Observations on the Caesarean section and on other obstetric operations : with an appendix of cases.

  • Radford, Thomas, 1793-1881.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tended with air, and were diiBcult to keep in position during the operation ; and could not be replaced or retained after it, until the wound was contracted with sutures. Their peritoneal coat was highly inflamed. The edges of the wound were brought together by inter- rupted sutures, and maintained by strips of adhesive plaister, and supported by a bandage placed round the patient. She bore the operation with great fortitude, and, indeed, scarcely made a com- plaint during its performance. Afterwards, she said she had not suffered so much pain as she had felt from some of the unavailing parturient pains. She now expressed herself as being very com- fortable. Nine o'clock p.m. Considerably worse; pulse 140; tongue furred; great thirst; vomits continually; surface cool; countenance anxious ; great tenderness of the belly; clyster not returned; had no sleep; a little urine passed. Ordered to take morph. acet. gr. j. Thursday, 23rd, two o'clock a.m. Mr. Goulden visited her. Pulse 160 ; vomiting unabated ; matter rejected of a dark colour ; skin rather warm ; breathing quick ; belly very tender ; had no sleep ; bowels still constipated. Ordered morph. acet. gr. j. Nine o'clock a .m. Mr. Goulden and Mr, Cheetham reported that she continued to vomit the same fluid ; skin warmer; pulse less fre- quent, and countenance less anxious ; bowels moved; passed urine ; lochial discharge ; abdomen tense and sore. To take morph. acet. gr. j., and saline effervescing mixture. Half-past one o'clock p.m. Mr. Goulden was urgently summoned: it was stated that she was dying. He found her very drowsy or lethargic ; had great difliculty to rouse her. Pulse 140; coun- tenance more flushed, and rather bluish in colour ; no vomiting ; abdomen distended. Two o'clock P.M. Present, Dr. Radford, Mr. Goulden, Mr. Dunn, and Mr. Pigott. She still continues very drowsy; pulse 140, and very tremulous ; skin bedewed with cold perspiration ; her coun- tenance is sunken, and her cheeks are of a purplish colour ; her breathing very hurried, with mucous rale ; does not vomit; belly tympanitic ; bowels not moved. Ordered an enema with spt. tere- binth., etc. The symptoms continued to grow worse until seven o'clock {ves- pers), when she expired : having lived about twenty-seven hours after the operation. Body examined twenty hours after death by Mr. Dunn and Mr. Gaskell, in the presence of Dr. Radford, Mr. Goulden, Mr. Pigott, and Mr. H. Winterbottom. General tumefaction of the abdomen, its parietes being extremely thin. The edges of the external wound were nearly altogether adherent; adhesion of the peritoneal surfaces of the intestines and that of the abdominal parietes. On breaking through these adhesions, about a pint of bloody serum was discharged. The convolutions of the bowels were firmly united, and effused lymph was seen on their surfaces. The colon ad- hered to the uterus. We were particularly struck by the very remarkable pallidity of the tissue of the intestines, when compared with their highly in- jected vascular state seen during the operation. The uterus stood obliquely; the wound in this organ was three and a half inches long; its edges were flabby and gaping ; the os was very patulous, and its lips ragged and gangrenous. The lower portion of the cervix was very soft and dark coloured. The internal surface of the uterus was