144 OF FA.LSE PREGNANCY. 



may refer to the memoir lately published by Madame Boivin. But 

 if the womb is filled with blood, or if the person has always had dif- 

 ficult menstruation, the touch shows that the hymen is imperforate, 

 that the vagina or some other part of the genital organs are not 

 properly formed; if it be a married woman, or one whose menses 

 had been previously regular, there will, in general, be found at the 

 same time more or less numerous indications of disease, which clear 

 up the diagnosis; besides, the motions of the fcetus are never met 

 with in those cases. 



372. In the case of hydrometra we are in possession of the same 

 resources, and the local affection is accompanied with so serious a 

 change in the general health, that with a little reflection error be- 

 comes from that very circumstance almost impossible. 



373. In uterine tympanitis the womb may acquire a considerable 

 size, but it always remains very light, there is no ballottement, and 

 percussion of the belly occasions such a resonance as at once dissi- 

 pates all uncertainty.* 



374. Encysted dropsy, fibrous or scirrhous tumors, any unna- 

 tural growth in the ovary or parts connected with the womb, might, 

 at most, be confounded with extra-uterine pregnancy, inasmuch as 

 the neck in those cases undergoes only very slight changes; the 

 want also of the positive signs of the presence of a child, the general 

 state and progress of the affections Avill always suffice to prevent us 

 from asserting that there is one, and frequently to lead us to main- 

 tain that there is no gestation in the case. 



375. As to ascites, peritoneal tympanitis, effusions of pus or blood 

 in the abdomen, encephaloid, fibrous, scrofulous, steatomatous, or 

 any other kind of tumors, and the various lesions of organs contain- 



* I seize this occasion to say that I cannot admit the existence of uterine 

 tympanitis as a disease proper. — It is not possible to retain air within the cavity 

 of the womb without the aid of a tampon of some sort. There is no ground to be- 

 lieve in the existence of such a malady. — Nevertheless, in some women, air is 

 occasionally discharged with noise from the vagina, as I can witness, having 

 repeatedly heard it myself in several different individuals — but this only takes 

 place upon some sudden motion, as stooping, &lc. and it consists in the expulsion 

 of air not from the womb but from the vagina. The uterus is sometimes higher, 

 sometimes lower down in the same woman: when it rises upwards, as upon lying 

 down, air enters the vagina and is retained there, until, upon some sudden effort 

 ofthe woman, it is forced out again, in consequence of the womb being again 

 forced downwards by the movement of the body or change of attitude. I have 

 also witnessed the discharge of volumes of foetid air from the womb, upon the 

 forced removal of a putrid and crepitating placenta. But this is a case of acci- 

 dental distention — and not a real case of disease worthy of the title tympanitis 

 uteri.— M. 



