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The majority of the cases of labor extend over a period of from twelve to twenty-four hours. Sometimes the external opening of the vagina does not dilate enough to allow the passage of the child. As the head presses hard against the perineum it tears it. This tear should be repaired immediately after completion of labor.
After labor, sloughing of the parts commenced and progressed to such an extent that in one month there were no traces of the labia, nymphae, vagina, perineum, or anus. There was simply a large opening extending from the meatus urinarius to the coccyx. The rectovaginal septum, the lower portion of the rectum, and the neck of the bladder were obliterated.
His purse, like an oil cruet. The fibulae, or lesser bones of his His genitals, like a joiner's planer. legs, like a pair of stilts. Their erecting muscles, like a His shin-bones, like sickles. racket. His elbows, like a mouse-trap. The perineum, like a flageolet. His hands, like a curry-comb. His arse-hole, like a crystal look- His neck, like a talboy. ing-glass.
This vein does not convey the milk to the udder, as some suppose, but is the channel by which the blood returns; and its contents consist of the refuse of the secretion, or of what has not been taken up in forming milk. There are also veins in the udder, and the perineum, or the space above the udder, and between that and the buttocks, which it is of special importance to observe.
O'Neill speaks of a case in which the clitoris was five inches long and one inch thick, having a groove in its inferior surface reaching down to an oblique opening in the perineum. The scrotum contained two hard bodies thought to be testicles, and the general appearance was that of hypospadias. Postmortem a complete set of female genitalia was found, although the ovaries were very small.
But even though tears are sewn up successfully, there is invariably some relaxation of the perineum until the restorative process, which here again chiefly concerns the muscles, has been given opportunity to become effective. As with all the restorative changes in the lying-in period, to rest calmly in bed favors the perfect recovery of the pelvic floor more than anything else.
The physician started home for his forceps, but during the interval, while walking about in great pain, the man was relieved by the stone bursting through the perineum, falling to the floor, and breaking in two. Including the ounce already chiselled off, the stone weighed 14 1/2 ounces, and was 10 5/8 inches in its long circumference.
The mirrors may also be observed by holding the back of the hand against the perineum, and drawing it from above downward, when the nails rubbing against the up-growing hair, make the parts covered by it very perceptible. As the hair of the milk-mirror has not the same direction as the hair which surrounds it, it may often be distinguished by a difference in the shade reflected by it.
The horn then passed through the bowel and its coverings, just above the hymen, and was then withdrawn as she flinched and fell back. The resultant wound included the lower part of the vagina and rectum, the sphincter and, the fourchet, and perineum. Hemorrhage was profuse, and the wound caused excruciating pain. The subject fainted on the spot from hemorrhage and shock.
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.
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