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July 22, 1911


JAMA. 1911;LVII(4):285-286. doi:10.1001/jama.1911.04260070289009

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Emphysema of the skin is of rare occurrence, especially as a result of violent straining during labor. It has been known to occur from excessive vomiting or paroxysmal attacks of coughing, which caused a rupture of the pulmonary alveoli with the escape of air into the subcutaneous tissues. The case here reported is the only accidental complication of its kind that has occurred in the Sydenham Hospital.

The patient is a primipara, 20 years of age, a shop-worker by trade, admitted in labor into the maternity wards of Sydenham Hospital at 7 a. m., March 21, 1911. There was a three-finger dilatation of the cervix, head engaged (R. O. A.), membranes unruptured, heart sounds audible in the right lower quadrant anteriorly. A vaginal septum ¼ of an inch thick, extending from a point just below the meatus urethræ and disappearing into the fourchette, completely divided the orifice. The pelvic diameters

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