Inversion of the uterus : a report submitted to the New York State Medical Society, February 3, 1859 / by John V.P. Quackenbush.

  • Quackenbush, John Van Pelt, 1819-1876.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Inversion of the uterus : a report submitted to the New York State Medical Society, February 3, 1859 / by John V.P. Quackenbush. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    5th. Dr. Tyler Smith regards inversion as depending upon an irregularly active condition of the uterus, by which the fundus is first depressed, then carried downward by the annular contraction of the uterus, and finally completely everted. This undoubtedly has a great influence, and if not the exciting, is, in many cases, the predisposing cause; but how this irregular contraction can produce this depression or dimpling of the fundus, which presup- poses a lengthening rather than a shortening of the fibres, I am at a loss to discover. But of this I will speak in detail when I al- lude to the manner in which this accident occurs. 6th. Nauche considers the inactive state of the uterus and some effort made by the patient or attendant pulling the cord, as the principal causes. 7th. Henkel attributes it to violent after pains. 8th. Some authors have thought that a short funis is a frequent cause of inversion; but certainly no one can say that this can exert any influence, unless the shortness of the cord gives rise to traction. 9th. Boivin and Duges enumerate, as among the principal causes of inversion, a flaccid distensible state of the uterine parietes ; inertia of the uterus, especially if at the same time an effort be made for the extraction of the placenta; irregular uterine con- tractions and dragging at the cord ; while, 10th. Dr. Radford, of Manchester, thinks that the circumstances attending this accident warrant him in the deduction that the fun- dus and body of the uterus, so far from being in a state of collapse or relaxation, are really in a state of unnatural excitement and ac- tion. Thus we see that our French brethren attribute this acci- dent to a condition exactly the reverse of that which our English author maintains must be present. 11th. The last cause which I shall mention, and the one which, after study and reflection, I consider the true one, is this, irregu- larity of action; and by this term I do not mean an undue action of some of the fibres of the body and fundus, whereby a portion is drawn down or depressed, but a want of correspondence between the muscular action of the neck and the body of the uterus, in which there is a complete atony of the muscular fibres of the neck, which is consequently soft and yielding, and a partial action of the fibres of the body and fundus, sufficiently strong to draw it down through the patulous mouth of the womb, but not active enough to detach the placenta, which we usually find adherent. Here, then we have an atonic and patulous condition of the os