按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
s and six months after the mutilation； she was in perfect health。 Walters looked into the statistics of such cases and found 36 accidental removals of the uterus in the puerperium with 14 recoveries。 All but three of these were without a doubt attended by previous inversion of the uterus。
A medical man was tried for manslaughter in 1878 because he made a similar mistake。 He had delivered a woman by means of the forceps； and； after delivery； brought away what he thought a tumor。 This 〃tumor〃 consisted of the uterus； with the placenta attached to the fundus； the funis； a portion of the lateral ligament； containing one ovary and about three inches of vagina。 The uterus was not inverted。 A horrible case； with similar results； happened in France； and was reported by Tardieu。 A brutal peasant； whose wife was pregnant； dragged out a fetus of seven months； together with the uterus and the whole intestinal canal； from within 50 cm。 of the pylorus to within 8 cm。 of the ileocecal valve。 The woman was seen three…quarters of an hour after the intestines had been found in the yard （where the brute had thrown them）； still alive and reproaching her murderer。 Hoffman cites an instance in which a midwife； in her anxiety to extract the afterbirth； made traction on the cord； brought out the uterus； ovaries； and tubes； and tore the vulva and perineum as far as the anus。
Woodson tells the story of a negress who was four months pregnant； and who； on being seized with severe uterine pains in a bath； succeeded in seizing the fetus and dragging it out； but inverting the uterus in the operation。 There is a case recorded of a girl of eighteen； near her labor； who； being driven from her house by her father； took refuge in a neighboring house； and soon felt the pains of child…birth。 The accoucheur was summoned； pronounced them false pains； and went away。 On his return he found the girl dying； with her uterus completely inverted and hanging between her legs。 This unfortunate maiden had been delivered while standing upright； with her elbows on the back of a chair。 The child suddenly escaped； bringing with it the uterus； but as the funis ruptured the child fell to the floor。 Wagner pictures partial prolapse of the womb in labor。
It would too much extend this chapter to include the many accidents incident to labor； and only a few of especial interest will be given。 Cases like rupture of an aneurysm during labor； extensive hemorrhage； the entrance of air into the uterine veins and sinuses； and common lacerations will be omitted； together with complicated births like those of double monsters； etc。； but there are several other cases that deserve mention。 Eldridge gives an instance of separation of the symphysis pubis during labor；a natural symphysiotomy。 A separation of 3/4 inch could be discerned at the symphysis； and in addition the sacroiliac synchondrosis was also quite movable。 The woman had not been able to walk in the latter part of her pregnancy。 The child weighed 10 1/2 pounds and had a large head in a remarkably advanced stage of ossification； with the fontanelles nearly closed。 Delivery was effected； though during the passage of the head the pubes separated to such an extent that Eldridge placed two fingers between them。 The mother recovered； and had perfect union and normal locomotion。
Sanders reports a case of the separation of the pubic bones in labor。 Studley mentions a case of fracture of the pelvis during instrumental delivery。 Humphreys cites a most curious instance。 The patient； it appears； had a large exostosis on the body of the pubes which； during parturition； was forced through the walls of the uterus and bladder； resulting in death。 Kilian reports four cases of death from perforation of the uterus in this manner。 Schauta pictures such an exostosis。
Chandler relates an instance in which there was laceration of the liver during parturition； and Hubbard records a case of rupture of the spleen after labor。
Symphysiotomy is an operation consisting of division of the pubic symphysis in order to facilitate delivery in narrow pelves。 This operation has undergone a most remarkable revival during the past two years。 It originated in a suggestion by Pineau in his work on surgery in 1598； and in 1665 was first performed by La Courvee upon a dead body in order to save the child； and afterward by Plenk； in 1766； for the same purpose。 In 1777 Sigault first proposed the operation on the living； and Ferrara was the one to carry out； practically； the proposition；although Sigault is generally considered to be the first symphysiotormist； and the procedure is very generally known as the 〃Sigaultean operation。〃 From Ferrara's time to 1858； when the operation had practically died out； it had been performed 85 times； with a recorded mortality of 33 per cent。 In 1866 the Italians； under the leadership of Morisani of Naples； revived the operation； and in twenty years had performed it 70 times with a mortality of 24 per cent。 Owing to rigid antiseptic technic； the last 38 of these operations （1886 to 1891） showed a mortality of only 50 per cent； while the infant…mortality was only 10 2/3 per cent。 The modern history of this operation is quite interesting； and is very completely reviewed by Hirst and Dorland。
In November； 1893； Hirst reported 212 operations since 1887； with a maternal mortality of 12。73 per cent and a fetal mortality of 28 per cent。 In his later statistics Morisani gives 55 cases with 2 maternal deaths and 1 infantile death； while Zweifel reports 14 cases from the Leipzig clinic with no maternal death and 2 fetal deaths； 1 from asphyxia and 1 from pneumonia； two days after birth。 All the modern statistics are correspondingly encouraging。
Irwin reports a case in which the firm attachment of the fetal head to the uterine parietes rendered delivery without artificial aid impossible； and it was necessary to perform craniotomy。 The right temporal region of the child adhered to the internal surface of the neck of the uterus； being connected by membranes。 The woman was forty…four years old； and the child was her fourth。
Delay in the Birth of the Second Twin。In twin pregnancies there is sometimes a delay of many days in the birth of a second child； even to such an extent as to give suspicion of superfetation。 Pignot speaks of one twin two months before the other。 De Bosch speaks of a delay of seventeen days； and there were 2 cases on record in France in the last century； one of which was delayed ten days； and the other showed an interval of seven weeks between the delivery of the twins。 There is an old case on record in which there was an interval of six weeks between deliveries； Jansen gives an account of three births in ten months； Pinart mentions a case with an interval of ten days； Thilenius； one of thirteen days； and Ephemerides； one of one week。 Wildberg describes a case in which one twin was born two months after the other； and there was no secretion of milk until after the second birth。 A full description of Wildberg's case is given in another journal in brief； as follows： A woman； eighteen months married； was in labor in the eighth month of pregnancy。 She gave birth to a child； which； though not fully matured； lived。 There w