File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14766009254).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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sacralplexus, and pains, ting-ling, or numbnessrunning down the legs may result. It is conceivable thatlocal paralysis might follow, but I know of no instance.(4) The tumour may become gangrenous. This possibilityhas been denied; but a specimen by Robert Barnes, in themuseum of St. Georges Hospital* (Fig. 240), seems to prove it.(b) Their degeneration, (a) Obliteration of pedicle.When a fibroid projects from the uterine wall under theperitoneum, the contractions of the uterus tend to extrudeit altogether from the uterine wall, so that it may finallybe covered only by peritoneum, except at one place, wherea stalk joins it to the uterus. This stalk may be thick or * No. 16t. SOLID ABDOMINAL TUMOURS. 825 thin, long or short (Fig. 241). The tumour and the uterus willbe more or less independently movable, according to thelength of the stalk. A big tumour with a short stalk mayso pull up the uterus that the cervix gets out of reach. Itmay so pull the body of the uterus from the cervix that
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Fig. 242.—Uterine fibroid that has undergone calcareous degeneration. Half naturalsize. (After R. Barnes, from specimen, 9,9403, in the Museum of iit. ThomassHospital.) part of the canal may get obliterated, the cervix at thispart being converted into a thin fibro-muscular cord. Itmay twist the uterus, and thus block up its canal. Thefibroid receives its blood supply through the stalk. Thethinner the stalk, the smaller the vessels. If very thin, thetumour may atrophy or calcify. The latter term means thatcalcareous salts are deposited in the tumour (Fig. 242). Ifthe pedicle be thick, it may contain large vessels. It maybecome twisted, the circulation through these vessels may be 826 DISEASES OF WOMEN. stopped, and the fibroid become gangrenous* Peritonitismay occur near a fibroid attached to the uterus by aslender stalk; the tumour may in consequence becomeadherent to some other part, and thus may get pulled awayfrom the uterus, be detached, and henceforth derive itsnourishment from

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