A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs.
- Marc Colombat de L'Isère
- Date:
- 1850
Licence: Public Domain Mark
Credit: A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
118/764 (page 112)
![muscle by its contraction on the index was found to be perfect. A stout pledget of lint with a tape fastened to its base, and spread with cerate, was introduced into the vagina, and directions were given to the midwife to change it twice a day. The operation was not very painful, the patient made no outcries, and she did not lose more than half an ounce of blood. Fifteen days afterwards the midwife informed M. Stoltz that the lady had discovered a slight discharge of a few drops of blood from the vagina, which was at first attributed to an imperfect menstruation; but as it did not return, it was thought that it might have proceeded from a congress, with some laceration. Two years and a half had elapsed when M. Stoltz received the last accounts of the state of his patient. She was in the same condition, had never menstruated, felt from time to time, and at nearly equal intervals, the symptoms of the catamenial action, and had no difficulty in the cohabitation. Inasmuch as the symptoms of a case of obturation might be con- founded with those of imperforation or obliteration, and of absence of the vagina, we shall now call to mind some striking traits that may suffice to remove all uncertainty on this point. Where the imperforation is incomplete, menstruation may take place; if it be complete, the finger, if introduced within the vulva, encounters a membrane forming a fluctuating tumour, with an oval projection more or less prominent in front, and in such a case, a simple incision dispels every doubt and dissipates every symptom. Where the occlu- sion is owing to incomplete obliteration, the discbarge of the menses takes place, and a style may be passed into the contracted vagina: if the obliteration is complete, and affects the whole canal to a greater or less extent of its longitude, the diagnosis of the case, which is always accidental, may be made out by examining by the rectum, and with a sound introduced into the bladder. The obstacle that results from obliteration, instead of being as in obturation a compact thick cylindrical body filling up the vagina, consists in a thin membranous septum, or in cohesion of the sides of the canal,—a cohesion that may affect the whole length or only certain points of it. Moreover, in the case of obturation, if the finger be introduced into the vulva, it will be arrested by a very resisting body, whereas in imperforation and obliteration, the obstacle is always movable, membranous and fluc- tuating. [The last clause of the above paragraph is well worthy of the reader's atten- tion, for it is truth itself on this point, and should be always borne in mind during the diagnostic exploration of such cases.—M.] Nearly all the authors who have spoken of occlusion of the vagina have furnished us scanty details on the subject; and have confounded the accidental agglutination of the parietes, with obturation of the canal produced by the intermediate body, whose principal characters we have now pointed out. This is probably the reason why they desig- nate these new kinds of occlusion by the same term obliteration, and that they denounce the operation as impracticable and very dangerous](https://iiif.wellcomecollection.org/image/b21029313_0118.jp2/full/800%2C/0/default.jpg)
