Two cases of occlusion of the vagina with retention of menstrual fluid / by C.J. Cullingworth.

  • Cullingworth, Charles J. (Charles James), 1841-1908.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of occlusion of the vagina with retention of menstrual fluid / by C.J. Cullingworth. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    bladed kuife passed along it up to the tip of the cervix, when it was pushed W'ell forwai’d into the cervix in the direction of tlie uterine axis. The upper part of the blade was now felt to move freely in all directions within the uterine cavity; it was thereupon partially withdrawn, and re- introduced several times, with the cutting edge directed first forwards, then backw^ards, then to the left side, and finally to the right, so as to make a free opening. The uterine sound was now passed along the flat part of the blade up to the fundus, its point being easily detected by a hand placed over the hypogastrium. The canal of the uterus was showui by the sound to be three inches in length; the upper part of the cavity was expanded, its walls firm, and its inner surface rough and uneven. A tw'o-bladed cervical forceps, designed by Dr. Lloyd Roberts, was now introduced, and the opening enlarged by separating the blades. A small quantity of thick mucus and altei’ed blood thereupon made its escape from the uterus. Finally, Hegar’s dilators. Nos. 5 to 10, w'ere passed successively with the utmost ease. The uterine cavity could then be readily explored with the finger; it was found quite empty. A vulcanite stem pessary was left with Dr. Fox for occasional intro- duction to keep the cervical canal open. September 1st.—Dr. Fox writes : “You will be pleased to hear that your case is progressing most satisfactorily. Appetite good; discharge much diminished and less offensive; apertiu’e in uterus patent (I had my finger in the uterus to-day); vaginal dilator used twice a day for half an hour. Patient allowed to sit up in the room downstairs to-day, to allow of some purification of bed, clothes, and room. ...” Three weeks later, the patient’s condition had become less satisfactory. Her appetite had failed; she was daily losing strength; the discharge had increased in quantity and become more offensive; the temperature was 103°; the pulse 140 and very feeble. Under these circumstances, Dr. Fox, learning that I was away from home, and feeling that some thing should be done at once, made a careful examination under chloro- form and discovered, about an inch and a half wdthin the vagina, on its posterior wall, a small opening from which a purulent discharge was welling up. Having satisfied himself that the opening did not com- municate with the rectum, he proceeded to enlarge it, first with a knife