Page:Clinical Lectures on the Diseases of Women.djvu/14

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

bloody discharge, which is not fetid. Ordered to have daily a drachm of liquid extract of ergot. After a fortnight, there being no diminution of the bulk of the uterus, and irregular haeinorrhagic losses persisting, the cervix was dilated by tangle-tent. On the introduction of the tent, haemorrhage began suddenly, and proceeded to an alarming extent, two pints being the quantity estimated as lost within fifteen minutes. Mr. Garstang injected through a hollow probe a drachm of tincture of perchloride of iron diluted with an equal quantity of water, with no result. A small fiddle-shaped india-rubber bag was now introduced within the cervix. It stopped the haemorrhage. At 11 a.m., about thirteen hours after the haemorrhage, the bag was a second time expelled. Xo recurrence of haemorrhage. At 3 p.m. she was placed under the influence of ether, and the hand introduced into the vagina, two fingers with some difficulty into the uterus. On the posterior wall of the uterus was felt a projecting, moderately hard, wart-like mass of irregular form, and of extent equal to nearly two inches square. At first it was supposed to be a malignant out- growth, but as a line was found at which it could be detached, it was recognised as placental. Some difficulty was experienced in removing it by a sawing motion of the nails of the fingers in the uterus. About eight ounces of blood were lost during the operation ; but afterwards there was only a moderate amount of blood-tinted discharge. The mass was placental. On its foetal surface were only small patches of chorion. It was about a third of an inch thick, and dense in structure. The section was greyish- yellow, and bloody, it being almost certain that blood had continued to circulate in some of the sinuses, so maintaining the vitality of the mass. From these sinuses, where utero- placental, the flooding took place. The use of ergot was continued. Nine days after the operation the uterus mea- sured nearly three inches and a half only. The cervix felt