Friday, August 2, 2013

Hydatid & What Kind of Disease is this?

Roger Mitnick  /  at  3:04 PM  /  No comments

WHAT IS THIS HYDATID DISEASE ?


The disease called hydatid is not a peculiar production of the uterus, as it is often found in other parts of the body ; neither is it confined to the human subject alone, some animals, the sheep especially, are frequently affected by it. 

Hydatids, according to the Linnean system, constitute a tribe of 
the genus tenia, and belong to the class and order of intestinal 
worms. They are characterised by being famished with a vesicle, 
which is sometimes attached to them posteriorly, or in which some 
of them are altogether enclosed. They occasionally exist singly 
in the uterus, but more generally hang together in clusters, each 
little vesicle being attached to its fellow by a very delicate filamen- 
tous thread, the whole presenting an appearance very similar to a 
bunch of grapes ; they are connected with the lining membrane of 
the womb by a thickish substance, resembling fibrin, having, 
nevertheless, a bloody appearance when first expelled from the 
uterus. The size of these vesicular bodies varies, some are very 
small, whilst others are as large as the egg of a thrush ; when 
macerated and perfectly freed from blood, they are generally colour
less. Dr. Baillie, however, states that he has, in many cases, seen 
hydatids of the liver of a pale amber colour. 

Various opinions have been entertained with regard to the forr 
mation of uterine hydatids. As they so commonly exist in 
connection with a dead ovum, some have attributed their origin 
to this circumstance, whilst others believed that the death of the 
ovum has been the effect of the previous existence of hydatids in 
the cavity of the womb ; that, in truth, these animalcule were 
the actual devourers of the foetus. Dr. Blundell, late of Guy's 
Hospital, has preparations showing this work of destruction in 
progress. I have never seen a case of uterine hydatids in an 
unmarried female, and am not aware that it has been observed by 
others ; still it would be wrong to assert that these bodies cannot 
possibly form without sexual intercourse ; and, therefore, if called 
to an unmarried woman, from whose uterus hydatids were growing, 
I should not feel justified in expressing an opinion which might 
prove injurious to her reputation. Wherever there exists a reason- 
able doubt, it is but an act of common justice to give the patient 
the benefit of such doubt. 

I have stated to you that married women are very generally the 
subjects of this disease, and not only married, but in a state of 
pregnancy ; the symptoms, therefore, at first are those which are 
attendant upon that condition, but after the death of the ovum the 
signs of pregnancy disappear. The uterus, instead of diminishing, 
increases in size, in consequence of the enlargement of the hydatids
within its cavity ; and, therefore, it often happens that the medical 
man, as well as the patient, is deceived, as they imagine pregnancy 
to be still advancing. There is this marked difference, however, 
between the two : the enlargement which is the result of concep- 
tion is slow, whilst that from hydatids is very rapid. Again, there 
is the absence of the sensation called « quickening," although there 
may be a kind of indistinct flutter perceived by the patient herself, 
probably caused by flatus ; or, perhaps, it may depend upon that 
power of contraction which the hydatids themselves possess. Sir 
Charles Clarke states, that although hydatids in other parts have 
this power, yet it has never been"observed in those of the womb ; 
it however, by no means follows that because they have not been 

TREATMENT OF HYDATID :

Treatment of Uterine Hydatid — There are no known reme- 
dies which will prevent either the formation or growth of uterine 
hydatids, nor do we possess any means whereby we can procure 
their expulsion in the more early months ; all that can be done is to 
explain to the female the nature of her disorder, and to attend to 
any symptoms that may arise, patiently waiting until, from the 
distended state of the womb, its extraordinary action is excited ; 
and this, as before stated, will occur, sooner or later, varying 
greatly in different individuals ; the sooner this contraction takes 
place, the better will it be for the patient, as the blood-vessels 
increase in proportion to the enlargement of the uterus, and, 
consequently, are of smaller size in the earlier months.

 The os uteri under these circumstances, is usually considerably dilated. 
so that the finger can, with ease, be introduced into the cavity, and 
the hydatids distinctly felt. If, however, the hemorrhage be not 
alarming, no manual interference of this kind is cither necessary or 
proper : the main object of the practitioner is to control the 
hemorrhage : to this purpose all his efforts must be directed. The 
flow of blood, be it remembered, is in some instances so excessive, 
that the female's life is in immediate peril, the gushes being as 
profuse as during the puerperal condition ; indeed, they appear 
much more so in consequence of the large quantity of watery 
fluid with which they are mixed. In the attempt to restrain these 
bleedings, we must not forget that the only effectual method 
consists in exciting a general, perfect, and permanent action of the 
muscular fibres of the uterus, without which its renewal is certain. 
Confinement to the recumbent position is imperatively required, 
and every circumstance carefully avoided, which would be likely 
to produce either bodily or mental excitement. In some cases 
(that they are rare must be admitted) this plan of treatment, 
combined with great attention to diet, is all that is required, 
especially where the action of the uterus is powerful ; of course 
no nutriment, of a stimulating kind, should be allowed, and 
everything should be received into the stomach nearly or quite cold,
caloric, as you know, having a great tendency to excite the action 
of the heart and arteries. Next, in the list of remedial means, I 
would place the application of cold : a bladder, containing pounded 
ice, as recommended, in a previous lecture, should be placed upon 
the lower part of the abdomen ; a piece of ice has by some been 
recommended to be introduced within the vagina, by which a 
sudden state of contraction is often procured. 

After hydatid disease, there is sometimes a tolerably copious 
secretion of milk, which soon subsides after a laxative has been 
administered. Lastly, it is often necessary, in consequence of 
extreme debility resulting from this affection, to employ tonics and 
cardiacs for a long space of time, a return to perfect health and 
strength being often very protracted and tedious. Everything 
likely to increase tone in the general system is here required, 
avoiding, of course, all local stimuli. 

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