Three unusual cases of mammary growths / by Sir Alfred Pearce Gould.

  • Gould, A. Pearce (Alfred Pearce), Sir, 1852-1922.
Date:
1912
Catalogue details

Licence: Public Domain Mark

Credit: Three unusual cases of mammary growths / by Sir Alfred Pearce Gould. Source: Wellcome Collection.

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    floor. In the pelvis was a considerable quantitity of blood and blood clot. Early generalized peritonitis was present. I removed the blood from the pelvis, sewed up the rent with interrupted sutures, inserted a large-sized drain tube through the lower end of the abdominal wound, and closed the rest of it by the usual three-layer method. She made a rapid recovery, and left the hospital on the twenty-fourth day. On looking into the literature of the subject I find that ruptures of the vagina during coitus may be divided into two groups. In the first group the injury is in the nature of a laceration, and affects chiefly the introit and the lower end of the canal. Such injuries in women are usually the result of rape. Muller,1 for instance, records two instances, one in a girl of 24 years and one in a woman aged 72. In both the lacerations affecte'd the posterior vaginal wall without perforation into the peritoneum, and were the result of criminal assaults. Ruptures of this type do not commonly involve the peri¬ toneum, probably because the male organ does not proceed far enough up the canal. The lower end of the vagina is much narrower than the upper end, and hence is the part most likely to give way when acutely stretched by the insertion of a dis¬ proportionate body. The tear is usually situated either posteriorly or laterally, and opens up the para-vaginal cellular tissue. Exceptionally, it may extend until it reaches the peritoneum, through which it may penetrate into the peritoneal cavit}\ Ruptures of this variety are not uncommonly seen in mares after having been covered by a stallion, but, as in women, they rarely involve the peritoneum, though they may open the rectum. It has been stated to me that similar injuries are sometimes met with in bitches, but I cannot find any such cases recorded in veterinary literature, and Mr. Hobday, of the Veterinary College, tells me he has never seen one. In the second group, to which the case I now record belongs, the injury is in the nature of a perforation, and is evidently produced not by stretching but by the direct impact of the penis. In the museum of St. George’s Hospital a very interesting specimen of this type of rupture will be found. It is labelled,