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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    a permanent procidentia, it would be a duty to renounce all such attempts, and remain content with a treatment merely palliative. A medical man ought not, however, lightly to ienounce all hopes of reducing a hysteroptosis, no matter how severe nor of what old standing. Saviard succeeded in reducing Margaret Malaure's, which was congenital. Several other surgeons, as mentioned by Sabatier,1 and among them Mauriceau, Saviard, Horn and Leblanc, were suc- cessful in the reduction of frightful cases of prolapsus, the size of which had been first reduced by means of prolonged rest, dieting, baths, bleeding, emollients, &c. Dr. Leveille and Dr. Bobe—Moreau, {Bull, de la Fuculle de Med., 1815, No. 4,)—rendered prolapsus of long standing reducible by means of pressure with a bandage en doloire. However, let us remember the counsel already given, not to insist upon attempts to reposit when too man}' obstacles are met with. Im- provident and ill-advised manoeuvres have brought on fatal disease, such as acute peritonitis and metritis. (Nouvell. Bibliot. Med., deuxieme annee, torn. iv. p. 215.) After having tried the preliminary treatment above recommended, if reiterated attempts, vainly made, should render it evidently impos- sible to restore the womb to its place, we must rest content with giving due support to the tumour by means of a proper suspensory, which should be anointed with cerate, in order to obviate the evil effects of the friction of the material. [I can with difficulty imagine any case of prolapsus uteri that the surgeon could not reduce. I saw in 1845, a very distinguished London surgeon, of one of the chief London hospitals, baffled in every attempt to reposit a proci- dent uterus, which was immensely augmented in size. He tried long and with great force to return the organ, and at length being completely foiled, he said to Mr. Wm. Lawrence, that he could not succeed, inviting that great surgeon to attempt the cure. Mr. Lawrence in about a minute reposited the womb, and having done so said, I never saw the case I could not re- duce.—M.] As a means of more perfectly obviating this inconvenience, we have recommended and have made use of a bandage of oiled silk, doubled, the surface of which, being smooth, produces less friction than even the finest linen. The material is desirable, since it may be cleansed several times a day, while its impermeability protects the womb from the painful excoriations which the constant contact of the urine tends to produce. Should the procidentia take place at an advanced stage of preg- nancy, the reduction of the womb ought, nevertheless, to be attempted, and may be easily effected, particularly if the attempt be not long deferred. We have already advised that the bladder and rectum should be emptied before the institution of any attempts to reposit, and it ought not to be forgotten that the introduction of the catheter 1 Sabatier, in the Mem. de l'Acad. de Chir., t iii. p. 375, says that there is no case of procidentia of the womb that cannot be reposited, no matter how large it may be; but this talented practitioner admits that it is not always possible to keep it in place after reposition.