A Case of Pregnancy which terminated fatally, zcith
an Account of an unusual Appear anee of the Uterus, by
Cit. Neyronis. Communicated by our jennifershepherd@example.org.
THE author tells us that he was called to a woman
aged 42, who was then pregnant of her thirteenth child.
The account she gave of herself was, that at the fifth
month she had some flooding which lasted four days, ac-
companied by very sharp pains in the loins and cramps in
the extremities. These complaints returned again on the
seventh month. When Cit. N. was called she laboured
under a third attack, more severe than the preceding, and
from the strength and nature of the pains he had reason to
expect a speedy delivery. He had remarked, however,
that there was not the least appearance of dilatation of the
os tinea?. She complained much of a sense of weight
towards
Cit. Neyroni's Case of Pregnaney. 471
Wards the orifice of the. womb, and which she referred
lo the right side when- she lay oil the right, and vice versa.
On questioning her more particularly, she said, that she
had not perceived the child stir for five days; the pains,
losses, and other circumstances just described had conti-
nued four days; the waters had been discharged since the
first. From the resistance- which the matrix ofiered, he
thought it necessary to bleed her twice; many clysters
and baths were had recourse to, without any advantage
whatever. The pains ceased suddenly, and the patient very
soon expired. The author tells us that he proceeded im-
mediately to open the body, when the following appear-
ances presented themselves : On cutting through the inte-
guments, muscles, &e. into the uterus he found a male
child, the head of which wras of a monstrous size without
being dropsical, measuring 22 inches in circumference; the
epidermis came off on the least touch. He found the ma-
trix three inches thick towards* its fundus, particularly
where it lies towards the bladder ; but what most surprised
him was, that its thickness at the neck was not so consi-
derable, and which was nearly in its natural state. This
thickness, or rather carcinomatous appearance, the author
asks, was it not the cause of the floodings as well of pre-
venting the pains from affecting the neck of the uterus so
as to produce dilatation ? What was to be done, he asks,
to remedy a similar defect? Ought the Caisarean operation
be resorted to when every circumstance showed the child
to be dead? Lastly, he asks, was it advisable or practicable
when it was clear that the uterus itself made no efforts tom
discharge its contents ? These questions the author puts
without attempting to solve them, and contents himself
with proposing the facts.
critical


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