A case of complete inversion of the uterus : with remarks upon the modern treatment of chronic inversion / Clifton E. Wing.

  • Wing, Clifton E. (Clifton Ellis)
Date:
[1879?]
Catalogue details

Licence: Public Domain Mark

Credit: A case of complete inversion of the uterus : with remarks upon the modern treatment of chronic inversion / Clifton E. Wing. 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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    The patient was kept in bed for a few days, and the hot water injections continued. When she got up, five days after the return of the organ to its place, >he said that she felt perfectly well. A dragging sensation in the left side, from which she had suffered much, was gone, and she was able to stand and walk in a perfectly erect position, which she had not done since sick. She returned home a week later, and menstruation, which occurred soon after her return, was normal in every way. She regained her strength rapidly, and Dr. Bronson has recently informed me that she continues well and is again pregnant (at about the fifth month). Dunns the treatment she took no anaesthetic, and no anodyne except the i gr. of morphine referred to ; and according to her own statement, suffered no more pain than she had frequently had in the same length of time during her illness. She ate heartily and took her Iron tonic regularly. There was a free discharge of mucus from the inverted mucous membrane, bul scarce a trace of suppuration. The fundus bore the pressure without damage. Experience hassh own that the inverted organ is much more tolerant of continued pressure than would naturally be supposed. The instrument was removed and cleansed daily, and before it was replaced the parts thor- oughly washed out with a disinfectant solution. This diminished the risks of septicemia, and also afforded an opportunity of watching the condition of tin; parts where the instrument pressed. The effect of hot water injection, employed after the method indrodneed by Dr. Emmet, in reducing the congestion and sensibility of the parts, was very satisfactory. The value of continued gentle pressure in the treatment of inversio uteri seems to have been but little appreciated by the profession at largo, although its merits have been sufficiently proven by the suc- cessful cases which have been from time to time reported, particularly in Great Britain*. The main difficulty in the return of the uterus to its proper position lies in the fact that that portion of the uterus which is not inverted— or, in case of complete inversion, the cervix—contracts behind the Inverted portion, and must be dilated in one way or another before the inversion can be returned. It is a well known physiological fact that the strongest muscle, which would be powerful enough to resist great force applied for a comparatively short time, can yet be completely overcome and thoroughly stretched by the continued application of very little force. Now the whole uterus, and therefore, of course, that portion of it which in the given cases constitutes the impediment to reposition, is to all intents and purposes a muscle, a muscle strong enough to successfully resist in many*cases the force applied in taxis—a force which can be applied but a little while at a time, and which more- over is often not very great since the hand of the operator works at a great disadvantage and soon tires—but which cannot withstand the action of Iong continued pressure upon the fundus, even when the amount of pressure is but slight. There are two reasons which may partly explain why continued pressure has not been more highly esteemed in these cases. In the * In the Boston Medical and Surgical Journal of Jan. 13, 1876, is an interesting and in- structive report by Dr. Geo. G. Tarbell, of this city, of a case which occurred in his service at the Massachusetts General Hospital. Continued gentle pressure proved successful after other means had failed. This was one of the earliest cases treated by this method. Dr. T. had a second successful case not long afterward.