1000000031

'ha'fe

ce;,(.

d to

Ro\'!

for fome time in elderlv womeo, and

rc:tlan

\Vid)

¡" <t

'l ,

Ic.:h

fyiT1 p:om b f. t. yu.:·m iy lhe: fore·

·r unner ot

••

'Ieer;

bc(ore

o r "fter tllIS

ha pp,,; ns,

(onoe–

't iales a

L~ 'g~

Il .(h

;.ke

filtsll tn e \Vdl be! dlk!larg.'d wit h

1;rcitt

un rflo:mbl ng lh.H 01 labullr; and upon exami·

n.. IOn . arpcars to be no more lh 10 [he fibrous part of

tho b!ood which alrum, s th. , form by beiDg long prdf<d

in {he

u1erus

or vagi nd..

In th ls pla.:e, it wi ll nat be amiCs to obferve, that the

glands of [he uterus and v Ibina

\Vill

Cometimes ¡ncreare,

ano diflencl lhe adj acem pares to a furpnfing degrce;

(Ior

example) one of tbe gl. n'¡s of the uterus be fo ob·

fhuéted as

that (here

is a prefrure on

.he

returning veio

and e"cre'ory dut!. the arterial blood \vi 11 gradual ly lIretch

[he fm ..dler

vetl'ds,

and con(eql1e ntly incredfe the

fiz~

the cland , which will grow large r and Jarger, as long as

~he

torce of ,he impelled fluid is greater ,han the refi ltance

of the veffels tbat contai n

it;

by which me:m s, a very

fmal! gl. nd \ViII be enlarged

a grea, bulk. and ,he

",rus graduAlIy llre\ched as in uterine gellation, though

t he progrefs may be fo Oow as 'o be protraéled for yea rs

infiead of months . N t.verthelefs, the os ioternum will

be dilated. and ,he gland (if no, tOO large to pafs) will

rqueez~d

into rhe vagina, provided ir adheres to [he

'\lIerUS,

by a fmjlll neck

nay, it \ViII Icngthen more and

m ore, fo as to appear

0 0

rhe oUlride of lhe os externum;

in which cafe, it may be eafily feparated by a lig:Hu re.

This difea fe wiIl be rhe foo ner koown and eftrier remedied,

'1he lower ilS origin in the utérus is. But fh ould

Ihe

gland take ltS rife in the vagina, hard by the mourh of rbe

womb. i, \ViII lheIV itfdf lIiJl fooner. aed a lig..ure may

b e

ea(j~y

inrroduced, provided the tumour is nOI fo large

as to [, 11 up the cavity aod hinder , he neck of it f,om

being commodiouOy fel<. T hough the greatell dilliculty

occurs, wheo rhe glaod is contl0ed tO lhe m erus, being

t oO

much enJarged tO pafs (hrough lhe os int ernurlJ .

Sometirrles all, or mofi of rhe glands io rhe uterus, are

'thus affetled, and augment the womb

t O

(uch a degree,

that il \Vdl weigR a grear many pounds, and the woman

is deHroyed by ilS preffure upon the furrol1nding parts :

b ut. O,ould this indol<nt 1I:1Ie of the 'umOur be altered by

any accident that will produce irritation and in8ammation,

the pans will grow fchirrou9, and a cancer en{ue.

This misfortune. for the.motl pan, happens

\Vomen,

when their men(lrual evacuations leave.them; and fome–

t imes-(\hough feldom)

child bearing women. in

cODCe–

q uenee of fe·vere labour.

O/'h,

PLAC EN TA.

T H E

ovum is formed of the placenta with tbe chorion

aDd amnion. whieh are globularly dillended by the inclo–

fed waters that furround rile child. The placenta is com–

monly of a round r.gure, fomewhat refembljñg an oat–

cake, about

fix.

¡nches in diameter, and one ¡neh thick in

t be middle. growing a liule thioner lowards lhe árcum·

ference :

is eompofed of veins and an eries, \\ hich are

¿ivided ¡mo ao infinite number of finall branche5, the

Tenous parts of which unite io one large lUbe, clllled lhe

umbilical "ein, which brings back Ihe blood, and is fup.

'poftd tOca rry alor.g the nutriti"e fluid from the veffels of

the chorion and placenla, lO ,he child. \\ hofe belly

E R

perfora!es at lhe navel; from thence palhng ioto rhe liTcr,

where it commUOIcates with Ehe! vena portarum and

Ci1.va

• .

is furn iflled Wlth lV/O aneries, which arife from the

¡nternd l ¡(¡¿cs of (he ehild , and running up on

ed.ch

fide

of the

bl.td

j c:r, pertoriiteS lhe bclly wherc! the umbthcdl

n :in eflterea

(hen they proceed lOrhe placenta, in a fpi–

ral Ime, t\\ ining round the ve:o, in conjl1nétion wah

which they form the funiculus umbilicalis, \\ hich is com–

monly four or fi\'e hand breadths

~in

length, fometimes

only t\Vo or rhree, and fometÍmes it extends tO lhef

l~ng. h

of eight or ten.

The

t\Vo

arteries, on their

arrival al the inner furface oT th e placeota. are di

vi–

ded aod fubd ivided iato minute eranches, wh ich aE laíl:

end in fmall capillarit s lllat inorcuJate With the vejns

of l he [olme order.

Thefe arteries, together with

lhe umbilical veín, are fuppo{ed co do lhe (ame ot1lce in

the placenta whicA is afterwards performed

che Jungs

by the pulmonary ar. ery and veia, uni d the child is oeli ..

vered aod begins

breathe: and this opioion {eems tO

be confirmed by ,he following

experimer.ts

. If ,he child

and placenta are both delivered fuddenly, or ,he lall im–

..ediately after ,he fi¡{l; and if ,he chtld. ,bough alive,

does

00[

yet breathe ; [he blood may be feh circulati ng,

fometimes Dowly, al other times with great force, through

the arteries of lhe funis to the placenta, and from thence

back again tO tbe child. along ,he umbilical ve'n. \'lhen

lhe veff.!, are Oigh!ly preffed . the arteries f\Vell b«ween

the preffure and the child, wh ile the veio g rows turgid

bet"ween that and che placenta, from the furf<tce of which

no .blood is obferved ' o

BolV.

although it be lying iD a

bafon, among warm water.

As rhe child begios to

breathe, the circulation, though ie was weak before, im...

med iateJy grows Hronger aad Hrongei, and rhen in a few

minutes the pulfarion in the n(lvel.firing becomes more

languid. and., lall en,irely 1I0ps.

If.

after ,he child is

deli\'ered, and rhe navel flring cut, provided the placeo–

ta ;¡¡dheres firmly to the utc;:rus, which is thereby kept ex:

tended; oro ihhe womb is lIill dillended by a.otber child ;

no more blood Rows from the umbilical veffeJs, rhan what

feemed tO be comained in them at the inllant of cuniog;

and this, io common cafes, does not exceed the quantity

of two or three ounees

and fiaaIl y. when,

confe–

quence of O'iolent floodings, the mother expires, either in

time of d eJivery, or fooo after ir, the chiJd is fomerimes

fou nd alive aod vigoro"s. efpecially if ,he pl. centa is.

fou nd; bu, if ,ore. then lhe child willloCe blood as weU

as the mother.

T he external furface of ,he placenta is d ivided ioto fe–

veral lobe•• that i, may yield aod conform i,felf more

commodiou(]y tO the ioner furface of the uterus, to wh ich

it adheres, (o as ro prevent its beiog feparated by any

lhock or bJo\Vs upon the abdomen, unlefs when violent.

Thofe groupes of veins and arteri es whieh elHer iato

the compolidon of the plaCt'ota receive externaJ coats

from the chorion, which is the out\vard memurane of tbe

ovum, thick and Chong, Ol nd forms th lee fourths of the

exte, nal globe that coouins the watl!rs and the child; lhe

rernaining pan being covcrtd

,.rhe placenta

fo thél.t

thefe tWO in conjunélicn cooltilUte the \VhoIe extern.J

furfact"of the ovum . Sorne indeed alledge. tha< thefe

are wveloped wi,h a cribriform or ceJIular Cubll.Dce. by

which