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
Catalogue details

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.

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    tremity, and then thrust a trocar down to the director and directly through the spot usually occupied by the natural orifice of the intestine. Withdrawing both instruments, I next, with a probe-pointed bistoury, enlarged the opening made by the trocar, and, as soon as this was accomplished, the child passed an immense quantity of faecal matter, apparently with much relief. A sponge- tent was then introduced into the rectum, and the nurse instructed as to its objects and use. Being on the eve of sailing for Europe, I did not see the child again, but suggested the continued use of the sponge-tent, until the opening made had lost all disposition to contraction ; and, after this, if the orifice in the vagina did not heal of its own accord, in consequence of the natural channel for the fseces being established, that it should be touched occasionally with the argent, nitrat. I did not deem this a case in which the operation of Amussat was advisa- ble, nor was it one that indicated excision of the tissues occupying the posi- tion of the anal orifice, nor could any operation upon the fistulous opening between the rectum and vagina be with propriety proposed. I preferred the trocar to a sharp-pointed bistoury, for performing the operation, for the simple reason that wounds made with the former instrument are much less prone to heal by the first intention than when the latter is employed ; and as it was one object of course to prevent the close of the gut again, an event by no means uncommon, when a simple conical incision is made with a bistoury, I adopted the plan of operating described. I have not seen the child since my return, but understand from Dr. Jewell that there is some contraction of the orifice, and that, in all probability, it will be necessary again to divide its margins.—M.] ABSENCE OF THE WOMB AND MEANS BY WHICH IT CAN BE ASCERTAINED. The womb may be absent coincidently with absence of the vagina, as in the instances reported by Engel,1 Morgagni,2 Baudelocque,3 Dupuytren,4 Boyer,5 and Caillot.6 The absence of the uterus may also consist with a perfectly natural appearance of the external genitalia: Colombus,7 Lieutaud,8 and other authors have noticed such cases of uterine anomaly. For the purpose of ascertaining that the uterus is absent, or that it exists only in a rudimental state, several authors, and among others 1 De Utero Deficiente apud Schlegel, t. i. p. 239. 2Lettre46,n. 11 and 12. 3 Art. des Accouch. 3d edit. t. i. chap 3, p. 168. 4 Repertoire d'Anat. Pathol, t. v. p. 99. 5 Traits des Malad. Chirurg., t. x. p. 423. 6 Mem. de la Soc Med. d'EmuIation, t. ii. p. 470. 7 De re Anatomica. lib. xv. p. 495. 8 Histoire Anat. Med., t. ii. p. 343.