Basilysis for dystocia from hypertrophic elongation of the cervix uteri / by Alexander Russell Simpson.

  • Simpson A. R. (Alexander Russell), 1835-1916.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Basilysis for dystocia from hypertrophic elongation of the cervix uteri / by Alexander Russell Simpson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    10/16 (page 8)
    with the fingers or dilating bags. Sometimes a series of incisions have been made in the cii-cle of the os, extending an inch more or less up the cervix. Sometimes the cliild has been extracted with the forceps. Sometimes turning has been had recourse to. Occa- sionally, as in our patient, the mother has got the best chance when the head of the child has been broken down. The following history of a case by Benicke ' of a primipara with elongated cervix is interesting as illustrating the difficulty attend- ing the management of this kind of dystocia. The patient, ajt. 28, was last unwell in August 1876, and fell in labour on 7th May 1877. As the labour did not pi'ogress, notwithstanding some sliallow incisions made in the os by a physician who had been called in, help was brought from the r:,ying-in Hospital, and I saw the patient for the first time at midday. Out of the vulva pro- jected a tough bluish-red protuberance of about 15 centimetres in circumference, on its anterior part the os externum permeable for tlie finger, and below, on tlie posterior part, a granulating ulcer. Introducing the finger into the vagina, one could feel that the anterior vaginal fornix as well as the posterior were completely intact, also that one dealt with the much elongated cervix, now abnormally swollen with the influence of pregnancy and labour. If one introduced the finger into the cervix, it came upon the head, at a distance of about 6 centimetres, arrested in the upper part of the cervix. I ordered her to be conveyed to the Lying-in Hospital. Here, in the first place, a small Barnes bag was introduced, which Avas replaced in a few hours by another of larger size. In spite of this the dilatation of the cervix did not progress favourably. At 6 o'clock in the evening, therefore, an incision was made with a knife through the os externum and slightly the cervix. Meanwhile frequent injections of carbolic acid were ordered on account of bad- smelling discharges making their appearance. This incision was also of no use; therefore, at 11.30 p.m., an incision somewhere about 5 cm. long was made with the scissors on each side, the head seized with the forceps, and now completely drawn out of the cervix, the lips meanwhile being pushed up over it. The incision tore up a little further. The child was a well-developed Living girl, and weighed 3156 grammes. After the birth the interior was washed out with carbolic lotion and the incised surfaces cauterized with the strong acid. Notwithstanding this in the cliildbed, the temperature rose high; in about eight days symptoms of mania made their appearance, for which the woman was removed to the hospital. She has been discharged from thence cured. In the same paper Benicke describes several cases where the pregnancy was intemipted at various dates. The case which most resembles the one I have related to-night was in a multipara, who gave birth to a full-time dead foetus after a tedious labour, which ' Ueber GL-burtsstdnuigen durch die wiMclieu Geburtswege, in Zcitschrift fur Gehnrtshiil/e nnd Gijnai-oloiiic, ii. 240, 1878.