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Bedford of Sydney, according to Aveling, relates the story of a case in which malpractice was suspected on a woman of thirty-seven, who died while pregnant with her seventh child. The body was exhumed, and a transverse rupture of the womb six inches long above the cervix was found, and the body of a dead male child lay between the thighs.
Shortly after the first coitus her abdomen began to enlarge, the breasts to develop, and the areolae to darken. In seven months the abdomen presented the signs of pregnancy, but the cervix was soft and patulous; the sound entered three inches and was followed by some hemorrhage.
The mother's firm body gave her extraordinary pleasure, yes, not infrequently it led to the expulsion of a secretion from the cervix uteri. The patient had in fact suffered in her first year a concussion of the brain, through being thrown against a brick wall, with organic eclamptic attacks as a result.
The neck, or cervix, is somewhat spindle-shaped, and has a canal running through its center which opens by a small aperture the so-called external orifice, into the vagina. In the virgin uterus the apposition of the anterior and posterior walls reduces the cavity to little more than a longitudinal cleft. With the advent of old age the whole organ suffers marked atrophy.
Upon the cessation of the action, as related, the os suddenly closed, the cervix again hardened itself, and the intense congestion was dissipated." Paul Mundé has described "the gushing, almost in jets," of this mucus which he has observed in an erotic woman under a rather long digital and specular examination.
The patient first discovered her peculiar condition by a stain of blood upon the night-gown on awakening in the morning, and this she traced to the breast. From an examination it appeared that a neglected lacerated cervix during the birth of the last child had given rise to endometritis, and for a year the patient had suffered from severe menorrhagia, for which she was subsequently treated.
Small polypi may be treated by torsion or astringents. If cut, there is likely to be a subsequent abortion. Large polypi removed toward the close of pregnancy will cause hemorrhage. Carcinoma of the cervix should be removed at once. A few of the examples on record of operations during pregnancy of special interest, will be given below.
About 3 1/2 inches above the umbilicus there was a sulcus with its convexity downward. There was dulness over the whole abdomen, except at the sides parallel with the lumbar spines, and a resonant band over the stomach. The greatest girth was 54 1/2 inches. By vaginal examination the cervix was found to be pulled up and obliterated; the anterior vaginal wall was bulged downward by the tumor.
The second was a duplicate of the first, excepting that a few bands extended from the cervix to the membranous septum. In the third the lumen of the vagina, about two inches from the introitus, was distinctly narrowed by a ridge of tissue. There was uterine displacement and some endocervicitis, but no history of injury or operation and no tendency to contraction.
Zacutus Lusitanus relates the history of a case of uterine occlusion, with the flow from the lips of the cervix. There is mentioned an instance of menstruation from the labia. The occurrence of menstruation after removal of the uterus or ovaries is frequently reported.
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