On effusions of blood in the neighbourhood of the uterus, or, The so-called periuterine haematocele : a thesis for the M.D. degree / by Henry M. Tuckwell.

  • Tuckwell, Henry M.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: On effusions of blood in the neighbourhood of the uterus, or, The so-called periuterine haematocele : a thesis for the M.D. degree / by Henry M. Tuckwell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    occurring at the time of the catameiiia, may determine a rupture in one of the vessels of the parenchyma of the ovary, and give rise to the so-called apoplexy of the ovary/' In corroboration of this it will be found that in 7 of the 11 cases, in which men- tion is made of the condition of the menses, 5 were subject at the time of, or just before, the attack, to menorrhagia; in the other 2 the first accession of the symptoms was during the men- strual period, and was ushered in by an abrupt suppression of the discharge : cf. cases 24 to 34. E. By mjottire of a varicose vein in the pampiniform plexus of the ovary. Richet^ more than any other observer has studied the anatomy and pathology of these veins : he shews how the veins from the upper part of the vagina, from the fundus and cervix of the uterus, from the round ligament, tuba, and ovary, anastomose freely, and form between the layers of the broad ligament a long-meshed plexus. He further points out that the fact of their being without valves renders them extremely liable to be influenced by any obstruction to the circulation in Ihe vena cava. He has frequently in dissections found them remarkably varicose, so as sometimes to form a mass resembling that met with in varicocele of the spermatic cord. These veins become considerably congested at the time of the catamenia, but are more especially apt to become varicose during pregnancy, or in women who have borne many children: in the latter the veins of the labia are not seldom seen to be varicose, and hence Bernutz, not without reason, suggests, that if hsematocele occur in a preg- nant woman who has varicose veins of the labia, or even of the legs, the probability is great that the veins of the pampiniform plexus are also varicose, and that one of them has burst. Of the whole number of post mortem examinations made, in 4 only was the effusion traceable directly to this source ; in these the quantity of blood extravasated was, as would be anticipated, very large, and death followed in a few hours: cf. cases 35 to 38. CAUSE. Predisposing.—Age. An analysis of 91 cases, in which the age is noted, shews that the greatest tendency to accidents of this kind is met with at the very time of life when the generative Richet, 0J3. cit., p. 736.