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HOTEL-DIEU.
670 swan’s
WESTMINSTER HOSPITAL.
egg.
Mr. White examined ber (b
forenoon, and pronounced the disease tt be scirrhus uteri.
She refers
no
pain to the
uterus. SCIRRHUS OF THE UTERUS.
ELIZABETH COOPER, aetatis 49, entered 15th Julyy 1829, and was received under the care of the senior physician, having suffered a long while from red discharge e vagina. The patient states, that during infancy and childhood, she was of delicate health, but suffered the usual complaints of those pe. riods very favourably. At fifteen the catamenia appeared ; during maidenhood she enjoyed tolerable health, and was of a remarkably spare habit ; the menstrual periods were very regular, and the flux was not attended with pain. In her 22d year she was married, was twice piegnaut, and, at the full period of gestation, gave birth to two children, who are living. During 21 years of wedlock she enjoyed average health. After the birth of the first child, the bowels had always a diarrhoeal tendency, and were excited by the slightest emotion. She suffered a good deal from headach, which was ascribed to her sedentary habits, being employed as a semptress ; up to her 46th year sne was remarkably ttiin ; at this time was experienced her first attack of menorrhagia. For the last three years this discharge has been constant, with only one intermission of a month, the daily secretion amounting, on an average, to eight ounces, a great
20. Colic pains ; increase of discharge. grain of opium, taken three times daily. 21. Purging; and hæmorrhage from the womb ; the discharged fluid coagulates.Cordial and opiate draughts. X8. For the last week has appeareU to rally, the chief inconvenience beingaa flatu-
A
which was always relieved by carmnatives. Eats a mutton chop daily, and has increased in strength. The flux very much
lency,
abated.
August 1. The pain of boweis and loins has returned, and the discharge in a less degree. The opium continued, and a gill of port wine to be drunk every day. 10. The strength lessened daily; three days since the hæmorrhagic flow entire!’; ceased ; she has no pain of hypogastrium; sordis gathered on the gums and lips; occa. 4
sional vomiting and purging. Died quietly this morning. Autopsy sixteen hours after death. Soon after the woman’s decease, the beu, was removed by the husband, and it was with difficulty permission could be obtained to inspect the pelvic viscera. The uterus was found to be once and a half the na. tural bulk ; incipient dropsy existed in both ovaries, the right being about the size of a chesnut, and the left about the size of a increase, however, always taking place at small apple. The structure of the fundus each revolution of the menstrual epoch. She and corpus uteri was healthy, the lining gradually acquired obesity, and is now ex- mucous membrane being of natural tint; but tremely corpulent. About a year ago her the structure of the cervix and os was en. strength began to diminish with the in- tirely altered, being exactly analogous to creasing flux; and pain in the loins, varying that of medullary sarcoma; the surface in severity, supervened. On admission the was lubricated with a puriform fluid. The case stood as follows :-Stature tall, form was relaxed, and its inner tunic vagina round, extremely fat ; colour of surface yelthickened. lowish white; expression indicative of ute- appeared rine disease ; eyes dull; muscles flabby ; tongue furred; skin hot and dry; pulse 84, sharp and resisting ; bowels open ; oppresHOTEL-DIEU. sive sense of debility; and a dull pain in the loins. Cupped on the loins to ten ounces ; a pill of a grain of opium, and a ANEURISM OF THE POPLITEAL ARTERY.— LIGATURE OF THE FEMORAL, FOLLOWED grain of superacetate of lead, given every BY GAJ’GRENE AND DEATH. night ; an ounce of castor oil every morning, and a drauglit of sulphate of magnesia; in. F. B., a man thirty-iive years of age, of 1ll fusion of roses, and dilute sulphuric acid, irritable temper, and in the habit of drin!dr! thrice a day. much wine, having, during the last two 19. The cupping has relieved the pain of years, been subject to violent palpitation of the loins ; the feverish symptoms have abat- the heart and dyspnœa, had, since t’4: ed. A discharge of grumous blood, amount- periud, been in the habit of being bled ese:r ing to nearly two pints, took place this two months. Five years ago be felt, for u.: morning whilst at stool. Feeble pulse; first time, pain in the ham, whicii dissatongue broad and flabby. On introducing peared under an anti-rheumatic treatment the finger per vaginam, the os tincæ was but returned at irregular intervals, and, at the found large enough to admit three fingers, commencement of last year, became mare vioand its margin hard and rugged ; the uterus lent than ever. Under the use of a comappeared to the touch about the size of a pressive bandage it subsided, but, in Oc-
671
better, but still complained of burning pain along the limb, the lower portion of which
tober last, again returned, and was accompanied by a tumour in the ham, which pulated strongly, and was readily recognised for aneurism. The application of leeches caused temporary relief; the pain, however, soon returned with increased intensity, so that the patient was obliged to apply at the
On the 28th the toes were inand was codematous ; the countenance was greatly altered ; he was ordered wine and beef tea, On the 26th, the internal ancle was found Hutel-Dieo, where he was admitted in Feb-. covered with ecchymoses, and at the externuary last. The pulsation of the heart was nal side of the foot there was a vesicle filled talent and irregular ; that of the aorta and with brownish serum ; the limb was foment. the principal arteries were also very strong, ed with spirit of camphor. On the 27t!j, and accompanied by 11 bruit de soufflet," the foot was quite cold ; a large abscess had xud visibly raised the parietes of the thorax; formed above the wound, through the upper of the carotids, brachial, and angle of which a great quantity of sanious tite amoral arteries, and even of those of the matter was discharged. On the 28th, and articulations, were of unusual strength, and the first of March, the same symptoms condistinctly visible. The aneurism, which was tinued. On the 2nd, a counter aperture of the size of a hen’s egg, and perfectly was made at the upper part of the abscess, compressible, but very tender, offered vio- which extended as high as the iliac spine ; lent pulsations, synchronous with those of the foot was quite insensible, and covered the heart, and accompanied by bruit de with gangrenous plilyctenee ; the general soufflet; the skin over it was healthy, and health of the patient was but slightly afthe foot cedematous. He was greatly ema- fected. On the 5th, the violent pain in the ciated, and complained of headach and gid- limb had changed into a very unpleasant dmess; respiration appeared but slightly pricking sensation; the wound at the thigh affected; digestion was undisturbed. M. suppurated profusely. On the 9th, the nineDapuytren hesitated for a considerable time teenth day after the operation, the ligature belore he decided upon the operation, as it came away. From the 10th, the strength appeared that, besides the aneurism, the of the patient began to sin1;:; the gangrene patient was affected with hypertrophy of the I slowly proceeded, so as to extend, on the heart and disorder of the whole arterial systo two inches above the ancles. On tem ; on the other hand, the aneurism in- the 18th, there were great debility and difcreased in size, without exhibiting any ten- ficulty of respiration, and he died on the dency to form a coagulum, and a fatal ter- evening of the 19th. mination by haemorrhage was to be anticipatPost-mortem Exanzinataon. ed. The patient was bled from the arm, On examining the body, the lungs were and the operation performed on the 20th of February, in the usual manner. The found healthv, the heart double its usual of the left ventricle were ,emoral artery was almost double its usual size ; the size, and surrounded by very firm cellular more than an inch in thickness ; the internal tissue; the application of the ligature did lining of the heart was healthy, The aorta not cause much pain, and the wound was was down to three inches below the diaunited by the first intention. Two hours phragm, beset with yellow patches, which, alter the operation, the patient complained on closer examination, were found to proceed cf violent burning pain along the whole from a cartilaginous and steatomatous degeL:r,b, especially at its lower portion ; the neration of the muscular coat ; the caiotids pulsation of the arteries was very vio- were healthy, but on several points of the lent, the pulse 140, the face rather flush- arterial system, the muscular coat had uned. He was bled, and took a small dose dergone the same morbid alteration as that oi æther and opium, but passed a very rest- of the aorta. The parietes of the femoral less night. On the following day the vio- artery were of greater thickness and firmlent along the limb continued ; the ness than usual ; it had been tied about aneurism did not pulsate; the limb was! three inches below the profunda ; the rather cold ; the pulse 125. On the 22d, fibrinous clot above the ligature was about the patient had bled from the nose ; eight lines in length ; that below it was terer was increased ; the pulse 135; somewhat shorter ; the internal and muscuthe "!:Ib rather cold. The wound had not unit- lar coats were completely divided by the ed, butsuppuration appeared healthy. Rep. ligature, and their extremities, which formed zenaesect. In the course of the following a circular ring, were distant from each other the patient had two attacks of syn- about six lines. The aneurismal tumour On the 23d, slight erysipelas round was of an oval form, and exhbited an incope. the wound and stance of a general dilatation of the three swelling of the very feverish and rather irritable ; arterial coats; at its lower portion only the the thigh was covered with an emollient internal membrane was destroved, and formed was
cold.
sensibie ; the limb felt numb,
pulsation
14th,
parietes
pain
the
thigh.-
He was
.
On the 24th he seemed
a
little
a
circular aperture, which
led
into
an acces-
672 sory aneurism, as it were, formed by the ! pressed on the uterus, and thus greatly external coat only, and filled with a white moted its prolapse. The same having ’ -. fibrous clot, of little density. The popliteal done on the other side, the fallopian vein was strongly adherent to the sac, and were comprised within strong ligatures._. completely obliterated, the venous circula- M. Recamier had iutended to dinoe t.. tion of the limb having been carried on by posterior portion of the vagina in the M.means of the saphena external, which wasmanner as the anterior, viz. fromhelow L: considerably dilated. A great quantity ofwards ; he found, however, that the space purulent matter was found round the femoral was so considerably diminished by tLe cal.change artery, and between the abductor muscles. cerous tumour, that he was The abdominal organs were healthy; in the his plan, and to terminate the operation small intestines two tape-worms were found from above downwards ; the round and broad alive, and eight feet long each.-Rev. Med. ligaments, and the portion of the peritoneum which was still adherent, were a:. cordingly divided, and the body of the ute. EXTIRPATION OF THE UTERUS. rus being turned anteriorly and downwards, Agatbe B. setat. 50, of a nervous tempe- as much of the vagina as was considered to rament, was admitted on the 24th of July, be diseased, was detached by means of a 1829. Up to her fortieth year, she had been probe-poiuted bistoury from the anterior in the enjoyment of good health ; from this paries of the rectum. Immediatelv after hut period, however, menstruation became irre- the extraction, the epiploon gular, accompanied by a discharge of very was immediately reduced, and kept up. fetid bloody mucus, and at the same time she The whole operation lasted no longer than lost her appetite, fell away, &c. There was twenty minutes. On the 30th of J ulv, the hardly any pain in the uterine region ; duro third day after the operation, the patient ing the last three months only, the evacua- was going on very favourablv. The upper portion of the uterus was, on tion of faeces had caused a slight pain; the urine was clear, and passed without any dissection, found to be healthy ; its lower pain or difficulty. On examination through part was very hard, and evidently surthe rectum, a very hard prominent tumour rhous. The portion of the vagina, which was felt at the neck of the uterus ; the pos- was adherent to the posterior part of tl,e terior surface of the uterus itself appeared cellum uteri, was much softened.—Lane. healthy. On examining per vaginam the Franç. anterior lip of the os uteri was found degenerated into a very hard uneven tumour ; the posterior was rather small, but uneven ; the finger readily entered into the cavity of TO CORRESPONDENTS. the uterus, the tissue of which appeared The anterior the softened. paries of vagina was diseased at its uterine extremity only ; COMMUNICATIONS received from Mr. the posterior was ulcerated and softened up Wymer-Mr. Grose—Mr. to the prominence formed by the enlargement R. Fishwick—Dr. Penneck— of the anterior portion of the os uteri. The Mr. Randell-A Practitioner-C. R. B. examination wasfoliowed by a slight hæmorChirurgus must favour us with his name rhage ; the sanious discharge from the va- and address, before we can ofièr him a gina was, at the time of the patient’s admis- opinion on the subject he mentions. The letters of Dr. Penneck, Alexander sion, more copious than ever, and diffused a hornble fcetor around her. On the 26th of Amicus Scientiae, and Mr. T. L., next week July, the operation was performed in the C. R. B. We can speak in unqualified following manner:—The patient being terms of praise of the London University placed in the same situation as for litho- as a medical and surgical school.—Guy’s tomy, M. Recamier, without the assist- Hospital is certainly the last we should reance of a speculum, seized the anterior porcommend. Medical Students shall re tion of the neck with a curved forceps, ample information on the subject cf)!; and, by pulling it gently, succeeded in mak- hospitals and schools in the pages of il.,.i ing it descend between the labia. A trans- Journal, before the first ’of October. Lf: verse incision having now been made into them not precipitately enter to any insthe anterior portion of’ the vagina, three tution, and avoid, most studioush, 1-,lines from its insertion into the neck, the booking system" at Guy’s. We adver operator carried his fingers between the blad- them to be careful of their cash, and to r der and uterus, and having detached the ware of every description of shark of the hospitals and peritoneum, reached with his fore finger up to the free margin of the broad ligament,of anatomy. which was readily seized, and brought down, The case mentioned by Chirur;e:3 -: while the finger in the rectum aa private one, and we cannot interfere.
obiged to
protruded,
,Hadley—Dr.
Holland—Dr.
neighbourhood
forcibly
WESTMINSTER HOSPITAL.
egg.
Mr. White examined ber (b
forenoon, and pronounced the disease tt be scirrhus uteri.
She refers
no
pain to the
uterus. SCIRRHUS OF THE UTERUS.
ELIZABETH COOPER, aetatis 49, entered 15th Julyy 1829, and was received under the care of the senior physician, having suffered a long while from red discharge e vagina. The patient states, that during infancy and childhood, she was of delicate health, but suffered the usual complaints of those pe. riods very favourably. At fifteen the catamenia appeared ; during maidenhood she enjoyed tolerable health, and was of a remarkably spare habit ; the menstrual periods were very regular, and the flux was not attended with pain. In her 22d year she was married, was twice piegnaut, and, at the full period of gestation, gave birth to two children, who are living. During 21 years of wedlock she enjoyed average health. After the birth of the first child, the bowels had always a diarrhoeal tendency, and were excited by the slightest emotion. She suffered a good deal from headach, which was ascribed to her sedentary habits, being employed as a semptress ; up to her 46th year sne was remarkably ttiin ; at this time was experienced her first attack of menorrhagia. For the last three years this discharge has been constant, with only one intermission of a month, the daily secretion amounting, on an average, to eight ounces, a great
20. Colic pains ; increase of discharge. grain of opium, taken three times daily. 21. Purging; and hæmorrhage from the womb ; the discharged fluid coagulates.Cordial and opiate draughts. X8. For the last week has appeareU to rally, the chief inconvenience beingaa flatu-
A
which was always relieved by carmnatives. Eats a mutton chop daily, and has increased in strength. The flux very much
lency,
abated.
August 1. The pain of boweis and loins has returned, and the discharge in a less degree. The opium continued, and a gill of port wine to be drunk every day. 10. The strength lessened daily; three days since the hæmorrhagic flow entire!’; ceased ; she has no pain of hypogastrium; sordis gathered on the gums and lips; occa. 4
sional vomiting and purging. Died quietly this morning. Autopsy sixteen hours after death. Soon after the woman’s decease, the beu, was removed by the husband, and it was with difficulty permission could be obtained to inspect the pelvic viscera. The uterus was found to be once and a half the na. tural bulk ; incipient dropsy existed in both ovaries, the right being about the size of a chesnut, and the left about the size of a increase, however, always taking place at small apple. The structure of the fundus each revolution of the menstrual epoch. She and corpus uteri was healthy, the lining gradually acquired obesity, and is now ex- mucous membrane being of natural tint; but tremely corpulent. About a year ago her the structure of the cervix and os was en. strength began to diminish with the in- tirely altered, being exactly analogous to creasing flux; and pain in the loins, varying that of medullary sarcoma; the surface in severity, supervened. On admission the was lubricated with a puriform fluid. The case stood as follows :-Stature tall, form was relaxed, and its inner tunic vagina round, extremely fat ; colour of surface yelthickened. lowish white; expression indicative of ute- appeared rine disease ; eyes dull; muscles flabby ; tongue furred; skin hot and dry; pulse 84, sharp and resisting ; bowels open ; oppresHOTEL-DIEU. sive sense of debility; and a dull pain in the loins. Cupped on the loins to ten ounces ; a pill of a grain of opium, and a ANEURISM OF THE POPLITEAL ARTERY.— LIGATURE OF THE FEMORAL, FOLLOWED grain of superacetate of lead, given every BY GAJ’GRENE AND DEATH. night ; an ounce of castor oil every morning, and a drauglit of sulphate of magnesia; in. F. B., a man thirty-iive years of age, of 1ll fusion of roses, and dilute sulphuric acid, irritable temper, and in the habit of drin!dr! thrice a day. much wine, having, during the last two 19. The cupping has relieved the pain of years, been subject to violent palpitation of the loins ; the feverish symptoms have abat- the heart and dyspnœa, had, since t’4: ed. A discharge of grumous blood, amount- periud, been in the habit of being bled ese:r ing to nearly two pints, took place this two months. Five years ago be felt, for u.: morning whilst at stool. Feeble pulse; first time, pain in the ham, whicii dissatongue broad and flabby. On introducing peared under an anti-rheumatic treatment the finger per vaginam, the os tincæ was but returned at irregular intervals, and, at the found large enough to admit three fingers, commencement of last year, became mare vioand its margin hard and rugged ; the uterus lent than ever. Under the use of a comappeared to the touch about the size of a pressive bandage it subsided, but, in Oc-
671
better, but still complained of burning pain along the limb, the lower portion of which
tober last, again returned, and was accompanied by a tumour in the ham, which pulated strongly, and was readily recognised for aneurism. The application of leeches caused temporary relief; the pain, however, soon returned with increased intensity, so that the patient was obliged to apply at the
On the 28th the toes were inand was codematous ; the countenance was greatly altered ; he was ordered wine and beef tea, On the 26th, the internal ancle was found Hutel-Dieo, where he was admitted in Feb-. covered with ecchymoses, and at the externuary last. The pulsation of the heart was nal side of the foot there was a vesicle filled talent and irregular ; that of the aorta and with brownish serum ; the limb was foment. the principal arteries were also very strong, ed with spirit of camphor. On the 27t!j, and accompanied by 11 bruit de soufflet," the foot was quite cold ; a large abscess had xud visibly raised the parietes of the thorax; formed above the wound, through the upper of the carotids, brachial, and angle of which a great quantity of sanious tite amoral arteries, and even of those of the matter was discharged. On the 28th, and articulations, were of unusual strength, and the first of March, the same symptoms condistinctly visible. The aneurism, which was tinued. On the 2nd, a counter aperture of the size of a hen’s egg, and perfectly was made at the upper part of the abscess, compressible, but very tender, offered vio- which extended as high as the iliac spine ; lent pulsations, synchronous with those of the foot was quite insensible, and covered the heart, and accompanied by bruit de with gangrenous plilyctenee ; the general soufflet; the skin over it was healthy, and health of the patient was but slightly afthe foot cedematous. He was greatly ema- fected. On the 5th, the violent pain in the ciated, and complained of headach and gid- limb had changed into a very unpleasant dmess; respiration appeared but slightly pricking sensation; the wound at the thigh affected; digestion was undisturbed. M. suppurated profusely. On the 9th, the nineDapuytren hesitated for a considerable time teenth day after the operation, the ligature belore he decided upon the operation, as it came away. From the 10th, the strength appeared that, besides the aneurism, the of the patient began to sin1;:; the gangrene patient was affected with hypertrophy of the I slowly proceeded, so as to extend, on the heart and disorder of the whole arterial systo two inches above the ancles. On tem ; on the other hand, the aneurism in- the 18th, there were great debility and difcreased in size, without exhibiting any ten- ficulty of respiration, and he died on the dency to form a coagulum, and a fatal ter- evening of the 19th. mination by haemorrhage was to be anticipatPost-mortem Exanzinataon. ed. The patient was bled from the arm, On examining the body, the lungs were and the operation performed on the 20th of February, in the usual manner. The found healthv, the heart double its usual of the left ventricle were ,emoral artery was almost double its usual size ; the size, and surrounded by very firm cellular more than an inch in thickness ; the internal tissue; the application of the ligature did lining of the heart was healthy, The aorta not cause much pain, and the wound was was down to three inches below the diaunited by the first intention. Two hours phragm, beset with yellow patches, which, alter the operation, the patient complained on closer examination, were found to proceed cf violent burning pain along the whole from a cartilaginous and steatomatous degeL:r,b, especially at its lower portion ; the neration of the muscular coat ; the caiotids pulsation of the arteries was very vio- were healthy, but on several points of the lent, the pulse 140, the face rather flush- arterial system, the muscular coat had uned. He was bled, and took a small dose dergone the same morbid alteration as that oi æther and opium, but passed a very rest- of the aorta. The parietes of the femoral less night. On the following day the vio- artery were of greater thickness and firmlent along the limb continued ; the ness than usual ; it had been tied about aneurism did not pulsate; the limb was! three inches below the profunda ; the rather cold ; the pulse 125. On the 22d, fibrinous clot above the ligature was about the patient had bled from the nose ; eight lines in length ; that below it was terer was increased ; the pulse 135; somewhat shorter ; the internal and muscuthe "!:Ib rather cold. The wound had not unit- lar coats were completely divided by the ed, butsuppuration appeared healthy. Rep. ligature, and their extremities, which formed zenaesect. In the course of the following a circular ring, were distant from each other the patient had two attacks of syn- about six lines. The aneurismal tumour On the 23d, slight erysipelas round was of an oval form, and exhbited an incope. the wound and stance of a general dilatation of the three swelling of the very feverish and rather irritable ; arterial coats; at its lower portion only the the thigh was covered with an emollient internal membrane was destroved, and formed was
cold.
sensibie ; the limb felt numb,
pulsation
14th,
parietes
pain
the
thigh.-
He was
.
On the 24th he seemed
a
little
a
circular aperture, which
led
into
an acces-
672 sory aneurism, as it were, formed by the ! pressed on the uterus, and thus greatly external coat only, and filled with a white moted its prolapse. The same having ’ -. fibrous clot, of little density. The popliteal done on the other side, the fallopian vein was strongly adherent to the sac, and were comprised within strong ligatures._. completely obliterated, the venous circula- M. Recamier had iutended to dinoe t.. tion of the limb having been carried on by posterior portion of the vagina in the M.means of the saphena external, which wasmanner as the anterior, viz. fromhelow L: considerably dilated. A great quantity ofwards ; he found, however, that the space purulent matter was found round the femoral was so considerably diminished by tLe cal.change artery, and between the abductor muscles. cerous tumour, that he was The abdominal organs were healthy; in the his plan, and to terminate the operation small intestines two tape-worms were found from above downwards ; the round and broad alive, and eight feet long each.-Rev. Med. ligaments, and the portion of the peritoneum which was still adherent, were a:. cordingly divided, and the body of the ute. EXTIRPATION OF THE UTERUS. rus being turned anteriorly and downwards, Agatbe B. setat. 50, of a nervous tempe- as much of the vagina as was considered to rament, was admitted on the 24th of July, be diseased, was detached by means of a 1829. Up to her fortieth year, she had been probe-poiuted bistoury from the anterior in the enjoyment of good health ; from this paries of the rectum. Immediatelv after hut period, however, menstruation became irre- the extraction, the epiploon gular, accompanied by a discharge of very was immediately reduced, and kept up. fetid bloody mucus, and at the same time she The whole operation lasted no longer than lost her appetite, fell away, &c. There was twenty minutes. On the 30th of J ulv, the hardly any pain in the uterine region ; duro third day after the operation, the patient ing the last three months only, the evacua- was going on very favourablv. The upper portion of the uterus was, on tion of faeces had caused a slight pain; the urine was clear, and passed without any dissection, found to be healthy ; its lower pain or difficulty. On examination through part was very hard, and evidently surthe rectum, a very hard prominent tumour rhous. The portion of the vagina, which was felt at the neck of the uterus ; the pos- was adherent to the posterior part of tl,e terior surface of the uterus itself appeared cellum uteri, was much softened.—Lane. healthy. On examining per vaginam the Franç. anterior lip of the os uteri was found degenerated into a very hard uneven tumour ; the posterior was rather small, but uneven ; the finger readily entered into the cavity of TO CORRESPONDENTS. the uterus, the tissue of which appeared The anterior the softened. paries of vagina was diseased at its uterine extremity only ; COMMUNICATIONS received from Mr. the posterior was ulcerated and softened up Wymer-Mr. Grose—Mr. to the prominence formed by the enlargement R. Fishwick—Dr. Penneck— of the anterior portion of the os uteri. The Mr. Randell-A Practitioner-C. R. B. examination wasfoliowed by a slight hæmorChirurgus must favour us with his name rhage ; the sanious discharge from the va- and address, before we can ofièr him a gina was, at the time of the patient’s admis- opinion on the subject he mentions. The letters of Dr. Penneck, Alexander sion, more copious than ever, and diffused a hornble fcetor around her. On the 26th of Amicus Scientiae, and Mr. T. L., next week July, the operation was performed in the C. R. B. We can speak in unqualified following manner:—The patient being terms of praise of the London University placed in the same situation as for litho- as a medical and surgical school.—Guy’s tomy, M. Recamier, without the assist- Hospital is certainly the last we should reance of a speculum, seized the anterior porcommend. Medical Students shall re tion of the neck with a curved forceps, ample information on the subject cf)!; and, by pulling it gently, succeeded in mak- hospitals and schools in the pages of il.,.i ing it descend between the labia. A trans- Journal, before the first ’of October. Lf: verse incision having now been made into them not precipitately enter to any insthe anterior portion of’ the vagina, three tution, and avoid, most studioush, 1-,lines from its insertion into the neck, the booking system" at Guy’s. We adver operator carried his fingers between the blad- them to be careful of their cash, and to r der and uterus, and having detached the ware of every description of shark of the hospitals and peritoneum, reached with his fore finger up to the free margin of the broad ligament,of anatomy. which was readily seized, and brought down, The case mentioned by Chirur;e:3 -: while the finger in the rectum aa private one, and we cannot interfere.
obiged to
protruded,
,Hadley—Dr.
Holland—Dr.
neighbourhood
forcibly