On artificial dilation of the os and cervix uteri by fluid pressure from above : a reply to Drs. Keiller of Edinburgh, and Arnott and Barnes of London / by Horatio R. Storer.

  • Storer, Horatio Robinson, 1830-1922.
Date:
1863
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Licence: Public Domain Mark

Credit: On artificial dilation of the os and cervix uteri by fluid pressure from above : a reply to Drs. Keiller of Edinburgh, and Arnott and Barnes of London / by Horatio R. Storer. 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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    premature labor, for which the method to be considered was first proposed to the profession by both Dr. Keiller and myself, and for which its use is now urged by such competent authority abroad, there had been many measures suggested and practised—all of them, however, acting either secondarily or by reflex action, as do galvan- ism, mammary irritation, puncture of the membranes, their separa- tion from the uterus by bougies, the injection of water or air, an agent here so dangerous, or by the uterine sound, and also, there seems to me good reason for believing, the so-called oxytoxics, as ergot of rye; or by a stimulating or dilating force applied and first acting from below. These remarks apply with equal force to all methods that had then been proposed—to those of Hamilton and Hopkins; to the flexible catheter left in the cavity of the uterus by Merrem, Krause and Simpson; to the vaginal and cervical plugs and dilators of Briin- ninghausen, Osiander, Yon Busch, Hiiter, Gariel and Braun; to the carbonic-acid douche, suggested by Brown-Sequard and so fatal in the hands of Scanzoni and others; and to the water douches, of Kiwisch, applied to the vagina, and of Schweighauser and Cohen, to the uterine cavity. These several means, while they were applica- ble but partially and with varying success to the pregnant uterus, were wholly unfitted, with the exception of sponge tents, for open- ing up that which already contained no foetus; and for this the elastic bougies of Mcintosh and the unyielding ones of Simpson, the spring-knife of the latter, the hollow tubes used by Wakley for ure- thral stricture and adopted from him by Baker Brown, and the in- struments of Rigby, Graham Weir, Osiander, Busch, Krause and Jobert, with expanding metallic blades, are either insufficient or at- tended with too much hazard. Caoutchouc bags or sacs, distended with air, had been proposed some years previously by Gariel,* for the treatment of displace- ments of the uterus by pressure from below, and for plugging the vagina in cases of haemorrhage. He had also suggested their pos- sible introduction into the cervix, not, however, through it, for the purpose of overcoming stricture of that canal, and had even asked, if this property of the bulbous air sound could not be turned to advan- tageous use in inducing premature labor ? here referring, however to their use in the vagina, as had already been suggested by Hiiter and Braun. The proposals of Gariel, however, like those of Braun, were attended with singularly unfortunate results, Breit and others reporting a mortality of six patients out of fourteen.! To sponge tents applied to the cervix there attach, as I have already intimated, various important objections. They are readily acted upon chemically by the uterine and vaginal secretions, and from their organic character quickly undergo putrefactive decompo- * Gazette des Hopitaux, 1849, No. 141. -j: Goschen's Deutsche Klinik, Berlin, 1853.