Ligature of external Iliac Artery

Abstract

Domestic Summary. 249 union took place, even though all treatment, except rest, was neglected, and it is reasonable to infer, that if, instead of abandoning these cases to nature, as hope¬ less-a practice which, it is feared, the high authority of Sir A. Cooper has con¬ tributed to render too general-they were submitted to careful and judicious management, perfect recoveries would very often take place/' Double Vagina.-Prof. Meigs describes (Med. Exam., Dec. 1846j, two cases of double vagina. The first was observed in a lady 20 years of age, in labour with her first child. During an examination, whilst pressing the palp of his index finger to the left side of the pelvis, it caught in a seeming bridle, which at the instant led him to fear that the cervix uteri had been broken, so as to detach a semicircular portion of the os uteri, for the pains had been exceedingly sharp; but on pushing the index further and flexing the finger, he found he could draw the point of it outwards, pulling along with it the bridle in question. On examin¬ ing then the structure of the external parts, he found the lady had a double vagina. After the head had escaped from the os uteri, Dr. M. was not able to force the par¬ tition, definitely either to the right or left. The two orifices of the vagina were exactly alike, and the partition extended across the head of the child, from the front to the rear of the passage, which by it was prevented from dilating. As the lady was strong and the uterine pains powerful, Dr. M. feared the vagina might be ruptured, and, therefore, with strong scissors divided the wall; whereupon the child's head speedily advanced, and delivery was soon accomplished. She never complained afterwards of the operation. The second case occurred a week later, in a lady, ret. 30, in labour with her first child. The os uteri was very much dilated, and a buttock, near which was the right foot, presenting. While inquiring into the state of the cervix, he hooked his finger into a bridle, just as he had done in the case above mentioned, and the same thought was obvious to him, viz., that she had broken off a half ring of the circle of the os uteri, but he immediately afterwards discovered that he had another case of double vagina under management. In this case the partition was very firm and thick, extending from the os magnum almost up to the os tincre. He inspected the external structures, and the two vaginas were each perfect and alike, included within labia pudendi common to both. Dr. M. disengaged the right foot and brought it down the right channel, the left leg was flexed upon the belly and thorax of the foetus. With a little assistance the foot was delivered, and the buttock of the child coming downwards, thrust the vaginal wall to the left, and so the trunk was delivered. He had great difficulty to extricate the head of the child, which remained long in the vagina; the infant breathing from time to time the air that Dr. M. admitted through the hollow of his hand and fingers to its mouth and nostrils. The child, a male...