The pathology, diagnosis, and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: The pathology, diagnosis, and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt. 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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    the influence, however, of certain conditions, the nature of which is at present not perfectly understood, but which probably have the effect of setting up a sort of chronic inflammation of the lining membrane of the uterus, the mucous membrane of the uterus becomes sometimes greatly more thickened than usual, and being, in accordance with the ordinary rule, thrown off, it is presented externally. This is what appears to take place in these cases of membranous dysmenorrhoea. The membrane in question is smooth internally, rough and slightly flocculent externally. When thrown off in a single piece, the membrane presents three apertures, cor- responding to the apertures communicating with the uterine cavity, and is of a pyramidal shape. It is expelled during the catamenial flow, which, as a rule, is more profuse than usual. It is unlike the vaginal exfoliations just alluded to, being very much thicker. The distinction of this dysmenorrhoeal membrane from the decidua of an early ovum might, under certain circumstances, be difficult, as already stated, viz., when the supposed decidua is unaccompanied by any part of the chorionic structure. The concomitant circumstances will assist in the diagnosis : thus the ' dysmenorrhoeal membrane ' is not expelled at one catamenial period only, but on successive occasions; whereas, in the case of an abortion, the same thing is not likely to occur, or, at all events, with the same marked periodicity. See chapter on ' Dysmenorrhoea.' 3. The Covering of the early Ovum.—Portions of the decidua materna, the decidua reflexa, the chorionic sac, &c, may come away in the form of membranous substances. It is unnecessary here to repeat what has been already stated as to the diagnosis of the nature of these bodies. 4. Exfoliations from the Bladder.—The coats of the bladder have in rare instances been expelled ; in cases related by Mr. Spencer Wells and others, the whole lining of the bladder appears to have sloughed and to have come away by the urethra. Vesicular Bodies.—The Hydatidiform or Vesicular Mole.-— Little bladder-like substances, singly or connected in series like beads, may be expelled from the uterus. These bodies were for- merly considered to be hydatids formed in the uterus. They really result from certain alterations of the chorion villi, and they are always the result of conception. The embryo perishes at an early period, and the chorion villi continuing connected with the uterus maintain a slow growth, the development deing arrested. The vesicular bodies are thus the result of dropsical swelling of the chorion villi. It appears that the period of pregnancy during