The Harveian lectures on fibroids of the clinical and surgical standpoint : delivered before the Harveian Society of London on November 6th, 13th, and 20th, 1902 / by Alban H. G. Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: The Harveian lectures on fibroids of the clinical and surgical standpoint : delivered before the Harveian Society of London on November 6th, 13th, and 20th, 1902 / by Alban H. G. Doran. Source: Wellcome Collection.

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    work such as Josephson’s31 scientific monograph. An un- developed cornu seems predisposed to the development of a fibroid growth in its substance and the author just quoted discusses at length this remarkable association of pathology and teratology. In a short note on the Removal of a Fibroid from a Uterus Unicornis in a Parous Subject,32 published three years ago, 1 summed up most of the records of cases of this condition reported by contemporary authorities in this country. Whenever we have to do with the abdomen and pelvis in a woman we must remember that deformities of the uterus are not exceedingly rare. When detected, we can never feel certain how far other parts of the genito-urinary tract may be normal or malformed. In the case of fibroid of an undeveloped cornu diagnosis may be easy, a thin band being detected on palpation between the uterus and the tumour, whilst the uterus, or rather half uterus, is small and strongly deflected to the side of the pelvis opposite to the new growth. In other cases, especially when the half uterus is well-developed through past pregnancies and lies centrally, diagnosis is often impossible. Again, a normal uterus has been suspected to be bicornute or to consist of one cornu and most of us have come across doubtful cases of this kind. Extreme lateral displacement of the body simulates uterus unicornis. The mistaking of a normal for a bicornute uterus is possible in certain conditions when the patient is pregnant. Paul Bar 13 observed a case where in early preg- nancy there seemed to be a soft tumour containing the foetus and attached to a firm uterus ; between the two there was a certain amount of mobility. Yet the pregnancy proved to be perfectly normal. I relate this condition because the hard part of the uterus may be taken for a fibroid complicating pregnancy ; I once witnessed the opening of the abdomen by an able operator who practised midwifery. Cornual pregnancy with fibroid disease of the uterus was suspected. Yet the pregnancy was normal ; the uterus was found to be less bilobed than it felt; it became quite regular when it emptied itself a few days later. Bar reminds us that in these cases the ovum has become attached to the uterine wall close to the orifice of one tubal canal so that the adjacent part of the uterus develops at first much more rapidly than the remainder. After the middle of pregnancy the rest of the uterus undergoes softening until the normal condition is attained. I am speaking, however, of fibroid in an undeveloped cornu rather than of cornual pregnancy ; the above observations were simply made to warn us against diagnosing the coexistence of these two interesting conditions when it happens that neither is present. When, then, this 31 Uebcr die Neoplasmen der missgebildeten Gebiirmutter, Archiv fur Gynakologie, vol. lxiv. 32 Brit. Med. Jour., vol. i., 1899, p. 1389. 23 Note sur la Greffe de l’CEuf dans une Corne Uterine, Bulletin de la Societe Obstetriqne de Paris, March, 1902, p. 168.