The cause of this change is unknown. Lorrain Smith and Fletcher Shaw, after an examination of four specimens, three of which were associated with pregnancy, believe that the change is due to thrombosis of the vessels of the fibroid. In two tumours they isolated micro-organisms, e.g. staphylococci in one and diplococci in another: the patients with these tumours exhibited toxic symptoms.
In my early investigations of this disease I often took the tumours to the bacteriological laboratory with the hope of finding some micro-organism which would account for the degeneration. The results were so persistently negative that the search was abandoned. Since learning that Smith and Shaw had found micro-organisms in two cases I had the next specimen which came to hand examined, and it happened to be the fibroid obtained from the acute case described on [p. 79]. From the softened parts Mr. Somerville Hastings succeeded in obtaining staphylococcus pyogenes aureus in pure culture.
The views here expressed in regard to the red degeneration of fibroids are founded on an examination of thirty-four recent examples.
References
Bland-Sutton, J. The Inimicality of Pregnancy and Uterine Fibroids. Essays on Hysterectomy, 1905, 76.
Fairbairn, J. S. A Contribution to the Study of one of the Varieties of Necrotic Changes in Fibro-myomata of the Uterus. Journ. of Obstet. and Gyn. of the British Empire, 1903, iv. 119.
Smith, J. L., and Shaw, W. F. On the Pathology of the Red Degeneration of Fibroids. Lancet, 1909, i. 242.
Cases of Hysterectomy performed on Patients in Labour in which the Obstruction was due to Fibroids
| Operator. | Result to Mother. | Fate of Child. | Nature of Operation. | Reference. |
|---|---|---|---|---|
| Spencer | R. | L. | Cæs. Sect., Subtotal Hyst. | Trans. Obstet. Soc., xxxviii. 389. |
| Bland-Sutton | R. | D. | Total Hyst. See [Fig. 23]. | Trans. Obstet. Soc., xlvi. 238. |
| Morison | R. | D. | Cæs. Sect., Total Hyst. | Northumberland and Durham Medical Journal, July, 1904. |
| Acland | R. | ? | Cæs. Sect. and Subtotal Hyst. | Lancet, 1904, ii. 948. |
| Spencer | R. | L. | Cæs. Sect., Total Hyst. | Trans. Obstet. Soc., 1906, xlviii. 240. |
| Spencer | R. | D. | Cæs. Sect., Total Hyst. | Trans. Obstet. Soc., 1908. |
| Pollock | R. | L. | Cæs. Sect., Subtotal Hyst. | Trans. Obstet. Soc., 1908. |