[50] Our friend, Dr. Nebel, of Heidelberg, has a preparation of a fœtus which was retained for fifty-four years in the abdomen. This is the longest period on record of a fœtus being retained in the cyst of a ventral pregnancy. Many other cases have been described. (See Burns, 9th edition, where the notes contain very ample references.)
[51] We had lately a case of this kind. The patient had been under our care for inflammation of the cervix uteri. There was that general enlargement of the uterus which attends this condition; and, on endeavouring to lift a heavy weight, she was seized with violent pain in the pelvis, great difficulty in passing fæces and urine, and, on examination, the uterus was found retroverted. The bowels were well opened with castor oil, and in a day or two it recovered its natural position.
[52] Dr. W. Hunter has evidently taken the same view of the case, and invariably considers retention of urine as an effect, not the cause, of this displacement. (Med. Observ. and Inq. vol. iv.)
[53] We were once misled in a case of this description. The os uteri lay close behind the symphysis pubis, and its opening, as well as so much of the neck as we could feel, looked straight downwards. We were unable to pass the finger sufficiently high to trace the continuity between the neck of the uterus and tumour in the hollow of the sacrum formed by the fundus; and the haggard aged appearance of the woman put all suspicion of pregnancy out of our mind.
[54] Dr. Burns makes a similar observation. “In most cases the cervix will be found more or less curved; so that the os uteri is not directed so much upwards as it otherwise should be.” (Principles of Midwifery, p. 281. 9th edit.)
[55] “Sometimes it is perhaps better to introduce the fingers into the vagina only, and not into the rectum, not merely because, we can act better and more directly upon the uterus here, but also because if we press the posterior wall of the vagina upward towards the sacrum, and thus stretch the upper part of it which is between the fingers and the os uteri, it will act upon the uterus like a cord upon a pulley, and greatly favour its rotation.” (Richter, op. cit. vol. vii. sect. 57.)
[56] Among others, we may mention an exceedingly interesting case recorded by Mr. Baynham, in the Edin. Med. and Surg. Journ. April, 1830. The real nature of the case was not ascertained for six weeks, the catheter only being used night and morning. Even when the bladder was empty, the fundus resisted every attempt to return it. The most prominent part of the tumour in the rectum was punctured with a trocar, and about twelve ounces of liquor amnii, without blood, were drawn off: the reduction followed in about a quarter of an hour. A full opiate was given, and the patient passed a better night than she had done before. Twenty-five hours after the operation, the fœtus, was expelled; it was fresh, and about the size of a six months’ child. The patient recovered.
[57] Dr. Cheston’s case, where the child was afterwards carried the full time, and born alive. (Med. Communications, vol. ii. p. 6.)
[58] Merriman, Med. Chir. Trans. Vol. xiii. p. 338.
[59] Exposition of the Signs and Symptoms of Pregnancy: by W. F. Montgomery M. D. p. 253.