[Reprinted from the American Gynecological and Obstetrical Journal 
for October, 1894.] 
A CASE OF AD1POCERE O'F A FCETUS. 
Professor of Anatomy and Midwifery in the Medico-chirurgical School of Nova Goa. 
Dr. Viviato J. Pinto, 
Mrs. L., aged thirty years, mother of two children with normal 
labors, had no menstruation for two months. She went to a dancing 
party and returned thence with pain in the hypogastric region, which 
later on increased, and vomiting, together with troubles of micturition 
and defecation, appeared. She was treated for congestion of the uterus 
for two months ; under this treatment the hypogastric pain was greatly 
diminished, but there remained the rectal and the urethral tenesmus. 
When I saw her she was very emaciated. On vaginal examination, 
I noted that the uterus was enlarged and retroverted, but I could not 
then make a thorough examination because the patient complained of 
unbearable pain. Later on from her history I learned that, although 
irregular in menstruation for the last six months, no evil consequences 
had followed ; she could not account for the present cessation, neither 
did she suspect' pregnancy ; still I did. On vaginal examination, I 
found that the body of the uterus was movable and the pelvis pretty 
large. I did not pass the sound, but replaced the womb and main- 
tained it somewhat in position by means of a Hodge pessary, which, 
unfortunately, was too weak to support, consequently it became dis- 
placed and increased the pressure on the adjoining parts, and it was 
therefore removed. 
Some days afterward, when the irritation had passed off, I again 
reduced the uterus, which was more movable on genu-pectoral position, 
and introduced the sound, which went in for about five inches and a 
half ; but I could not give it a turn, so 1 withdrew it and put in a 
Hodge pessary and prescribed small doses of liquid extract of ergot. 
Some hours afterward painful uterine contractions set in and the pa- 
tient herself removed the pessary. On examination, I found the os 
uteri slightly dilated and in the cavity something tense to the feel; but 
I could not introduce the finger any farther because the patient com- 
plained of excruciating pain in the parts. I therefore introduced the 
sound ; at the same moment the patient made a movement while 2 
Dr. Viviato J. Pinto. 
the sound was in, and some liquid somewhat opaque came out emit- 
ting an odor of stearine. On re-examination, I found something mov- 
able in the cavity of the uterus, but could not dilate the os because 
the patient objected to the use of chloroform. An ovum forceps was 
then introduced, opened and closed at random, and eventually a some- 
what opaque and whitish fragment was extracted which to my sur- 
prise turned out to be one of the legs of the foetus, very slippery, 
and a powerful odor of stearine. I continued the extraction in the 
same manner and withdrew as much of the foetus as I could, but in 
pieces, with the exception of the membrane, which came off in larger 
fragments, all of which diffused a similar smell in the room. The ex- 
traction was attended with very little bleeding, probably due to the 
repeated use of the forceps through a narrow os. 
When the head of the foetus was out I left the patient alone, as 
she was in agonizing pain, washed the parts with an antiseptic fluid, 
and recommended to the family to do the same every three hours. 
Within two days all that was left in the uterus came out in fragments 
with scarcely any blood, and nothing like a placenta was seen, which 
I suppose was equally degenerated and expelled. 
In ten days more the uterus was of nearly normal size and in posi- 
tion and the patient quite well. In a few months more she became 
pregnant and the labor took place at the term of gestation. Three 
years afterward she had an easy labor. 
It is a rare case, and shows the possibility of the foetus turning 
into adipocere in the retroverted uterus. 
Nova Goa, July 25, 18Q4.