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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    recover their natural condition subsequently to the lying-in. By reflecting upon this, and by also recollecting that the womb is much larger and heavier after a labour than it is in the nongravid state,*we may comprehend why displacements of the womb are so frequent, and so easy to be brought about, in the first days that follow the child- birth, especially in women who have been delivered whilst standing up, or who have risen too soon after their lying-in. [Prolapsus of the womb is, virtually, shortening of the vagina, and nothing more and nothing less. The womb has no ligaments—properly speaking— save its two broad and its two round ligaments. .It is true that the organ is united to the bladder in front by means of the utero-vesical septum—but be- hind it has no connection to the parts of the pelvis. In fact, the womb rests on the vagina, and sinks and rises with the shortening and lengthening of that tube.—M.] The predisposing causes of prolapsus uteri, are : Congenital capa- ciousness, or brevity of the vagina; a pelvis of excessive dimensions, either actually, or from the want of a proper embonpoint; reiterated pregnancy ; engorgement of the uterus ; scirrhous, fibrous or steato- matous tumours formed upon the womb, or upon the mons veneris, as in the case mentioned by Wagner,1 the abusus coitus, chronic inflam- mation, and the natural or accidental relaxation of the peritoneal expansions, by which the womb is attached to the pelvis, to the rec- tum and to the bladder. Finally, a chronic and profuse leucorrhoea, the lymphatic temperament, living in a low, damp situation, and espe- cially a sudden or habitual state of emaciation; these predispose to prolapsus of the womb. N The exciting causes are not less numerous. Thus, these disor- ders are most common among the inferior classes of the population, whose women are obliged to be more upon their feet, walk more, and use violent exercise shortly after their confinement. Falls upon the feet, upon the seat or on the hypogastrium; pressure on the lower belly by tight dresses or lacing; violent efforts in raising of burthens, or in carrying them for a long time resting against the abdomen, as is the case with the itinerant saleswomen of Paris; jolting in a car- riage ; in a Word, all motions requiring frequent and powerful con- tractions of the diaphragm and abdominal muscles; such as straining at stool or in vomiting, in passing the urine, in coughing, sneezing, singing, dancing, wrestling, leaping, riding on horseback; any of which may be occasional causes of the affection under discussion. Abortion; violent labour pains, particularly in labours where the woman stands on her feet; traction and imprudent manoeuvres in the extraction of the child, or placenta; too early sitting up and walking about after parturition, and before the uterine ligaments have had time to recover their firmness; all these causes, indeed, give rise to the various degrees of prolapsus uteri. 1 Biblioth. Med., t. xiii. p. 114. In Wagner's case, the womb had been depressed by an enormous tumour on the mons veneris, and had yielded to an impulse communicated from above downwards, of sufficient power to cause the uterus to yield, but insufficient to sink the umour along with it into the cavity of the pelvis.