Woman, her diseases and remedies : a series of letters to his class / by Charles D. Meigs.

  • Meigs, Charles D. (Charles Delucena), 1792-1869.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: Woman, her diseases and remedies : a series of letters to his class / by Charles D. Meigs. 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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    themselves, or by the tension of other parts, whose accidents or dis- eases implicate these external textures. You are acquainted with the origin of the pudic artery from the ischiadic, in some individuals, and in others from the internal iliac; and you are aware, that this vessel runs upward on the inner face of the ramus of the ischium, and sends branches forth to supply the external organs. Now, it occasionally befalls a woman in labor, or one affected by a wound, to fracture or divide this pudica interna artery, or a considerable branch of it;—and as the labium externum is full of loose cellular tela, it is easy to see how a rupture of the vessel may cause such a quantity of blood to be dashed into the dis- tensible texture within the labium, as to give the appearance of an enormous tumor, of a very livid or even black color ; and producing all the pain to be expected from laceration of the inward textures, and the stretching of the others not immediately broken, by quanti- ties of congealed or fluid blood, with which the organ becomes thoroughly soaked and filled. The rupture of a vessel within the brain may suffice like a wooden wedge driven into it to tear the brain to pieces. So, in the spleen, a vessel giving way tears that organ to pieces—and, in like manner, a broken trunk or branch of the pudic artery may demolish the internal texture of the labium majus. I have seen examples of the accident of various degrees of severity. Some of them were discovered before the termination of the labor, and others not until many hours subsequent to the accouchement. In the cases where the mischief is not complained of until long after the child is born, we may infer that the vessel is an arteriole only,— some branch of the pudic ; which had given way during the expanded state of the inner genitalia, and which could not bleed while they were so expanded; but commenced to scatter the extravasation within them, as soon as the distending and compressing cause was withdrawn. Such cases are less likely, I think, to prove mischievous, than the other sort, in which the labium begins to swell before the child's head has descended so far as to push the labium aside. When the labium fills in this way, antecedently to the emergence of the presentation from the arch of the pubis, we must suppose it to arise from the rupture of a trunk, not an arteriole. It is therefore more dangerous. The quantity of fluid thus extravasated is surprisingly great; and doubtless the bloody infiltration will run backwards into the loose cellular laminae that are in relation with the sides of the vagina; 6