The diagnosis, pathology, and treatment of diseases of womem : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis, pathology, and treatment of diseases of womem : including the diagnosis of pregnancy / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Fluctuation is usually present when the tumour is large, but it is not a sign the presence of which can be greatly depended upon. One form of distension to which the uterus is liable, is that pro^ dueed by retention of the menstrual fluid, in young women who have never menstruated. In women who have menstruated also, menstrual retention may occur in consequence of the 08 uteri or the vaginal canal becoming occluded, as after parturition, or by the presence of tumours in the canal of the cervix uteri. (See ' Examination of Uterus from Vagina.') Then there are cases in which purulent collections from various causes take place in the uterus, or in which fluid of a more or less serous character is found distending the organ. The latter class of cases are those which are more particularly described by authors under the term ' hydrometra.' Lastly, cases of pregnancy ; for although, normally, the amount of fluid in the uterus under such circumstances does not entitle the 'enlargement of the uterus due to pregnancy' to be considered in this place, yet occasionally the quantity of fluid present in the uterus, together with the foetus, is very considerable indeed, and it has even been sufficient to obscure the diagnosis of pregnancy in some instances. The diagnosis of these various forms of distension of the uterus is generally to be made out by a careful consideration of the attending circumstances and of the history of the case. They have all of them this in common, that menstruation is absent, a necessary condition of fluid distension of the uterus being closure of the outlet for the menstrual fluid. [The only possible exception, and that only an apparent one, to this statement, is in the case of cancerous disease of the lower part of the uterus occasioning purulent distension of the cavity above, and at the same time, possibly, giving rise to a sanguineous discharge below.] The symptoms produced by men- strual retention in young women who have never menstruated will be found described in the chapter on ' Amenorrhoea.' The physi- cal signs are identical with those of early pregnancy, so far as the abdominal examination is concerned, but the vaginal examination throws light on the matter by revealing the presence of an imper- forate hymen or other occluding barrier to the escape of the menstrual secretion. Enlargement of the uterus due to menstrual retention in women who have menstruated does not very frequently come before us clinically, for the retention rarely proceeds to sucli a degree as to give rise to a considerable enlargement of the uterus. The uterus