An Account of a Hydrops Ovarii, with a New and Exact Figure of the Glandulae Renales, and of the Uterus in a Puerpera. Communicated by Dr Douglas, F. R. S.

Author(s) Dr Douglas
Year 1706
Volume 25
Pages 15 pages
Language en
Journal Philosophical Transactions (1683-1775)

Full Text (OCR)

second cast in upon our Shore in my time. There is so little to be seen in the Natural History relating to such Animals as this, I thought this rude account, such as it is, would not be unwelcome to you. II. An Account of a Hydrops Ovarii, with a new and exact Figure of the Glandulae renales, and of the Uterus in a Puerpera. Communicated by Dr Douglas, F.R.S. I Lately opened the Body of a Woman, aged 27, who dyed the third day after Delivery, on which I made the following remarks. 1. She measured round the Waste a yard and three quarters, and from the Scrobiculus Cordis to the Os Pubis a yard and a quarter. 2. All the cutaneous Veins of the Abdomen were of a very unusual and extraordinary bigness, and very much distended with Blood. From the largest of them, being opened, I extracted several polypous concretions. 3. The Cuticula, from the Umbilicus downwards, was rough and scaly to the naked Eye. In several parts it appeared gangreened, occasioned probably by the sharpness of the Serum that always ouzed out of it, when she scratched the little Pimples or Wheals that arose on its surface; these for some time used to go off without any Scar, but as her strength decayed they became mortified. 4. Upon all the Regio Epigastrica the outward Integuments were very thin, little or no fat being visible: But from the upper part of the Regio Umbilicalis, down to the Os Pubis, the Skin was almost half an inch thick, of a whitish colour and hard, some of it appearing as if it were granulated, caused by some obstructions in the Miliary cutaneous Glands. 5. The Fat under this part of the Skin did exceed the thickness of an inch, being distinguished into several Lobules of an irregular figure, and lodged in so many Cells adhering to the Membrana adiposa, which here also was much thicker than it usually is in a natural state. 6. Her Thighs, Legs and Feet were all Anasarcaous, being extremely big and swelled, easily retaining any Impression made by the Fingers: And her Nurse told me, that she used to wet a great deal of Linen in drying up the Water, that would always issue out from these parts on the least rubbing, yet all her superior parts were extremely lean and emaciated. 7. The fleshy part of the Abdominal Muscles was much extenuated by the great distension, yet their Tendons were as thick as usual; and being very easily separable one from another, I could plainly observe that the Tendon of the Obliquus Internus adhered firmly to that of the Transversalis, along the edge of the Musculus rectus, and was not double, as Realodus Columbus, and all Anatomists after him, down to Diemerbrock, who was first aware of this mistake, have maintained: However, this straight Muscle derives the same benefit from this situation, being as it were hemmed in on one side by this firm adhesion, and on the other by what they call the Linea alba, as if it had indeed been Inclosed between the two supposed Tendons of the Obliquus ascendens; that is, 'tis much strengthened thereby in time of acting. I observed also, that the Tendons of the two oblique Muscles, and the fleshy part of the Transversalis, between the Anterior Spine of the Os Ilium and the Pubis, near its commissure, did inseparably join and unite with one another, forming as it were a thick and hard border, from the out- outside of which there was continued over the Blood Vessels, Nerves and Muscles, on the fore-part of the Thigh, a large Aponeurosis, which braced them down: The two Laminae of the Membrane of the Abdomen being expanded on its inside. Now this border is what Authors call the Ligamentum Pubis, and what I have in another place supposed to be the firm union of the Tendons of these three Abdominal Muscles with the Peritoneum. 8. Having perforated the Abdomen in the most convenient depending part, for it would have been endless labour, considering the great bulk of the Tumour, to have laid it bare, by freeing it carefully from the Muscles and Peritoneum, there issued out with great Impetuosity in a rising stream a vast quantity of slimy Viscid Water, in colour and consistence very much resembling a brown, thick and ropy Syrup. This Water measured between 16 and 17 Gallons, besides what was lost on the floor, and imbibed in Sponges and Linnen made use of in drying it up. 9. When the Water was quite emptied, I fancied it had been all contained in a duplicature of the Peritoneum, and had made a Dropsy in that Membrane, because none of the Viscera appeared; for in such a case I have more than once observed, that the inner Lamella of that Membrane of the Abdomen being separated from the outer, is forced inward by the weight of the Water upon the Bowels, to which it closely adheres, contracting the Guts and Mesentery into a very small volume. But upon a narrower view I perceived that the thick Membrane, including the Water, could be easily separated from the Viscera, having freed it from its adhesions by membranous filaments to the Peritoneum, and by Blood Vessels to the Omentum. Now this Bag reach'd from the Pubis to the Midriff, and from the Left Region of the Loins to the Right; in a word, it filled up the whole cavity of the Abdomen, distending her Belly so far, that a Plate could easily lie upon it, when alive. Having gradually freed freed it from all the neighbouring parts, and rolled it up, I found it adher'd inseparably to the Left Tuba fallopiana, the Spermatick Vessels being ramified upon it; and observing no Ovarium, which in the other side was naturally disposed, I concluded that the Bag was nothing but the Membrane of the Ovarium covering the Ova preternaturally thickned and distended by the collection of the above mentioned humour, and that the Distemper was a true Hydrops ovarii, inasmuch as all this vast quantity of Water was included in one Bag, being all of the same colour and consistence. 10. All the other Viscera in the Abdomen were found, and in their natural state. 11. In both Cavities of the Breast there was contain'd a great quantity of reddish Water. 12. The Liquor in the Pericardium was very abundant, and of a greenish hue. 13. The Right Lobe of the Lungs was tyed to the Membrane of the Thorax, covering the upper part of that cavity, but the Left was free from any adhesion. 14. In the Left Ventricle I found a large Polypous or Serous Concretion, of a round figure, a white colour, and of a pretty hard consistence, with several long Roots of a Red colour, which extended thro the Auricle and Bulb of the Pulmonary Vein into its nearest divarications in the Lungs. Having carried home this large Bag, with the Uterus appendant, cut off below the Orifice of the Meatus Urinarium, and viewed it at leisure, I observed, 1. That the Right Spermatick Vein, which opens into the Cava a little below the Emulgent, was three times larger than the Left; and from a little above the Ovarium it was continued, without any division to its termination. 2. The Right Ovarium was in a very natural state. The Cicatrix or Caruncula, whence the fecundated Ovum had dropt, was yet remaining, and the Blood Vessels were ramified upon this Testis, in a very pleasant and beautiful manner. 3. The Tuba Fallopiana, with its Fimbria, were all well disposed. 4. The Diameter of the Left Spermatick Vein, which opens into the Emulgent of that side, was much less than ordinary. And from the extraordinary narrowness of the bore of this Vessel we may draw a not very improbable Reason of some Cause of this Watery Swelling; for the Blood being hereby hindred in its Reflux to the Heart, a great deal of Serum or Lympha, thro' its slow return, must needs be thrown off upon the Ovarium, already indisposed, whence the gradual Increase of the Tumor did proceed. 5. The two Spermatick Arteries were contorted, and full of turnings and windings, from their meeting with the Veins to the Ovaria and Tube. 6. A little below the Kidneys each Artery sent out a Branch, which was lost on the Peritoneum, and fatty Membrane of the Kidney: And from the same places the Veins received two considerable Branches. 7. One of the Arteries went off by a narrow Orifice from the side of the Aorta, the other rose up from its middle, a little below the first. 8. Between the Bag and the Uterus all these Vessels were much dilated, making several Turnings and Circumvolutions upon the Peritoneum, called in this place the Ligamentum Uteri latum. 9. The Left Tuba Fallopiana was only remarkable in its being much longer and larger than usual. 10. In the Bag, which was nothing but the Membrane called Dartos, which covers all the Vesicular Glands of which the Ovarium is compos'd, I observ'd several little Bladders of different sizes, distinct from one another, which contain'd a limpid or clear slimy Serum, in Colour and and Consistence like a Mucilage of the Semen Cydoniorum, these were either Hydatidal Tumors only, or the Eggs themselves distended. This Liquor hardened by a slow heat into the Consistence and Colour of the White of an Egg. 11. All the Fundus Uteri was about an inch and a half thick, but near the Collum minus it grew something thinner, which did proceed from the distention of its Spongy and Vesicular Substance, by the Blood in the Vessels running thro it in variety of turnings and windings; so that when it was cut, it very much resembled the substance of the Lungs. 12. Upon the inner Membrane of the Uterus I observed, upon wiping it with a Sponge, several little eminencies, which I took to be the Glands mentioned by Malpighius, which separate a Humour, to Lubricate and Moisten its cavity. 13. On the upper part of the Fundus Uteri I took notice of a great number of small Vessels, like slender Filaments or Threads, running off from its Membrane, and terminating into a reddish and soft spongy sort of substance, not unlike the Uvula, bating its colour, which hung down from that side of the Womb in form of a Nipple. These perhaps are the Vessels, which, in the opinion of some, do separate and excern the Matter of the Lochia and the Menses, they being only visible at those times. 14. Near the beginning of the Tubes, I perceived two Tubercles, or little Bunchings, about the bigness of a Nut, to which perhaps the Placenta was fastned, and to these adhered several Glandules of a Blackish colour, of different sizes. 15. The Collum minus was composed, as it were, of two Labia, the uppermost was most protuberating, and upon it I observed several small Glands, out of which, upon compression, issued a viscid clear Liquor, which is said said to seal and close up this part, in time of Pregnancy. The lower Labium was longer and thinner, its Edges being cut or indented in several places. 16. The Ruge in the lower part of the Vagina run as they are represented in Books, but those in the upper part had a quite different course, as they are exactly delineated in the annexed figure. 17. Near the Orifice of the Meatus Urinarius there were observable two very large Caruncles, in shape like a Mulberry. This is what I observed in the opening of this Woman. I come in the next place to relate, as far as I was informed, the Symptoms that accompanied her big Belly, and the Method made use of for her Recovery. About three years ago, not long after she had lain in of her first Child, she had a violent blow upon the Left side of her Belly, very painful for the present, but in two or three days, upon keeping herself quiet in Bed, the pain and anguish went off. About two months after this, she began to feel some small pains in the Left Hypogastric Region, where she had lately received the Blow; and she observed that side of her Belly to grow abundantly bigger than the other: These pains increased more and more, till they grew very violent, but upon Conception, which was three months after she was first afflicted with them, they went off, and her Belly swelled gradually, as is usual in Pregnancy, having no other Symptoms but what is incident to that state, only she was much bigger than ordinary; and on that account she forbore the use of Medicines, which possibly might have been effectual in her beginning Distemper, had she been well aware of her Danger. After Delivery, the swelling and bulk of her Belly continued much the same as before the Birth, only upon a plentiful evacuation of the Lochia it decreased a little. When her month was up, she advised with several Phy- Physicians, Apothecaries, &c. who used Emeticks, strong Catharticks; Diuretick Dyet-drinks, and all the train of Medicines commonly used in a Dropsy, her supposed case. All the effect they had, was to prevent the farther Increase of the Swelling while she used them; but, being weary of the trouble and charges to no purpose, she left them wholly off, and then the Tumor increased very remarkably. Thus she continued about one year, and then she Conceived again, which she suspected by the stoppage of her Catamenia, having always been very regular but at such a time. Her Stomach was always good, she never was very thirsty, so drank but little, made Water freely and in great quantity, and was attended with none of the Symptoms of an Ascites, except the Swelling of her Belly: Only when she was half gone, her Legs began to swell and pit, growing very big all of a sudden; from these, and likewise from her Belly, there would often issue out a great deal of watery Humour upon rubbing, as I have mentioned already, especially if she scratched the little Pimples, that would often arise in these parts. About this time she began to be afflicted with a difficulty in breathing, with a violent Trembling and Palpitation of her Heart, and to be often subject to great and involuntary Sighings. She was not able to lie down, but was still obliged to sleep in a sitting posture, for fear of being choak'd. Now I think it probable, that all those Symptoms did proceed from the Deluge of Water contained in the Cavities of the Thorax and the Pericardium; which no doubt did more effectually hasten her end, than the bigness of her Belly, with which she might have lived several years. After she was brought to Bed of a live Child she became exceeding weak, being unable to fetch her Breath, and complained much of a heavy Load and Oppression on her Breast; and the third day she expired. The Explanation of the Figures. Fig. 2. Representeth the Glandulae Renales, the Uterus, with the parts belonging to it, and the large Bag or Membrane of the Ovarium preternaturally distended. a The Glandula Renalis on the Right side. b An Eminence, or rising in its middle. c A Vein that runs from it to the Cava. d The Glandula Renalis on the Left Side. e A Sulcus or Furrow in its middle. f A Vein running from it to the Emulgent. g A small Vein that comes from the Diaphragm, and opens into this Vein before it leaves the Gland. h Two Small Arteries from the Aorta. i Two Nervous Twigs from one of the Intercostal Plexus's. A The Kidneys. B The Uterus cut off. C The Cava cut off. D Its Division into the Rami Iliaci. E The Internal Branches into which the Hypogastricks open. F The Emulgent Veins. G The Aorta cut off. H Its division into the Iliacks. II Its Internal Branches, which are spread upon the Uterus. KK The external Iliacks of both Vessels. LL The Emulgent Arteries. MM The Spermatick Veins. NNNN The Spermatick Arteries, very much contorted in their Progress, that on the Right side being cut off. O The Union of the Branches of the Spermatick Vein on the Right side. P The Right Ovarium, with Blood Vessels ramified on its inner Membrane. Q The Right Tube. q Its Fimbria. R The Tube on the Left side, its Fimbria adhering to the large Bag. SSS The Membrane of the Left Ovarium, distended to a vast Bigness, with the Blood-Vessels ramified upon it. T Some of the Ovula grown big. W Some Hydatidal Tumours on the Inside of the Great Bag. VVV The Ligamenta lata. U The Fundus Uteri. XX The Ligamenta Rotunda; the Membrane that covers them, being laid open, that the Vessels of which they are compos'd may be view'd. Y The Vagina cut off. Z The Vesica Urinaria. ** A Small Artery and Vein on each side, the first going off from the Spermatick, is spread upon the Membrana Adiposa and Peritoneum under the Kidney; the latter bringing back the Blood from these Parts, opens into the Spermatick Vein. Fig. 3. Sheweth the Vagina and Uterus cut open. AAA The Fundus Uteri laid open, and its sides folded back. Fig. 4. The inner Spongy Substance, with the Orifices of the Hysterick Vessels. 22 The Glands appearing on the Inner Membrane of the Uterus. 33 The Small Vessels, by which the Lochia, &c. are separated. 4 A soft Substance, depending from the Upper Part of the Uterus, into which the foresaid Vessels terminate. 5 Two Tubercles, seated near the Beginnings of the Tubes, to which the Placenta adher'd. BB The Vagina laid open. 6.6. The two Labia of the Collum minus. 7.7. Several Small Glands placed on the Upper Labium. 8. The Course of the Rugae on the upper side of the Vagina. 9.9. Their direction on the under side of that part. 10.10. Two Orbicular substances, near the Orifice of the Meatus Urinarius. --- III. An Account of an Experiment made before the Royal Society at Gresham-Colledge, touching the Extraordinary Elasticity of Glass, producible on a smart Attrition of it; with a Continuation of Experiments on the same Subject, and other Phenomena. By Mr Fra. Hauksbee, F.R.S. I Took a Hollow Tube of fine Flint Glass, about an Inch Diameter and 30 in Length, which having rubb'd pretty smartly with Paper in my Hand, till it had acquir'd some degree of Heat; it was then held towards some pieces of Leaf Brass, which so soon as its Effluvium had reach'd, became suddenly in Motion, flying towards the Tube, even at 9 or 10 Inches distance; and it seem'd that the hotter the Tube was made by Rubbing, the farther it would Attract, but that it would do so to any Degree of Heat, I dare not determine. And what farther observable was, That sometimes the Bodies Attracted would adhere to the Tube, and there remain quiet. Sometimes would be thrown violently from it to good