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The tumor had been present three years, but the patient and her family refused an operation until the size of the tumor alarmed them. Its largest circumference was five feet 11 inches. The distance from the xiphoid to the symphysis pubis was three feet. The tumor was covered with veins the size of the little finger.
The most striking feature is the extreme lordosis, accompanied usually by a secondary and compensatory curve in the cervico-dorsal region, so that the shoulders are rounded, with the head poked forward. Viewed from in front the abdomen is seen to be prominent, overhanging the symphysis pubis, while the shoulders have receded far backwards.
She had a very broad pelvis, two imperfectly developed legs, and a supernumerary limb attached to the symphysis, without a joint, but with slight passive movement. There was a duplication of bowel, bladder, and genitalia. At the junction of the rudimentary limb with the body, in front, were two rudimentary mammary glands, each containing a nipple.
There was another burn, 12 inches long and three inches wide, passing from just above the crest of the ilium forward and downward to the symphysis pubis. The next burn began at the patella of the right knee, extending to the bottom of the heel, upon reaching which it wound around the inner side of the leg.
There was a wound of the perineum, and penetration of the posterior wall of the vagina, with complete separation of the soft parts from the symphysis pubis, and extrusion of the bladder.
He married in 1870, and upon being told that he was a father he slit up the hypogastrium from the symphysis pubis to the umbilicus, so that the omentum protruded; he said his object was to obtain a view of the interior. Although the knife was dirty and blunt, the wound healed after the removal of the extruding omentum. A year later he laid open one side of the scrotum.
The testis, with the mesonephros, forming the epididymis, closely attached to it, projects into the coelom, and without losing its connexion with the peritoneum changes its position gradually during development, passing backwards and downwards until it comes to lie over the wall of the abdomen just in front of the pubic symphysis of the pelvic girdle.
While, on the other hand, the produced rostral form of the snout, the long symphysis, and the low coronary process of the mandible are approximations to the cetacean form of those parts.
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.
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.
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