Observations on occlusion of the vagina and uterus, with its means of prevention, and the operation necessary for its removal / by Evory Kennedy.

Date:
[1839?]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on occlusion of the vagina and uterus, with its means of prevention, and the operation necessary for its removal / by Evory Kennedy. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    sequently a band of adhesion in the vagina near the os was divided, and she recovered perfectly. After these operations, as well in the os uteri as vagina, although the divided surface will cicatrize healthily, an inclina- tion is sometimes taken on to ulcerative inflammation at certain points, leaving communications with the adjoining cavities. We have seen, in the case of Hughes, that this took place to a small extent in the recto-vaginal septum, leaving an opening into the rectum. This however is a matter of little moment or inconve- nience, and if treatment be necessary, can be easily remedied by di- minishing the aperture by the application ofthe cautery or caustic. It is of much more serious moment, however, if it extend to the vesico-vaginal septum, and attended with still greater dan- ger, if it occur after puncturing the uterus; as here, the ulcer may open into the pelvic cavity through the peritoneum. This occurred in the case which follows : Fitzsimmons, whose case is above referred to, returned to hospital in September, having through neglect allowed the pas- sage to become again contracted to very small dimensions; the os was again quite imperforate ; candles of successive sizes were used to dilate the vagina, which succeeded without any opera- tion ; and on the 28th the os was again pierced, and opened to about its natural size, and a dossil of lint left in the opening. 30th. Some menstrual secretion adheres to the catheter when introduced into the artificial os uteri. ■ October 1st. In passing up the catheter cautiously this morn- ing, it went up so far as to leave no doubt that it must have got into the cavity of the peritoneum through an ulcerated opening; she immediately complained of pain of abdomen and loins, similar to what she usually experienced during the menstrual period; she was immediately placed under the most active mercurial treatment. About 5 o'clock she was reported to be very ill; pulse was then 112, and small and hard; she had had rigor during the day ; skin was hot; tongue foul; excessive tenderness on pressure ex- isted over the uterus, and in the right iliac region; she was