On curettes and curetting / by Alexander Keiller.

  • Keiller, Alexander, 1811-1892.
Date:
[1878]
Catalogue details

Licence: Public Domain Mark

Credit: On curettes and curetting / by Alexander Keiller. Source: Wellcome Collection.

    5/10 (page 327)
    previously deranged utero-gestation where placental and mem¬ branous remnants are retained, their retention giving rise sooner or later to increased turgidity, and ultimately to recurrent or even continuous hgemorrhage, during the investigation of which their true source is usually ascertained, though previously un¬ suspected. The ready diagnosis, successful removal, and consequent sub¬ sidence of the, it may have been, long-continued and danger¬ ously exliausting discharges, usually prove exceedingly satisfactory in cases of this kind, where all that is required to effect a speedy iind lasting cure is the removal of the adherent placental masses or villosities which nature may have been labouring under difficul¬ ties to discharge. [Only the other day I witnessed an illustrative case along with Dr Pridie, whose note I here introduce. “On Septeinber 1578, I was requested to visit Mrs-, aged 27, 4J months married. While in London, a month previous, she miscarried at about the 3^ month. On her recovering so far as to get up, she went out of doors as usual in London. A fortnight afterw^ards severe flooding came on; when it disappeared she came down by rail to Scotland, and was constantly moving about, walk¬ ing or otherwise. On the dav before I saw her, among other places she walked to the top of Arthur’s Seat; in the evening she had to retire to bed on account of a return of flooding, which she had of late been so accustomed to as not to regard it as anything uncommon; but its increasing during the night alarmed them. Her husband’s friends, being old patients of mine, made them anxious that I should attend her; it was, however, late in the morning before I saw her; she was then quite blanched, greatly exhausted, and still flooding; everything about the bed was saturated with blood, although the clothes had been removed two or three times. I was then informed of the miscarriage, and assured by her husband that at the time everything was believed to have come away. 1 introduced the hand into the vagina with difficulty, and with the point of the Anger touched what I suspected to be a retained placenta, but could not grasp it, from the con¬ tracted state of the parts; as haemorrhage was still going on I with¬ drew the hand, and introduced high up into the vagina a sponge with a tape attached, and plugged by means of a larger one as well. This arrested the flow of blood ; some brandy and water was then given with opium. (In her fairly rallying, she took full doses of an infusion of secale cornutum, and afterwards slept well at intervals. Next day her colour had returned, and she was able to take food as usual. (Tn the 3d, after a dose of castor-oil, taken of her own accord, and which acted freely, she vomited some of the food she had taken the day before; at the same time both tlie sponges were expelled, with¬ out any return of the haemorrhage. Though still weak, slie had made up her mind as soon as possible to return to the South of England