Page:Transactions of the Provincial Medical and Surgical Association, volume 1.djvu/95



April 16.—The wound healed. The hysterical fits return three or four times daily. The patient walks out, and has not yet menstruated. She has constant pain in the left side of the abdomen, which is tender.

May 14.—Being again in the neighbourhood of her residence, I called to inquire after her; when I was much pleased to find that she had menstruated profusely a few days after the last report. The discharge was perfectly natural; and the hysteria had subsided about a week ago.

In performing the operation of dividing the morbid vaginal membrane, great circumspection is requisite; as death has been the consequence in several instances. De Haen, in the sixth part of his Ratio Medendi, mentions a misfortune of this kind, occasioned by the operator having carried his incision, by mistake, into the bladder; and Denman lost a patient with peritonitis, produced by the operation.

The incomplete obstruction usually admits of a minute aperture at the upper portion of the hymen, through which part of the urine is forced out in drops, or a small stream, with great pain, resembling that produced by stone in the bladder. As this pain and distress exist from birth, not more than three or four years elapse before the malformation is discovered; the little patient being then able to describe her sufferings. Many such cases have come under my care, and have been permanently cured by a free incision. When allowed to proceed without relief, the disease has terminated in death. An instance of this kind is recorded by Dr. Schmiedt, in which