Licence: Public Domain Mark
Credit: Practical manual of obstetrics. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![Duration ; Terminations.—The duration of extra-uterine pregnancies varies from some weeks to several months or even years. At the normal term of gestation, sometimes earlier, at other times later, the woman experiences pains similar to those of labor, which soon cease, to reappear some time afterward at variable intervals. These con- tractions can have their seat only in the uterus, and lead to the expulsion of the mucus and albuminous matters it incloses ; for, excepting tubal and interstitial pregnancies, the cysts do not possess any muscular fibres, which alone are capable of contracting. In other instances, the cyst incites a very grave peritonitis, or, when •distended beyond the natural limits of its elasticity, it ruptures and causes a rapidly fatal hemorrhage. Finally it may contract adhesions with neigh- boring organs, and, by means of a suppurative or ulcerative process, form abscesses which, opening externally or communicating with the rectum, bladder, uterus or vagina, permit the putrid foetus to escape by degrees and piecemeal. This termination is the most favorable for the woman, who, after having been reduced to the last degree of marasmus, sometimes regains perfect health. Management.—The indications vary according to the period of gesta- tion. If it have been ascertained from the beginning that the ovum is im- planted outside the uterus, its development must be prevented by repeated blood-letting, and especially by the constant application of refrigerants over the foetal tumor. It is admitted that the dietetic regimen has too uncertain an influence on the development of the foetus to rigorously sub- mit the mother to it, but it may be combined with iodide of potassium. [Other methods of treatment which have been employed in the early months are injection of poisonous agents into the sac, and the use of both galvanic and faradic currents of electricity—destruction of the child and arrest of development being the results which are sought to be obtained. Quite a number of well-authenticated cases have been reported, in which success has attended the use of the electrical current, the number of appli- cations varying between one and a dozen. The current may be passed through the sac by needles penetrating into it, or by one pole introduce. 1 into the rectum with the other placed firmly upon the abdominal wall. There has been one case of recovery after vaginal incision of the sac by the incandescent knife.—Ed.] Should grave accidents supervene before the seventh month, should the cyst rupture, it is still preferable to let the woman run the chance* of an internal hemorrhage and consecutive inflammation, always combating it by repose, diet, cold to the abdomen, than to attempt to extract a non- viable infant by an operation almost invariably fatal. When at term or after the seventh month labor seems to set in. it must be arrested by injections of large doses of laudanum. Indeed, it seems to »be more rational to sacrifice the child than to expose the mother, by ms-](https://iiif.wellcomecollection.org/image/b2100013x_0093.jp2/full/800%2C/0/default.jpg)
