The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Franics H. Ramsbotham.
- Francis Henry Ramsbotham
- Date:
- 1865
Licence: Public Domain Mark
Credit: The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Franics H. Ramsbotham. 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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![selves to us, and the same plan of treatment has been successful; in two of them there was not the raspberry-like condition of the cervix uteri, but the neck was lengthened, hypertrophied, and the follicles congested. In one of the other cases there was positive ulceration of the neck of the uterus, in- volving both lips, and extending up the inner portion of the cervix; the application of the nitrate of silver failed in this case, and it only yielded to the actual cautery. It is essential to the proper treatment of these cases to recollect, that this tendency to abortion does not depend solely upon a positive ulceration of the cervix uteri, but that an inflammation of its tissues, or the products of it, and in some cases a mere exaltation of a previous condition of the follicles of the mucous membrane, may suffice to provoke this tendency, by presenting a focus of irritation which is reflected upon its muscular tissue, exciting the contraction of its fibres, and finally resulting in destroying the retentive facul- ties of its sphincter. It also frequently happens that in these cases of disease of the cervix uteri, ■where abortion supervenes as the result of such an affection, that this very accident increases the original irritation by the amount of pain which tbe female has to undergo, previous to the delivery of the detached ovum through a narrow tube like the cervix uteri. A higher grade of inflammation is de- veloped ; Me may then have as a constant product of this inflammatory con- dition of the follicles an effusion of viscid lymph, plugging up the cervix to such a degree as to obstruct the access of any spermatozoa to the uterine cavity. Assuming the ingenious view of Mr. R. S. Pittard to be correct, that the office of the vesiculne seminales is to secrete and keep in store a mucus of such a nature as is congenial to spermatozoa, and recollecting that the secretion of the cervix is viscid, transparent, and alkaline, we find in it a fluid analogous to that of the vesiculae; and knowing, moreover, as has been pointed out by Mr. Tyler Smith, that the glandular structure of the cervix uteri has for its function to secrete every month a sufficient quantity of viscid mucus to fill the canal of the cervix, and that therefore this secre- tion is in the most fluid condition just after the completion of the menstrual flow—the time when impregnation is most likely to take place: it seems a natural inference that this mucus, like that of the vesiculpe seminales, must be well adapted for the preservation and ascent of the spermatozoa to the cavity of the fundus uteri. Especially is this probable, since Mr. Donne long since pointed out that in the healthily acid mucus of the vagina the sperma- tozoa preserved their vitality for a considerable time, but they are speedily destroyed when the acid of the vagina is in excess from any cause. May we not assume, then, that an inflammatory condition of the mucous membrane of the cervix uteri must necessarily alter the character of its se- cretions, totally unfitting them for their specific action upon the spermatozoa. In those cases of sterility attributed to the last abortion, the cause being referred by many to retentions of portions of the placenta altering the mu- cous membrane of the uterus to such a degree as to unfit it for future con- ception ; by others attributed to debility of the uterus preventing it from retaining a vivified ovum ; ought we not to recognise the true condition of things, and consider that the abortion has developed in the cervix uteri hypertrophe and induration of its structure, altered secretion of its follicles, and perhaps ulceration of its tissues, leaving the organ in such a condition as to preclude all possibility of future conception and pregnancy unless the evil be remedied ? If, then, the efficient cause of the first abortion be ignored, the subsequent tendency to a similar accident and the future sterility cannot be obviated.]](https://iiif.wellcomecollection.org/image/b21007123_0720.jp2/full/800%2C/0/default.jpg)
