Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

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    speedily got well. Dr. Montgomery* lias removed a cauliflower excrescence of the uterus by means of the ligature, and the patient continued well at the end of difo months, having menstruated regularly during that period. He re¬ commends the use of the ligature in the treatment of such cases, since the pain it occasions is comparatively slight, and there is no reason to fear serious hemorrhage after its application, while the good which results from it is almost immediate. He advises that after the separation of the part inclosed by the ligature the wounded surface should be at once touched with some powerful caustic. Dr. ftiberif has published an account of four cases of malignant disease in which he amputated the cervix uteri. All of the patients were under 40, and the disease, which was fungoid rather than pure scirrhus, was not of long standing, though extensive. The disease returned in every in¬ stance within three months after the operation, attended with profuse hemor¬ rhage, and had already proved fatal to three of the patients at the time of his communication. DISEASES OF THE UTERINE APPENDAGES. Diseases of the ovaria. Dr. Kohlrauschf describes the anatomical structure of an ovarian cyst containing hair and teeth. It was made up of many cysts, some of which were filled with gelatinous matter. Others, which had thicker parietes, contained fat, hair, and teeth. The cysts were lined with flattened epithelium scales, below which was a layer of cells not flattened, then a structure resembling cutis, and below that a kind of sub-cutaneous cellular tissue. Hairs were implanted in a perfectly normal manner into this cutane¬ ous tissue, in which there likewise existed greatly developed perspiratory and sebaceous follicles. The teeth were imbedded in a piece of bone in the wall of one of these cysts. They were all inclosed in tooth sacks, and in different stages of development. Cases of the spontaneous rupture of dropsical ovaria are related by Dr. Fraser, Dr. Lambrecht, and M. Camus.§ In the first case the bursting of the sac into the rectum was followed by permanent cure ; in the second the patient recovered after it had twice emptied itself at the navel; and in the third case the cyst burst on three occasions into the abdominal cavity, followed each time by the rapid absorption of the effused fluid, and great temporary improve¬ ment in the patient’s condition. Mr. Brown,|| in two very interesting papers, combats the generally received opinion concerning the uselessness of medicine in ovarian dropsy, and relates five cases in which the plan which he advocates proved very successful. This plan consists in the internal employment of small doses of mercury, and in the use of mercurial frictions to the abdomen, so regulated as to keep the mouth slightly sore for some weeks; and in the administration of diuretics, succeeded by tonics, while the food is light and unstimulating, and daily exercise attended to. The local treatment consists in careful and constant tight bandaging the abdomen with flannel. When these measures appear to have taken effect, by the non-increase or positive decrease of the tumour, he advises that the cyst be then tapped and emptied. After the operation, pads should be applied over the cysts, and tight bandaging should be continued for three weeks, and the friction and medicines for at least six weeks longer. A case is related by Mr. Atkinson,H in which a woman, aged 53, was tapped 78 times in seven years and a half, six gallons being drawn off at each of the first 50 operations, but only half that quantity on each subse¬ quent occasion. The interval between the operations, which used to be five months, came at last to be only three weeks, but the patient resumed her usual * Dublin Journal, Jan. 1845. f Gazetta Medica di Milano, 9 Settembre, 1843. X Muller’s Archiv, 1843, Heft iv, p. 365. § Montreal Med. Gazette, May 1844; Med. Zeitung, Nro. 30, 1844; Revue Medicale, Nov. 1844. J| Lancet, May 4, 1844, and April 5, 1845, Ibid. July 20, 1844.