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Updated: June 22, 2025
The body of the ischium in this case was fractured and a rent in the bladder was caused by a sharp projecting piece of bone. Autopsy revealed, in addition to the fracture and rent of the bladder wall, a large quantity of urine in the peritoneal cavity. In other instances hemorrhage caused death and not infrequently infection was responsible for a fatal issue.
The two uteruses had a common cervix; the anterior of the two organs had no adnexa, though there were lateral peritoneal ligaments; it had become pregnant." Hollander explains the anomaly by stating that probably the Mullerian ducts or one of them had grown excessively, leading to a folding off of a portion which developed into the anterior uterus.
There was subsequently at attack of inflammatory fever, followed by tumefaction of the abdomen, convulsions, and death on the ninth day. The fetus had been contained in the peritoneal coat of the ovary until the fourth month, when one of the feet passed through the cyst and caused the fatal result.
On this theory we have to consider how such strains could cause a shifting of the peritoneal attachment, why the testes should be supposed to be particularly affected more than other abdominal organs. The answer to the second question is that the testes are at once the most compact and heaviest organs in the abdomen, and at the same time the most loosely attached.
His gruffness seemed heroic to her. As he shaped the flap of flesh she murmured, "Oh, you ARE wonderful!" He was surprised. "Why, this is a cinch. Now if it had been like last week Get me some more water. Now last week I had a case with an ooze in the peritoneal cavity, and by golly if it wasn't a stomach ulcer that I hadn't suspected and There. Say, I certainly am sleepy. Let's turn in here.
The heavy, lead-containing varieties of glass throw very definite shadows little inferior in sharpness and definition to those of metal; almost all the ordinary forms of commercial glass also may be shown up by the X-rays. Foreign bodies encapsulated in the peritoneal cavity are specially dangerous, as the proximity of the intestine furnishes a constant possibility of infection.
After confinement, the pus that always naturally forms in the injured parts of the uterus instead of remaining pure becomes contaminated with microscopic organisms from outside, notably the organism in long chains and the pyogenic vibrio. These organisms pass into the peritoneal cavity through the tubes or by other channels, and some of them into the blood, probably by the lymphatics.
The closure of the tubes is not the only result that may follow the course of this disease. The infection may extend into the peritoneal cavity causing peritonitis, which so often results in the untimely death of the woman. Here let me say that not all cases of peritonitis or of inflammation of the womb, tubes or ovaries are due to this infection.
Within a few hours the peritoneal surfaces are glued together by a thin layer of fibrin and leucocytes, which is speedily organised and replaced by fibrous tissue. Fibrous tissue takes the place of the muscular elements, which are not regenerated. The mucous lining is restored by ingrowth from the margins, and there is evidence that some of the secreting glands may be reproduced.
How was that to be got out? If the head were large, the mother old, the walls of the peritoneal cavity tight or hard, a natural delivery might be impossible. There were whole chapters on Craniotomy, Cephalotripsy, which in plain English means crushing the head with an instrument....
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