Dilatation of the cervix uteri for the arrest of hemorrhage / by G.H. Lyman.

  • Lyman, George H. (George Hinckley), 1819-1891.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Dilatation of the cervix uteri for the arrest of hemorrhage / by G.H. Lyman. 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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    These facts would all seem to indicate that the hemor- rhage was in some manner influenced by constriction of the inner os causing congestion and strangulation of the mucous membrane and all morbid growth above that point, even admitting that these growths, whether hypertrophic or hyperplastic, are not in themselves influenced in their de- velopment by this constriction. I am aware that the objection to this theory will be raised, that in many cases there is no apparent constriction at the inner os, the canal being found soft and patulous, the sound entering with perfect facility, and the resulting arrest of the hemorrhage being attributable to compres- sion of the membrane and possibly destruction of some of its vascular papillae. The answer to this is, that a thick- ened apparently edematous membrane may occupy the parts, permitting the easy entrance between its folds of a small metal sound, and yet be surrounded by irritable cir- cular fibres so constricted as to interfere with the circula- tion under the influence of morbid innervation. This view is strengthened by the fact that mere compression of the thickened congested membrane by the tent could cause no permanent relief, inasmuch as the removal of the pressure must be followed by a rapid refilling of the vascular tissues, unless we admit that the vessels are actually and perma- nently obliterated, which is quite incredible. It seems much more probable that the root of the evil is to be found in the underlying tissues of the organ itself, and that the morbid innervation and consequent constriction are effectually modified by the distention of the tent. Some- what analogous results are seen in the dilatation of spas- modic strictures of the esophagus, the urethra, and the rectum. In conclusion, the causes of metrorrhagia are said to be subinvolution, fibroid tumors, mucous polypi, chronic en- dometritis, simple hypertrophy or a true hyperplastic en- largement of the mucous membrane, etc., etc., and no doubt some of these are found to be present in many of the severe
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