A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ur, there have usuallybeen present the most intense expulsive pains. Thesesevere bearing clown efforts tend to displace all the abdom-inal viscera downwards in any case of labor, and where theyare strong enough to cause a laceration of the perineum, orto exhaust the patient, so that forceps have to be used, thedownward displacement of the intestines must be consider-able, on account of the straining and the atonic conditionproduced by the general exhaustion incident to labor. Strain-ing at stool from
A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ur, there have usuallybeen present the most intense expulsive pains. Thesesevere bearing clown efforts tend to displace all the abdom-inal viscera downwards in any case of labor, and where theyare strong enough to cause a laceration of the perineum, orto exhaust the patient, so that forceps have to be used, thedownward displacement of the intestines must be consider-able, on account of the straining and the atonic conditionproduced by the general exhaustion incident to labor. Strain-ing at stool from constipation tends to produce prolapse,which may come on gradually, forcing down the intestinesupon the uterus and weakening the broad ligaments. The straining from efforts of the uterus and voluntarymuscles of the abdomen to expel a polypus from the uterusmay also in the same way cause prolapse. Tight lacing ofthe chest and upper part of the abdomen tends to force theabdominal organs downwards upon the uterus, and produceprolapse. Dr. Emmet says, page 368: In early life, even Plate XXVII. COMPLETE PROCIDENTIA UTERI. PROLAPSUS UTERI AND PROCIDENTIA. 611 with extensive lacerations of the perineum, the formation ofa procidentia is not the rule, unless the woman is exposed tothe risk by accidents, or from the character of her occupa-tion. He does not explain why this may be in early lifeand not when older. To my mind the explanation is to be found in the factthat in advanced years the muscular tissues—in fact, all thetissues—are more relaxed, and do not so readily regain theirnormal condition after delivery, as when younger. Hence,the fact which he gives regarding the immunity of }oungwomen from procidentia, even though suffering from lacera-tions of the perineum, is the best of argument in favor ofthe position which I hold, that laceration of the perineum isnot the principal cause of procidentia, though Dr. Emmetteaches, in another place, that it is, as I have quoted him.(Pa
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