On a hitherto undescribed disease of the uterus, namely, unnatural patency of the inner extremity of a fallopian tube / by J. Matthews Duncan.

  • Duncan, J. Matthews (James Matthews), 1826-1890.
Date:
[1856]
Catalogue details

Licence: Public Domain Mark

Credit: On a hitherto undescribed disease of the uterus, namely, unnatural patency of the inner extremity of a fallopian tube / by J. Matthews Duncan. Source: Wellcome Collection.

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    because, in the one case, there was no abscess; and, in both, this idea was negatived by the facility of the passage into the canal, by the mobility of the uterus, by the freedom of the probe’s motion, and by the facility of feeling it through the anterior abdominal wall, lhat the probe did not perforate the uterus is certain, for it was passed repeatedly, and without the use of any force. Moreover, t le cuie of the affection was distinctly noted by the impossibility of passing the probe through the os farther than is usual. When seeing these cases, I was quite aware of this source of error, having heard of several examples where it was undoubtedly done. Fortunately, this awkward and unintentional thrust seems to be unattended with any great danger, if the uterine walls are not disorganized, as in cancer, when the softness and deficient elasticity will allow the small, and m this case easily produced perforation to gape, after with¬ drawal of the probe, and the hole giving issue to blood or uterine discharges, will speedily light up peritonitis.1 In the healthy state ot the tissues it is different. I have known the perforation to be seen after death, where it was made in course of a difficult diagnosis shortly before; and I have seen an undeveloped uterus, not bigger than the end of the thumb, through whose os a probe had been repeatedly passed for inches, without any bad result.2 The diagnosis from that affection, described by Hooper, Simpson, Heck, and others, as morbid hypertrophy after delivery, but better under the new name of deficient or arrested involution, is sufficiently decisive, although I think it is more than probable that some cases described, as of deficient involution, were of this kind. The length to which the probe passes in deficient involution, is only a little more t lan m natural cases ; here its passage is for many inches. In the ormei, it may pass for three inches or occasionally even more; in the latter, it will pass easily twice as far. In deficient involution the probe is always felt to be contained within the thick uterine wails, to have its direction determined by the direction of the uterine mass, and to have its movements limited by it. In this disease, all these circumstances are altered. The following details of two cases, are far from being so perfect as I could wish. Their brevity arises partly from my having, in the previous part of this paper, already described some of the circum¬ stances of them. Mrs N. set. 35, came from a midland county to consult me, under 1 Perforation slowly produced by the advance of ulceration, such as, I be- tmVflhaPPerd .fro“ ^the pressure of the point of an intra-uterine pessary, disc-sed intt’etkt110^ ° ? ^ “d d°6S “0t bel°n= to the «****« JJ** speaking. hypotheticaUy of catheterism of the Fallopian and tho/rb B'd 1 fUiPP°Sc h FaI]PIan tube would bear no rude treatment, and that the accidental perforation of it would be certainly fatal.”—Lancet, II., J 849 p. 119. If the remarks in the text are well founded, this opinion of Sir .Benjamin s is groundless. 1