A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
The early stage of normal pregnancy is said to have been mistaken for
this disease. I can hardly conceive how this mistake in diagnosis could
be made, although I have met with several cases where the congestion
consequent upon fecundation was so violent as to result in actual
pelvic inflammatory symptoms with subsequent exudation.
The following case, which I saw with H. A. M. Smith of Gloucester,
N. J., markedly illustrates and confirms this opinion: Mrs. B----, æt.
21, had been married five years, but had never conceived. Her catamenia
had always been regular in time, but the flow had been slight in
quantity. In the latter part of November, 1884, or about three months
before I first saw her, she was attacked with severe pain in the
pelvis, accompanied by rise in temperature and accelerated pulse. She
was compelled to go to bed, where she had remained up to the time of
coming under my care. During this time she suffered from great
tenderness over the hypogastrium, some tympanites, and considerable
nausea and vomiting. She {217} did not menstruate in November--the
period was due when she was first attacked with pain--but in December
she had severe uterine tenesmus and a profuse metrorrhagia--symptoms of
abortion. Pregnancy had not been suspected, however, as she had been so
long sterile, and the inflammatory symptoms had been so violent that
the signs of gestation had been masked by them. At the time of my first
visit (March, 1885), there was great tenderness of the hypogastrium
with slight tympanites; nausea and at times vomiting; great nervous
prostration; loss of flesh; menses absent since November, except the
uterine tenesmus and hemorrhage in December, as above stated; and at
each menstrual cycle afterward she had the symptoms of uterine
contraction with a profuse leucorrhoeal discharge, but no hemorrhage.
The mammary glands showed the usual signs of gestation at about the
fourth month; the vagina was purplish; the cervix uteri low down on the
floor of the pelvis, and the mucous membrane around the os
hypertrophied, soft, and abraded. The body of the uterus was anteverted
and symmetrically enlarged to about the size of the organ at the third
month of gestation. The uterus seemed to be fixed--incarcerated within
the pelvic cavity--by an indurated exudation in the lower portion of
the right broad ligament. I diagnosticated pregnancy, and accompanying
parametritis as a result. The treatment consisted in painting the right
side of the fundus of the vagina opposite the base of the broad
ligament with iodine; the application of iodized glycerin on pledgets
of cotton, together with the use of the hot-water douche; internally,
opium enough to relieve pain and an alterative tonic in the form of the
four chlorides, the formula for which will be given at another place.
She began to improve at once, but as she was still threatened with
abortion and the uterus was still incarcerated within the pelvis, ether
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account