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after. On examining the body after death, an extensive rent was found in the right side of the uterus, reaching from the orifice of the organ to the round ligament, passing through the entire thickness of the substance of the uterus, but leaving its peritoneal tunic quite uninjured. In both of the preceding cases the rupture was spontaneous, and not the result of ill-directed mechanical interference. We must therefore admit, says the reporter of the cases, an organic predisposi. tion to laceration of the uterus, which is probably nothing else than an inflammatory softening of its tissue. In both of the cases, too, the rupture was in the right side of the uterus, instead of in its anterior surface, as it is more generally observed. We agree with the reporter, in thinking that M. Dubois' motive for non-interference, viz.“ a fear of public opinion, which is always wrong," is, more especially in one of his reputation and experience, a very ridiculous, and possibly a highly dangero's, guide in practice.- Monthly Jour. of Med. Science, from Journ de Med. et de Chirurg.
Prolapsus of the Vagina, Laceration of the Unimpregnated Uterus, and Protrusion of the Uterus.-In the preceding page there has been recorded a case of laceration of the gravid uterus, with protrusion of the intestines through the rent, and the following case is an example of a similar injury in the unimpregnated condition. The patient was 60 years of age, and had borne seven children ; she suffered under prolapsus of the vagina, and having never applied for medical advice, nor adopted any remedial measures, the affection proceeded from bad to worse ; the sense of weight and dragging in the hypogastric region, the tenesmus, and dysuria became so severe, that she, by degrees, found herself less able to maintain the erect position, and was ultimately compelled to rest her head constantly upon her knees. On the 12th October, M. le Chaptois was called to her assistance ; upon entering the room he was struck by the fetid cadaverous odour which exhaled from the bed in which the patient lay, in a state of profound prostration. An enormous mass of small and large intestines had protruded through the uterus, which was torn and dragged down by the mass; the womb was everted, and hung between the thighs like the finger of a glove ; near the angle of the right Fallopian tube there was a laceration of nearly four inches in length, which had given passage to the intestinal mass. The patient had, for some hours, been speechless ; the pulse was small and weak, and she was, to all appearance, moribund. M. le Chaptois, notwithstanding her desperate condition, having carefully washed and cleansed the viscera returned them with his hand into the pelvic cavity; they were then maintained in their place by the introduction of a sponge into the vagina. During the succeeding night the patient vomited frequently, and suffered from convulsions ; but, after the bowels had been freely moved, an amelioration took place, and the case proceeded to a favourable termina.ion.-Ibid from Ibid.
On the Constitution and Functions of the Cervix Uteri. By M. NEGRIER.—The following are the most important conclusions which M. N. draws from his investigations. The superior orifice of the cervix endeavours to contract powerfully the instant that the dilating body, whether the ovum or the fætal head, has passed out of it ; the superior orifice alone may oppose an obstacle to delivery, it alone may incarcerate the placenta, whereas the inferior orifice, when it has been fully and slowly dilated, returns to its ordinary size after a considerabie time, and gradually. In females who are delivered for the first time, the orifices of the cervix contract before the walls of its cavity; and in women who have been delivered more than once, the lips of the external orifice close more slowly than the cavity of the cervix ; and in all women the parietes of the cervix are thrown into folds from above downwards. These perpendicular folds result from the closure of the superior orifice, and are not entirely effaced ten days after delivery. In cervical implantation of the placenta, M. N. seems to prefer plugging far before any other mode of treament. -Ibid, from Arch. Gen. de Med.
Chinese ideas respecting the Anatomy of the Circulating System.The heart is figured low in the thorax, is considered a single cavity, and the reservoir of good things; it has little active connection, none that can be traced with the general circulation. From above, the windpipe passes directly into it ; while from below, the tube of a second, elective stomach, connected with the first, recipient stomach, by some kind of conduit, enters it at nearly the same point with the windpipe. Short work is thus made with the complicated and mysterious process of assimilation. One vessel proceeds from the heart to the liver, and another descending along the course of the spine, after communication by a broad reservoir-like expansion, with the kidneys, it is presumed, terminates in the genitals. There is, besides, a double canal, connecting the heart at a point near its apex, with the tube last noticed. But what all those things mean, and what part, if any, the heart acts in propelling the blood, the professor who was asked to explain what appeared in the plate, failed to show. Chinese notions regarded the circulating system, as on most other subjects, are peculiar to themselves, and differ entirely from those entertained by European physiologists, anterior to the time of Harvey and Servetus. In this, as in other vital actions, they introduce the sexual system. They have some idea of difference between arteries and veins, but what it is, and what offices they assign to each, could not be ascertained.
The arteries are said to be male and female. Of the former, three, belonging to the hand, proceed from it to the head; while three, belonging to the foot, originate in the hand, whence they descend to their proper place. On the other hand, three female arteries proceed from the bowels to the hand, to which they belong; and three, belonging to the foot, originate there, and then proceed to the intestines.
Besides these vessels, there is the pulse artery, which moves with every respiration three inches, and performs ils circuit in two minutes. The chief concern of the doctor is the study of this artery, that he may clearly understand, and accurately unfold its manifold meanings; for in so much as he has skill to read its language accurately, by so much is he excellent as a practitioner. From it, besides the temperament of the patient, he deduces the diagnostic character of the disease he is called to treat, after which, having settled the kind and degree of disorder which has arisen among the elements, he sets manfully to work, and boldly promises a cure, knowing, what is not peculiar to China, that the man who promises most in medicine is most followed.
The veins are said to circulate day and night, but it does not appear that they believe the motion to be onward and in a circle : for they say, that having arrived at the end, it again commences where it left off. Nor do they admit that the arteries and veins have any connection ; for they allege that all the arteries and veins have their respective cavities, twelve in all, such as the liver and heart, from which they proceed, and corresponding places where they end; and that, throughout the body, there are paths, ducts, and channels, distinct and appropriate to each, so that the blood does not meet with obstruction in its passage, though why it passes, and by what mechanism, does not appear.
The heart is said to be the ruler, from which the spirits proceed; it is also held to be the receptacle of marrow, which comes from the brain, and goes to the reproductive organs. The lungs are vehicles by which the temper is regulated. The liver holds the place of a general, whence proceeds contrivances and orders. The bile acts as umpire, settling disputed points. The spleen performs the part of messenger, and is the fountain of joy—a function not before ascribed to it, but to which it has as good a title as to be considered the seat of ill-humour and despondency. The stomach is the granery of the body, and the
of the five tastes. The great duct is the promoter of principles, and the operator of changes; the smaller ones being the receptacles of superfluity, where digestion is carried on. The kidneys are the rulers of strength, whence all skill proceeds. The bladder, having no connection with the kidneys, is the general reservoir of the absorbents. Wilson's Med. Notes on China.
Nasty Notices.-A foreigner looking over the English newspapers must think the people for whom they are printed, the nastiest on the face of the earth. No language, however gross, indelicate, offensive, or disgusting, is considered unsuited to the eyes polite which scan the contents of the “usual channels of information.” At the head of the columns appears the doctor's " book-advertisement on costiveness, with all its evils embellished with words and expressions suited to the subject, and to it alone; then the instrument-maker's flourish of syringes, operative vases, fountains, and other delicate contrivances; and at the end, the plumber's announcement of water-closets, stationary and portable. This is no fanciful picture. We see it every day. But
the abomination is not consummated until the fistula-curer closes up the march, and here he is with the Lord Mayor and all his merry men in his train :
“ Infirmary for Fistula.—A deputation from the Fistula Infirmary, consisting of Mr. John Masterman, M. P., treasurer, the Rev. Dr. Vivian, chairman of the committee of management, Mr. Frederick Salmon, honorary surgeon, and Mr. William Carter, the secretary of the charity, waited yesterday on the right Hon. the Lord Mayor, to request his lordship's acceptance of the presidency of the infirmary for the ensuing year. The deputation was received by his lordship with the greatest courtesy, who expressed his desire to further the interests of the institution in every possible way, and fixed Monday, April the 19ht, for the anniversary festival of the institution, at which he signified his intention to preside.”
The quid nunc family of Cockneyland is at present all in an uproar of most amiable indignation against the horrid Irish, who will not starve quietly; and words can scarcely be found sufficiently strong to express the contempt entertained for Hibernian delinquencies; but we challenge the greatest advocate of Saxon refinement to match the above paragraph in Celtic barbarity. Just let us picture to ourselves the Lord Mayor of Dublin seated in state to receive a deputation headed by one of the city members ushering in a fistula-curer to bespeak his lordship's patronage and custom ; and soliciting the first municipal officer of the city to "accept the presidency" of his filthy " institution!” Such a thing could not take place amongst us, or if it did, we should not at all events have it thus blazoned forth.-Dub. Med. Press.
Lithotrity - Statistics by M. Civiale. From the year 1836 to 1845, M. Civiale has applied his method in 266 cases, with success in 259 patients, a few of which obtained only partial relief. In seventynine instances M. Civiale considered that the operation of crushing presented no chance of success, and refused to operate. Lithotomy was performed on twenty-eight, and seventeen recovered.
The statistics laid before the academy, at various periods, show that 582 patients have been operated upon by the author; and the tables point out distinctly this remarkable fact, that three-fourths of calculous patients who present themselves now-a-days, for treatment, are operated upon by the method of crushing.–Lon. Med. Times.
New York PATHOLOGICAL Society, JANUARY 27TH, 1847. Dr. Wood exhibited a polypus uteri which he had removed by ligalure from a woman in whom it had existed for nine years. It was about the size of a Vergaloo pear, and hung by a well defined pedicle from the fundus. Several fibrous tumours were attached to other parts of the uterus, appreciable by the hand externally applied, varying in size from that of a marble to that of the fist. In three days after the application of the ligature, the polypus came away without hæmor. VOL. X.
rhage; it had lost nearly half of its bulk. Confirmatory of his previously expressed opinion, Dr. W. had found this polypus, as he had others, supplied by one large artery in the pedicle; this gave off other small ones. It was difficult to secure arteries after their section in all fibrous tissues, as room, owing to their elasticity, is not given for the hold of the ligature beyond the tenaculum. He had attempted it, uncuccessfully, upon this specimen. Hence the great danger of excising these growihs, which he considered a bad and hazardous practice. He exhibited an instrument well adapted to the purpose of ligating polypi, and, coinciding with Dr. Montgomery in the belief of the identity of the three forms of uterine fibrous tumours, and his condemnation of the knife, strongly recommended the perusal of his late valuable paper on the subject of this disease. Dr. W. stated further, that he had recently confined a woman, whose child (a female) when five weeks old, weighed two and a quarter pounds. It was born in the seventh month, and for two weeks did not nurse. It is now doing well.
Dr. Van Buren exhibited the parts taken from a patient with aneurism of the femoral artery, and communication of the artery and rein. The gentleman was twenty-one ; he had been wounded two and a half years ago in an affray, with a pistol ball, which entered below the ant. sup. spinous process of the i!ium, traversed the front of the thigh, and came out on the inside of the symphysis, under the skin, At the moment, much hæmorrhage ensued, arrested by pressure. He recovered entirely in six weeks; on getting about, he discovered a pulsating tumour in the middle of the ihigh, three inches below Pou. part's ligament. When examined, on his arrival here, it was irregular and ill-defined, three or four inches in circuinference, and over it, a very unusually distinct thrill could be felt. The tumour was in contact with Poupart's ligament. The external iliac artery was tied by Professor Moit on the 16th of December, and on the 22d he died, yangrene having extended over the whole limb, commencing at the foot. The operation was ill borne ; severe pain was felt at the moment of tightening the ligature for several minutes, followed by numbness of the whole limb; soon after he had pain and oppression at the heart. Next day there was much agitation, with oppression about the chest and pain in the belly, and the temperature of the limb was eight or nine degrees lower than that of the opposite side. The pulse was never as full as before, after the operation.
Post mortem (which was difficult on account of the state of the parts.) A little lymph upon the peritoneum around the wound, not affecting that of the adjacent intestines. The ligature was applied about one and a quarter inches above the circumflexa and epigastric arteries, and a clot of about an inch in length above it. The artery began to be atheromatous just below Ponpari's ligament. A true aneurism com. municated with the attery jusi above the origin of the arteria profunda, a little larger in size than a partridge egg, and of a regular oval shape like a pouch, having a small jug-like neck, and containing coagula formed before the ligature of the artery. It was enveloped by gristly