The science and art of obstetrics / by Theophilus Parvin.

  • Theophilus Parvin
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: The science and art of obstetrics / by Theophilus Parvin. Source: Wellcome Collection.

    678/693 page 673
    in such cases the impression upon the brain is first reflected to the bulb, then probably through the pneumogastric nerves the bulb itself arrests the action of the heart, and hence the sudden paleness, the cerebral ansemia, and the syncope.1 Wundt, adopting Kant's classification of emotions into sthenic and asthenic,2 says that the former kill by apo- plexy, and the latter by cardiac paralysis, or rather by the interruption of cardiac function which energetic aud persistent excitement of the in- hibitory nerves of the heart causes. The greater nervous susceptibility of woman than of man, and its notable increase during pregnancy, would explain the special liability she then has to be injuriously affected by a profound emotion, whether of pain or of pleasure. Chevallier has narrated cases of sudden death occurring to puerperse which he attributed to idiopathic asphyxia. But, as remarked by McClintock,3 some very competent authorities look upon the mortal affection described by M. Chevallier as merely a form of syncope. Undoubtedly the later term is the correct one. It is remarkable that several of the cases adduced were those in which death followed a strong emotion; in other words, they were instances of fatal emotive syncope. One of these, for example, taken from Morgagni, was that of a multipara, who, after an easy labor, was delivered of a girl, her husband and she both being desirous of a boy; the sex of the child was imprudently told her; she was affected with such deep sorrow that her pulse became weak and her skin cold, and in a few hours she died ; the autopsy presented no satisfactorv cause of the fatal result. Winckel4 refers to strong mental emotion, especially severe suffering, as a cause of sudden death, and states that Baart de la Faille has col- lected 13 cases of post-partum collapse in which neither embolism nor the entrance of air was probable, but in which, however, the entire complexus of symptoms had very great similarity to cardiac paral- ysis. 1 Dr. Lusk lost a primipara two hours after delivery with forceps, and he attributed the death to nerve-exhaustion and shock. Dr. Fayette Dunlap in the case of a patient dying a few hours after the termina- tion ot her labor, regarded exhaustion as the cause of the unhappy 1. Death may be Caused by Pulmonary Embolism. A thrombosis having formed in uterine, pelvic, or femoral vein, an embolus is de- tached, and passing to the right heart is arrested in the pulmonary artery. The most frequent instances of this accident have been ob- served in patients suffering with phlegmasia alba dolens. Ihe unhappy victim may take the erect or sitting position after hav- ln?l deIYeCUm a!°\ daySAr weeks> or make other slight exertion, and death come suddenly as if from a thunderbolt. a.i^ n?^r^^CaUfd.byemboIi8m jnst after labor asaconse- C renlS\%r0mh0S]S in a Auteri°e vessel. Herman and Brown have reported the following case: An intra-uterine injection of a solu- tion of perchlor.de of iron was used for post-partum'hemorrhage, and 1 Strauss, op. cit. „ ™ I Dublin Medical Press. 1852 I t uunt^°,f Physiological Psychology. • Journul of the American Medical Association, l884LehrbUCh dGr GebUrtShUlfKhi(1 1RR7 0 Ibid., 1887. 43
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