DINAPORE DISPENSARY. CASE OF RUPTURE OP THE UTERUS.
By
"W. A.
Gardiner,
Assistant
Surgeon,
R. A.
1 send you the following notes of a case of rupture of the uterus which occurred in the dispensary practice here, as such cases are fortunately rare, and in this one several of the symptoms which books give us as most prominent, were absent. On the 2nd of March last, the police gave notice that a woman was lying in her house in the bazar in a very bad state, having been in labor for several days. I sent the native doctor to see her, and he had her brought to the dispensary in a dooly, where I saw her. She was a young woman of about 27 years of age, and had two children before. She told me that labor had been fully established tive days previously, and that the pains had been very severe, and constant, but that no proirade. She was very much exhausted gress was by the want of rest and the long continued pain ; but her pulse was fairly full, although fast, and the surface warm. No htetnorrhuge had taken place, nor was there any thing in her history to lead me to suppose that so grave an accident as rupture had happened. There was a very offensive discharge from the vagina. I found one foot lying partly in and partly out of the vagina, and from its condition, I kuew the child must have been dead some days ; the abdomen was tense, and very tender over the right side, where I felt the head very plainly, with the structures between it and my hand so thin, that I at once suspected rupture of the womb had taken place. I gave her stimulants freely, and proceeded to deliver her, by hooking down the other foot and leg, which was folded on the body, and then getting down the arms one after another. What with the decomposed condition of the body, and the powerfully contracted state of the uterus, this was effected with the greatest difficulty. The head was lying free in the abdomen, external to the uterus; the rent in which was tightly clasping the neck. I first got the head back into the uterus, by passing my hand high up in it, and forcibly drawing on the lower liinos. My hand several time3 was rendered quite powerless by the uterine contractions, and notwithstanding the uterus had been in action over four (lays, and was ruptured, it took almost all effect my strength exerted continuously for nearly two hours to delivery. The child was hydrocephalic, which had no doubt exaggerated the difficulty. I gave her opium and brandy very freely, but she sank from exhaustion in 8 hours. Post-mortem the examination showed a rent in the upper and right side ol uterus about four inches long, the edges of which were soft,
July 1, 1871.]
VACCINATION AND SYPHILIS.
jagged and nearly black; the greater part of the organ was of a deep livid color. The womb was fairly contracted; no haemorrhage had taken place into the abdomen; but extensive peritonitis had begun.
143
By
"W. A.
Gardiner,
Assistant
Surgeon,
R. A.
1 send you the following notes of a case of rupture of the uterus which occurred in the dispensary practice here, as such cases are fortunately rare, and in this one several of the symptoms which books give us as most prominent, were absent. On the 2nd of March last, the police gave notice that a woman was lying in her house in the bazar in a very bad state, having been in labor for several days. I sent the native doctor to see her, and he had her brought to the dispensary in a dooly, where I saw her. She was a young woman of about 27 years of age, and had two children before. She told me that labor had been fully established tive days previously, and that the pains had been very severe, and constant, but that no proirade. She was very much exhausted gress was by the want of rest and the long continued pain ; but her pulse was fairly full, although fast, and the surface warm. No htetnorrhuge had taken place, nor was there any thing in her history to lead me to suppose that so grave an accident as rupture had happened. There was a very offensive discharge from the vagina. I found one foot lying partly in and partly out of the vagina, and from its condition, I kuew the child must have been dead some days ; the abdomen was tense, and very tender over the right side, where I felt the head very plainly, with the structures between it and my hand so thin, that I at once suspected rupture of the womb had taken place. I gave her stimulants freely, and proceeded to deliver her, by hooking down the other foot and leg, which was folded on the body, and then getting down the arms one after another. What with the decomposed condition of the body, and the powerfully contracted state of the uterus, this was effected with the greatest difficulty. The head was lying free in the abdomen, external to the uterus; the rent in which was tightly clasping the neck. I first got the head back into the uterus, by passing my hand high up in it, and forcibly drawing on the lower liinos. My hand several time3 was rendered quite powerless by the uterine contractions, and notwithstanding the uterus had been in action over four (lays, and was ruptured, it took almost all effect my strength exerted continuously for nearly two hours to delivery. The child was hydrocephalic, which had no doubt exaggerated the difficulty. I gave her opium and brandy very freely, but she sank from exhaustion in 8 hours. Post-mortem the examination showed a rent in the upper and right side ol uterus about four inches long, the edges of which were soft,
July 1, 1871.]
VACCINATION AND SYPHILIS.
jagged and nearly black; the greater part of the organ was of a deep livid color. The womb was fairly contracted; no haemorrhage had taken place into the abdomen; but extensive peritonitis had begun.
143
