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

  • Dewees, William P. (William Potts), 1768-1841.
Date:
1843
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 Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.

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    distended to its utmost bearing; extremely black; and nothing but the internal surface of the labium presented itself. Before I arrived, however, the tumour had burst, from the efforts made to expel the second child. When I examined the patient, there was little swelling remaining in the labium, but there was disco- vered a considerable opening from its superior portion to its in- sertion in the perineum. The second child was well situated; pelvis faulty; pains pretty frequent and severe; and great pain was experienced immediately above the pubes. In about fifteen minutes after my seeing the patient, the labium was again dis- tended, and again it discharged itself: this took place four times before the birth of the child. This frequent bursting destroyed the connexion of the labia with each other so completely, as to leave nothing but the common skin at the perineum to support the pressure of the child's head when passing through the exter- nal parts; this proved insufficient to sustain the force with which it was urged against it, and an extensive laceration, even to the verge of the anus, took place, notwithstanding every precaution which a timely fear could suggest. She lost from the part, by this laceration, at least twelve ounces of blood. 25. Complains of no soreness in the parts ; the swelling nearly subsided; is feverish; some slight after-pains; passes no water; ordered a tea-spoonful of the sweet spirit of nitre, and a purga- tive enema. 26. She passed water freely, after the sweet spirit of nitre and the enema. From this time but little inconvenience was expe- rienced, except that which arose from the lacerated perineum. She was confined for some time to a horizontal posture, and at the end of the month was pretty well recovered. This case differs very much from the two about to be related, first, in the blood being discharged from the tumour almost as soon as formed; secondly, in the integrity of the perineum being very much injured by the repeated yielding of the labial tumour, and in laceration being inevitable; thirdly, in the wound healing up in the labia without trouble, in consequence of its cellular structure retaining no coagula. Case II.—1809, July 2nd. Mrs. A. was delivered, at 11 o'clock, A. M., of her second child, which was very large, after a severe labour of four hours. She appeared very well after de- livery, except the frequent recurrence- of severe after-pains, which, however, were relieved by the use of opium. At 9 o'clock, P. M., she complained of much pain, soreness, and ten- sion, in the right labium pudendi, which upon examination, was found to be much swelled; it continued to increase until it ac- quired a very large size, and quickly became vesicated. The in- ternal lining of the labium was stretched to extreme thinness; was very black; and studded all over with little blisters, which