Observations on hypertrophy, / by Evory Kennedy.

Date:
1838
Catalogue details

Licence: Public Domain Mark

Credit: Observations on hypertrophy, / 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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    state of the os as a cavise of tedious labour ; a fact naturally to be'explained less upon the obstruction afforded from the bulk of the enlarged and protruding lip, than from the inter- ference or restraint exerted by the affection upon the efficient and natural contraction of the uterus. The practice to adopt in these cases, is to press the pro- truding lip very gently upwards, and retain it there with the fingers during two or three pains; this is very easily accom- plished, the tumour in general remaining, or the head appearing to be pressed down beyond it. If, on the contrary, it show any disposition to descend, then the finger may be retained for some time longer within the vagina, in order to keep the part up ; or, if this fail, a small piece of soft sponge may be pressed up, so as to rest at the upper part of the space through which the lip protrudes, and prevent its relapse. This simple mani- pulation we have found to act most beneficially ; the head, although perhaps resting for many hours previously without advance, coming down quickly, and the delivery being speedily accomplished. In some cases, where, from the extremely pro- truded state of the lips, and the want of room between the head and pubis, the tumour cannot be reduced, but rather increases in size, and the head remains without any advance, we have derived benefit from puncturing the protruding hp with a lancet: one, two, or three, slight punctures being fol- lowed by a slight discharge of blood and serum, a diminution in the distention, and marked benefit to the progress of the labour. In certain cases, generally those of protracted labour, one of the lips of the os (occasionally both) become infiltrated and edematous; this oedema occurs with extraordinary rapidity. The os uteri that was perfectly natural, and of its ordinary size at the commencement of the labour, becoming, in a few hours, very much distended and pendulous. If the fluid ritt* n infiltrated into the cellular tissue of the part be clear, no dis- coloration is perceptible in the tumour; on the contrary it is