Pathology, diagnosis and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Pathology, diagnosis and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt. 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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    sinking of the tumor to a slight extent. [Fig. 29 shows a not uncommon position of the gravid uterus at the sixth month.] Then, as regards the position of the tumor, it must not be supposed that the gravid uterus rises up in the median line and Fig. 29. maintains this position throughout the whole period of preg- nancy. This is a very common error, and one which has fre- quently led to misconception, and even worse. The fact is, that the uterus does at first, and during the first two or three months, occupy a median position—until it becomes bulky and rises into the abdomen. But, once in the abdomen, it generally occupies for the next two months—that is to say, speaking broadly, dur- ing the fifth, sixth, and part of the seventh months—a lateral position, being most frequently found on the right side of the abdomen. The degree of the lateral displacement varies in dif- ferent cases, it being greater in some cases than in others, and, when the abdomen is large, the intestines tympanitic, and the uterine tumor small in proportion to the period of the pregnancy, the tumor may be, and has been, overlooked, owing to the ob- server not being aware of this normal lateral deviation {see Fig. 29). We may now consider for a moment the indications to be drawn from the size and position of the tumor in the abdomen, as to the existence or abseuce of pregnancy in the case before us. The most important circumstance to bear in mind in deciding for or against pregnancy—size and position of the tumor alone considered—is the 7'elation which we find to subsist between the