Contributions to the knowledge of osteomalacia / tr. from the German by J. Matthews Duncan.

  • Litzmann, Carl C. T. (Carl Conrad Theodor), 1815-1890.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the knowledge of osteomalacia / tr. from the German by J. Matthews Duncan. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    39/50 (page 34)
    by the movability of the integuments over the smooth reddish- white peritoneal covering of the uterus, as well as by the spouting of a small artery. After the bleeding of this vessel was quickly stopped by torsion, I completed the incision. A small quantity of serum flowed from the open peritoneal cavity. The uterus pushed strongly forwards through the wound in the belly, and could only be kept back with difficulty. The cutting through of it3 wall, which was nearly an inch thick, at the upper angle of the wound, wa3 accompanied by only moderate bleeding. At the bottom of the wound I saw and felt the yet urinjured pla- centa, raised it easily with the finger, and without much increasing the bleeding, as far as its lower border, and then completed the section downwards through the strongly resisting and slightly bleeding tissue, while at the same time the uterus contracted. Already during the incision the placenta was completely expelled above my hand through the upper angle of the wound; a hip of the child followed, and as I laid aside the knife, the child had already half-emerged through the wound. The releasing of the arms caused no difficulty, but then the uterus held the neck of the child so tightly encircled, that I found it necessary to enlarge the wound downwards; and even then it required some considerable exertion of strength to deliver the head. The child, a female, gave at first only slight signs of life, but completely recovered after its nose, mouth, and pharynx were freed of blood-clots, and after resuscitating measures were set about in the warm bath. Before the completion of the nterine section, the assisting physicians had already on both sides, with their fingers hooked and placed in the upper angle of the wound, secured the uterus to the abdo- minal wall, and held it firmly. The bowels, which after the extrac- tion of the child advanced forwards on every side, and especially from below, were pretty easily replaced, the bleeding was stopped by the sprinkling of cold water, and thereupon the uterus contracted well. After a quarter of an hour the external wound was united by means of the interrupted suture (Knopfhath). On account of the great relaxation of the abdominal walls, there were, placed some