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

  • Dewees, William P. (William Potts), 1768-1841.
Date:
1833
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 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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    ceeds from vessels situated rather within the vagina; for those which compose the vaginal plexus, immediately behind the cor- pus spongiosum, are the most likely to suffer during the passage of the child's head, and to furnish this large quantity of blood. And this opinion appears to be strengthened, by cases in which the accident happens before the delivery of the child ; as the part just mentioned will suffer distention, before the head has entirely escaped through the os externum. Dr. Maitland accounts for this case, by supposing, that from the pressure of the child's head, and the violent stretching of the parts during the labour pains, some of the small vessels had burst. Med. Comment, vol. vi. p. 89. Now, it must be evident, that the nymphse cannot be put upon the stretch while the head is confined within the pelvic cavity; and perhaps the hardness of the head may contribute to the occurrence of the accident, as I have not seen, or found relat- ed, a case in which it took place, where any other part had pre- sented. The vessels which furnishxthe blood must be of considerable size; as the tumour which constitutes the disease, is very sud- denly formed, and is oftentimes enormous. The cases which I have witnessed, were all of this rapid kind; occupying but a few minutes for the formation of the tumour. Mr. Burns, how- ever, declares, that it has been known to advance so slowly, as not to attract attention for two days. p. 60. This may doubtless have happened; since the rapidity of the formation of the tumour must necessarily depend upon the size or the number of the vessels injured. In these slow cases, mentioned by Mr. Burns, it may have arisen from the rupture of a vessel in one of the nymphae. This complaint has been mistaken for the distended and pro- truding membranes, and for an hernia; but a careful examination of the deranged part, will soon remove these errors. For it ex- hibits neither the position nor the colour presented in either of the cases, with which it has been confounded. Its position is la- teral, unless both labia are involved; in which case, the natural sulcus must be observable; and its colour is that of extreme lividity, or entirely black, which resembles neither the mem- branes nor hernia. Owing to the unequal density of the external covering and in- ternal face of the labium, it becomes irregularly distended; and scarcely any thing is seen but its excessively stretched, internal