Anomalies and Curiosities of MedicineGould, George M. (George Milbrey)
Science
Anomalies and Curiosities of Medicine
Gould, George M. (George Milbrey)
Abnormalities, Human; Medicine -- Anecdotes
The British Medical Journal quotes: "Pinard (Bull. de l'Acad. de Med.,
August 6, 1895) records the following, which he describes as an ideal
case. The patient was aged thirty-six, had had no illness, and had been
regular from the age of fourteen till July, 1894. During August of that
year she had nausea and vomiting; on the 22d and 23d she lost a fluid,
which was just pink. The symptoms continued during September, on the
22d and 23d of which month there was a similar loss. In October she was
kept in bed for two days by abdominal pain, which reappeared in
November, and was then associated with pain in micturition and
defecation. From that time till February 26, 1895, when she came under
Pinard's care, she was attended by several doctors, each of whom
adopted a different diagnosis and treatment. One of them, thinking she
had a fibroid, made her take in all about an ounce of savin powder,
which did not, however, produce any ill effect. When admitted she
looked ill and pinched. The left thigh and leg were painful and
edematous. The abdomen looked like that of the sixth month of
pregnancy. The abdominal wall was tense, smooth, and without lineae
albicantes. Palpation revealed a cystic immobile tumor, extending 2
inches above the umbilicus and apparently fixed by deep adhesions. The
fetal parts could only be made out with difficulty by deep palpation,
but the heart-sounds were easily heard to the right of and below the
umbilicus. By the right side of this tumor one could feel a small one,
the size of a Tangerine orange, which hardened and softened under
examination. When contracted the groove between it and the large tumor
became evident. Vaginal examination showed that the cervix, which was
slightly deflected forward and to the right and softened, as in uterine
gestation, was continuous with the smaller tumor. Cephalic
ballottement was obtained in the large tumor. No sound was passed into
the uterus for fear of setting up reflex action; the diagnosis of
extrauterine gestation at about six and a half months with a living
child was established without requiring to be clinched by proving the
uterus empty. The patient was kept absolutely at rest in bed and the
edema of the left leg cured by position. On April 30th the fundus of
the tumor was 35 cm. above the symphysis and the uterus 11 1/2 cm.; the
cervix was soft as that of a primipara at term. Operation, May 2d:
Uterus found empty, cavity 14 1/2 cm. long. Median incision in
abdominal wall; cyst walls exposed; seen to be very slight and filled
with enormous vessels, some greater than the little finger. On seizing
the wall one of these vessels burst, and the hemorrhage was only
rendered greater on attempting to secure it, so great was the
friability of the walls. The cyst was therefore rapidly opened and the
child extracted by the foot. Hemorrhage was restrained first by
pressure of the hands, then by pressure-forceps and ligatures. The
Public-domain text, read in full here on John Shaqi.
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