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![first place, it has probably been pretty generally supposed that the inverted organ would not tolerate pressure upon its mucous mem- brane for any length of time. This idea experience has proved to be fallacious, although \vc may of course expect that certain cases may be the exceptions which prove the rule. Secondly—where con- tinued pressure has been attempted, stupidly enough, in most cases an elastic bag introduced into the vagina, and then distended with water or air, has been employed. The bag being in contact with the vaginal walls over a much larger surface than it is in contact with the inverted uterus, in accordance with well known laws much more of its power has been expended in dilating the vagina and stretching the surrounding tissues than in elevating the uterine body. This very distention of the vagina, if the bag be forcibly distended, of itself often causes more pain than the patient can bear, as is well known by many who have employed such bags as vaginal tampons in cases of uterine haemorrhage. Where success has followed the use of the vaginal bag, in these cases, either the vagina and surround- ing tissues have been remarkably tolerant of distending force, or, as has undoubtedly been the usual case, the uterus has been replaced by remarkably little continued pressure exerted upon it. It is evi- dent that a full and fair trial of continued pressure cannot be made in this way. Although the inefficiency of the elastic vaginal bag has been repeatedly pointed out and written about, it is still resorted to in such cases; and where it has been found on trial that the patient could not bear its continued use, or that it did not replace the uterus, the operators—often those who might be expected to know better— have generally concluded that the uterus was too sensitive for continued pressure treatment, or that pressure faithfully tried had proved a failure. Often, too, the pelvic pains and tenderness, caused simply by the distension, have been mistaken for the symptoms of pelvic peritonitis. [There is a noticeable want of clearness on the part of certain writers as to what constitutes elastic pressure in these cases. Some of the text books, in treating of the methods of reduction, use the term elastic pressure in a somewhat peculiar and, it would seem, in an improperly restricted sense. For example : Dr. T. G. Thomas, in his work on The Diseases of Women, distinguishes the method of reposition by pressure by vaginal stem and cup or bulb from those by elastic pressure combined with taxis and elastic pressure alone. Certainly the first method (by vaginal stem etc.), as prac- tised by Barnes, Tait, Aveling and others, and employed in this case, stretched elastic bands furnishing the power, is a most practical way of employing elastic pressure; whereas the elastic vaginal bag, which the author apparently means when he says elastic pressure/' is, as already stated, a decidedly inefficient agent. Dr. Barnes, also often uses the expression elastic pressure, when he means the vaginal bag. It is a loose use of terms likely to confuse the reader.] It is rather strange that in one of the latest works upon Gynaecology —the excellent book of Dr. Emmett, published in 1879—the author,](https://iiif.wellcomecollection.org/image/b21164861_0006.jp2/full/800%2C/0/default.jpg)
