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In his "Diseases of Women" Simpson speaks of a fistula left by the passage of an infant through the perineum. Wilson, Toloshinoff, Stolz, Argles, Demarquay, Harley, Hernu, Martyn, Lamb, Morere, Pollock, and others record the birth of children through perineal perforations. Birth Through the Abdominal Wall.
The rectal opening gradually cicatrized, the sac became obliterated, and the woman left the hospital well. Birth Through Perineal Perforation. Occasionally there is perineal perforation during labor, with birth of the child through the opening. Brown mentions a case of rupture of the perineum with birth of a child between the vaginal opening and the anus.
He anesthetized the patient and delivered the child with forceps, and without perineal rupture. There was little hemorrhage, and the placenta was removed with slight difficulty.
Horses running at pasture sometimes become injured by trampling upon pieces of wood, causing one end of these or of various implements to become embedded in the soft earth and the other end to enter at the inguinal region and even penetrate the tissues to and through the skin and fascia just below the perineal region.
Cassidy reports a case of child-birth through the perineum. A successful operation was performed fifteen days after the accident. Dupuytren speaks of the passage of an infant through a central opening of the perineum. Capuron, Gravis, and Lebrun all report accouchement through a perineal perforation, without alteration in the sphincter ani or the fourchet.
In the latter case he can make use of the dream to dismiss the external stimulus, and this, again, in more ways than one. For instance, he can stay the stimulus by dreaming of a scene which is absolutely intolerable to him. This was the means used by one who was troubled by a painful perineal abscess.
J. B., a retired draper, born in 1828, while a youth of seventeen, sustained a fracture of the leg, rupture of the urethra, and laceration of the perineum, by a fall down a well, landing astride an iron bar. A permanent perineal fistula was established, but the patient was averse to any operative remedial measure.
No one approaches him or takes any notice whatever of him. A house is prepared for him which is put in charge of two or three small boys as servants. He may eat only toasted bananas, and only the centre portion of them the ends being thrown away. On the third day of his seclusion a small feast is prepared by his friends, who also fashion some new perineal bands for him. This is called ivi poro.
Old muslin or some of the diapers are generally used for covers. The sanitary pads, also called vulval or perineal pads, absorb the discharge which always occurs after delivery. They are made of absorbent cotton and cotton-batting covered with gauze; a convenient size is ten inches long and three to four inches wide.
In the year 1852 he became aware of the presence of a calculus, but not until 1872 did he ask for medical assistance. He explained that he had introduced a chisel through his perineal fistula to the stone, and attempted to comminute it himself and thus remove it, and by so doing had removed about an ounce of the calculus.
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