A Letter from John Burton M. D. to C. Mortimer M. D. & Secr. R. S. concerning the Extirpation of an Excrescence from the Womb

the Shoulder-blades, which resembled those of Sheep. [See an Article in the Scots Magazine for October 1748. printed at Edinburgh in 8vo.] In a Letter to me, he adds, that probably this was a [Pelagian or] Ocean Fish, wandring by chance into the Frith of Forth; and, by the Tide ebbing, being left upon a considerable Shoal, or flat Sand, near Leith, was discover'd from Land in a State of Distress; whereupon some Fishermen plunged into the Sea, and with a Net surrounded it, and brought it to Shore. XXI. A Letter from John Burton M. D. to C. Mortimer M.D. & Secr. R. S. concerning the Extirpation of an Excrecence from the Womb. SIR, Read July 5. I HAVE at last got a Drawing of an Excrecence * growing from the Inside of the Os Tinea on the right Side; which I herewith send you, (see Tab. I. Fig. 6.) along with as full and perfect an Account of the Case as I can. The Wife of one Chapman, a Whitesmith, at Selby, ten Miles off, upwards of seven Years ago lay in of her last Child, and had a tolerable easy Labour: Soon after which, she had what she called the Fluor albus, that continued ever since, and increased upon her; insomuch that she says, she has sometimes * It is exactly the Dimensions of the Original, which weighed 5 Ounces and a half. That Part below the pricked Line appeared out of the Vagina; that above reach'd from the Labia to the Os Uteri. sometimes had such a Discharge, as to wet the Place she sat upon thro' all her Petticoats, &c. For some Months before we were concerned for her, she began to complain of a Pain and Weight in the Uterus; which increased as the Substance grew in Bulk; and at last the Excrecence was so large as to appear outwards, and then it grew very fast. The Patient consulted her Midwife, who thought the Womb had come out; but was so prudent as not to do any thing; and desired they would call in better Advice. Accordingly they sent for Mr. Fell, an eminent Man-midwife and Surgeon in this City; who, not having met with a Case like that, desir'd me also to go and see her; which was in December last (1749). The Substance not only fill'd, but extended, the Entrance into the Vagina. I introduced a Finger into the Passage, and soon found the Excrecence to be less in Bulk there than what appear'd without the Body; and to be in Shape as you see in the Drawing. I follow'd the Substance till I reach'd the Os Uteri, which I found chiefly fill'd up, with the Neck or smallest Part of this Substance, leaving only a small Part of the Os Tincæ to be perceived on the left Side, obliquely towards the Back. I tried to penetrate the Os Tincæ with the End of my Finger, but could not; however, I so far open'd it, as to let out a sort of bloody Ichor, which was a little offensive in Smell. I asked her, if, when her Discharges were so large as to wet her Seat, they differ'd in Smell from those which came in less Quantities; and if they smelled something like what then came from her when I searched her, which she answer'd in the Affirmative: From whence I concluded she had an Ulcer cer just within the Os Uteri, from the Edge of which this Fungus or Excrecence grew. The Patient complain'd of Pain in the Uterus and Back, was very faint, and frequently was provoked to vomit, with a feeble Pulse, and sometimes Sweat. Upon Consultation, we thought proper to tie a Ligature as high up within the Vagina as the Surgeon could reach: Which being done, and some internal Medicines being order'd, we return'd home; and in two or three Days we went again, but found no great Alteration as to the uterine Complaint; except that the Part below the Ligature was somewhat more livid, and the fetid Smell was much greater, and very like that of a confirmed running Cancer: And as the Matter was somewhat confin'd in the Passage, I order'd them to wash the Vagina by an Injection made of the common emollient Decoction, with Mel Rosarum and a little Tinct. Myrrha. This was frequently done; by which the Smell was less offensive; and two Days after the Excrecence dropp'd off at the Ligature. The Patient has since, in part, recover'd her Strength; tho' she is not in a good State of Health, and her Fluor albus, as she calls it, is still troublesome to her. This was the last Account I have had of her. The Excrecence was very solid, of a dark liver Colour, and, whilst adhering to the Uterus, was quite insensible. When cut in two, it resembled the solid Substance that is taken out of Cancers. I am, SIR, York, March 28, 1750. Your very humble Servant, John Burton. July 5, 1750. the Society adjourned to Oct. 25