Case of Imperforate Vagina
A. B. SHIPMAN
1834
Boston Medical and Surgical Journal
Miss-, eftat. 15, of a good constitution and plethoric habit, was taken on the 14th of May last with a total retention of urine. She did not inform any one of her condition until the evening of the 15th, when the pain and distension were such as lo compel her to disclose her case to her mother. Several domestic remedies were made use of, but to no purpose, when I was sent for, at 11 o'clock in the evening. On arriving at the house, I found her suffering great pain, and perspiring profusely ;
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... re was but little fever, tongue clean, bowels regular. She was of good size, of a healthy robust aspect, and every appearance indicated that she had arrived at ihe period of puberty, although I was assured that she had never menstruated. I found the abdomen greatly distended, and proposed using the catheter ; this, after some reluctance, was at length consented to, and I drew off six pints of urine with complete relief. On visiting her next day 1 found she had made no water since I left, and I used it again, and <lrew off three pints more, bled her lo sixteen ounces, gave a cathartic of sup. tart, potass, and jalap with mucilages. After this she passed water freely, and was otherwise as well as formerly. On the 19th of June, I was sent for again ; she had remained perfectly healthy since the last, attack in May, just one month. About three days previous to my visit the last time, she was taken with pain in the hypogaslrio region, which increased to such a degree as to deprive her of sleep for the last two nights. She had made water freely, and when I arrived a cathartic of ol. licini, which they had given her, had operated freely ; this, together wiih fear, kept her quiet while I remained. There was no febrile action, tongue clean, skin warm and moist. A slight examination of the abdomen discovered considerable fulness there ; but I did not examine her critically, as the patient was very timid. I gave her an anodyne of morphine, and left with directions to repeat it if necessary. On the 21st I was again sent for, and was informed that she began to complain immediately alter 1 left, the anodynes gave no relief ; that she had now pain in the back and hips, extending down the thighs, with alternate intervals of ease, but of short duration. She had not slept since the 17th, and looked exhausted, like one worn down by long and severe suffering-she was covered with a profuse cold perspiration, and the remedies which had been used, such as the steam of hot herbs and stimulating drinks, had all served to aggravate her sufferings. The pulse was now frequent but soft, the tongue moist but coated ; she passed water frequently, but in small quantities at a time ; the abdomen was much distended, and tender upon pressure. I was led from this assemblage of symptoms to suspect retained menses, and communi-
doi:10.1056/nejm183412240112005
fatcat:fej3sgo5ibhppkpmw34f2znqrq