On rupture of the perinæum and its treatment : illustrated by cases read before the Medical Society of London / by Isaac Baker Brown.

  • Brown, Isaac Baker, 1812-1873.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: On rupture of the perinæum and its treatment : illustrated by cases read before the Medical Society of London / by Isaac Baker Brown. Source: Wellcome Collection.

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    the parts together with sutures, by keeping the thighs in close approximation, and by drawing off the urine by catheter. I have seen three of these cases, and they all did well under this treatment. Thirdly,—Where the perinseum, during its state of dis¬ tension, becomes torn between the constrictor vaginae and sphincter ani, without lacerating either of these muscles, and the head and body of the child, if small, may, in fact, pass through the opening thus formed. These cases are rare; by immediately bringing the parts together by suture, the treatment will generally be successful. Fourthly,—Where the rupture is through the constrictor vaginae, through the entire perinaeum, and sphincter ani, and sometimes also through the recto-vaginal septum. This last form of rupture is the one to which I wish specially to allude in the following paper, and to illustrate the treatment of by 4 cases terminating successfully. The causes to which these accidents may fairly be ascribed are three in number, 1st. Laceration may be produced by a sudden and violent action of the uterus, before the os externum has become dilated. 2nd. The continuance of a more moderate degree of pres¬ sure in persons of lax fibre. 3rd. The improper and injudicious employment of instru¬ ments. There are three conditions of the soft parts which I think should be here referred to as necessarily existing in concur-