Observations on some of the more important diseases of women / by James Blundell ; edited by Thomas Castle.

  • Blundell, Dr., 1790-1878.
Date:
1837
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some of the more important diseases of women / by James Blundell ; edited by Thomas Castle. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    a retroversion of the body only, the uterus doubling backwards upon its own cervix, and the os uteri remaining nearly in its former situation ; or, secondly, which is a great defect in the diagnostic, where you have an enlargement of the ovary, this viscus will some- times fall down and tilt the uterus, so as to place it with the fundus upon the promontory, and the mouth upon the symphysis, insomuch, that the mouth of the womb will stand much in the situa- tion in which it would be placed, provided the retroversion were of the ordinary kind. It therefore follows, here, as in many other instances, it is by a combination of all the symptoms, and not by any single indication only, that your opinion must be guided. When you find the abdomen fluctuating, the pelvis filled with a tumour, with the vagina before it, and the rectum behind, and when empty- ing the bladder, and raising the swelling, you find it takes the situation of the uterus, then, and not till then, can you determine, with certainty, the nature of the complaint. TREATMENT OF RETROVERSION. Before you attempt to put the womb into its proper place remember that it should be your first object to evacuate the bladder thoroughly, and for these reasons,—first, because, if the bladder is full, and lying over the cavity of the pelvis, it will obstruct the pelvis so much as to render the reduction of the uterus, if not impossible, very difficult, for want of room alone; and, secondly* because even if you were to overpower the resistance, and replace the uterus, by forcing the womb into the abdomen, you might tear the bladder, and, in that way, destroy your patient. Dr. Cheston was once called to a case of retroversion, where large accumulations of urine had taken place, and where the catheter could not be in- troduced ; anxious, of course, to avoid the need of tapping the bladder, (a very grave operation), he and others attempted to reduce the retroversion without previous evacuation ; but, fortu- nately, they did not succeed ; I say fortunately, because if they had succeeded in urging the tumour above the brim of the pelvis, dis-