A treatise on the diseases of females / by William P. Dewees.

  • Dewees, William P. (William Potts), 1768-1841.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of females / by William P. Dewees. Source: Wellcome Collection.

Provider: This material has been provided by the Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.

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    the uterus was found to reach as high as the navel, and the external parts were stretched by a round soft substance at the entrance of the vagina, in such a manner, as to resemble that appearance which they have when the head of a child is passing through them; but there was no entrance into the vagina. On the following morning an incision was carefully made through the hymen, which had a fleshy appearance, and was thickened in proportion to its distention. Not less than four pounds of blood, of the colour and consistence of tar, were discharged ;* and the tumefaction of the abdomen was immediately removed. Several stellated incisions were afterwards made through the divided edges, which is a very necessary part of the operation; and care was taken to prevent a reunion of the hymen till the next period of menstruation, after which she suffered no incon- venience.—Introduction to Mid. Francis's ed. p. 110. When the hymen is imperforate,.the-patient suffers at each re- turn of the menstrual period; and these pains so much resemble the pains of labour, as to have been sometimes mistaken for them. Dr. M'Cauley confesses, that, in one instance, he mistook the protrusion of the hymen for the membranes forced down by the pains of labour;-, this case, like that of Dr. Denman, was relieved by incision through the dense and resisting membrane. Smellie's Col. I, No. L.Case V. In the case just related from Smellie,.the patient suffered se* verely; and what added to her distress much, was the suppres- sion of urine, which was not relieved until the contents of the vagina were discharged.f There is something curious in the economy of the uterus, 'when its body becomes distended by the accumulation of the menstruous fluid : it seems to yield for a time without much opposition; but by and by, it makes an effort to discharge its contents,.and pains are excited. After these pains * Dr. Denman observes of this blood, that it was not putrid, nor coagulated, and seemed to have undergone no other change, after its secretion, but what was occasioned by the absorption of its more fluid parts.'1 This is one among the many proofs that present themselves, that the menstruous fluid is not common blood. Frank mentions a case, (torn. 3, p. 243.) from Les Actes Medico-Phy- siques, of a young girl of fifteen years of age, in which the hymen was imper- forate. Her abdomen was distended as much as is usual at the sixtli month of pregnancy, from the accumulated blood behind the obstacle. She was subject to- violent pains in the back, hypogastrium,.and in the genitals; and thought she felt something within her. An incision was, made through the hymen, from which were discharged five pounds of thick black blood, without any disagreeable odour, and by which she was entirely relieved. He also mentions one, furnished by one of his pupils, of a young girl, whom every body accused of being pregnant—an incision through the hymen, gave issue to several pints of blood, no ways changed; this operation was followed by fainting, but the girl's reputation was saved. t A similar case is reported by Mr. Coley, in the Provincial Medical and1 Surgical Transactions. In this case, recourse was had to the division of the hymen, with entire success. Nearly four pints of tar-like fluid gushed out.— See Medico-Chirurg. Rev. for July, 1833., p. 190.