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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    and thus allows the womb to approach the os tinea? ? There can be no pro- lapsus with a vagina of due length, nor cure of a prolapsis but in the restora- tion of that due longitude.—M.] In the operation of Touching, the neck of the womb is soon felt, and the os tincce is found to be resting upon the posterior Avail of the vagina, which is thus completely obturated, and two-thirds of its upper portion are inverted like a finger of a glove turned partly in- side out. In its new situation, the womb, as it follows the direction of the axis of the inferior strait, acquires a position totally different from that which it ordinarily assumes. The unnatural tumour that projects from the entrance of the vagina may be easily raised upwards by the finger, but falls down again as soon as the support is withdrawn, unless the womb has contracted adhesions with the vaginal parietes. The nature of the tumour is readily distinguished by the presence of the os tincse and the neck of the uterus, whose circumference is surrounded by a sort of cushion composed of the vaginal walls. By placing one hand on the hypogastrium and touching with the index of the other, we are enabled, except when the person is very fat, which is not common in these cases, to perceive the void left in the upper part of the pelvis, by the descent of the womb ; and in the same way we may discrimi- nate between prolapsion of the womb, and the elongation of the cervix, which is sometimes very considerable. Most of the symptoms of prolapsus in the second stage are pro- duced by the pressure of the womb upon the surrounding parts, espe- cially the bladder and rectum, or by the stretching of the uterine ligaments. This is put beyond question by the fact that all the symptoms are diminished by rest, and particularly by rest in the hori- zontal posture, whereas their violence is redoubled by standing and walking. Where the displacement has been gradually produced, the symptoms attending it are less severe than where it takes place sud- denly ; where it is suddenly produced, it is frequently accompanied with long, protracted faintings, violent fioodings, severe pain in the pelvis, vomiting, and sometimes even an intense attack of peritonitis. But, on the contrary, where the displacement takes place slowly, these phenomena are rarely observed, because the organs, having slowly abandoned their natural situation, become, in a measure ac- customed to the unnatural situation they have assumed. [Seeing that the womb is attached to the rectum solely by the recto-vaginal septum, and to the bladder by the vesico and urethro-vaginal septum, it is manifest that these two septa furnish the sole means of its vertical support; while it is true that those parts themselves depend upon other attachments for their own firmness and ability to sustain the womb. I should think that no one would attribute to the ligamenta lata any other mechanical function in the case than that of acting as a stay, on the right and the left sides, to the womb —a stay by means of which it is kept in place while the woman lies on the right side or on the left side. The ligamenta rotunda, which, coming off from