Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

Bedford Gunning S., 1806-1870.

Date:: 1872

Credit: Clinical lectures on the diseases of women and children / by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$confinement was as large as it is now?” “ Oh! no, sir; but the trouble commenced then.” “ AVhat kind of trouble do you speak of, my good woman 1” “ I had pain, sir, in my groin, and it extended down my limb.” “ When did your limb begin to enlarge ?” “ A few days after I felt the pain, sir.” “AVas it white and shining as it now is]” ‘O did not notice, sir, particularly.” “ Do you have much difficulty in walk- ing]” “Yes, sir; I walk with great difficulty.” “Had you a physi- cian to attend you in your confinement ]” “ Yes, sir.” “What did he do for the pain in your groin ]” “ lie applied a dozen leeches, sir, and gave me medicine.” “ You ought to be very grateful to your physician, my good woman ; he did what was right for you.” It was important, gentlemen, before expressing an opinion as to the character of this swelling, to ascertain some particulars touching its origin. The questions which I have addressed to this patient are suffi- cient, together with the appearance of the limb at the present time, to establish the nature of the disease. She is aflcctcd with what is some- times called the “ swelled leg of the lying-in woman,” and by the older writers the “ milk leg.'' This latter term was employed from the sup- position, that the tumefaction wivs occasioned by a deposit of milk in the affected limb. The disease, with this view of its pathology, has received various designations. By the French, it was formerly called “/a mo- ladie laiteuse. By others, cedema lacleum, metastasis lactis, etc. But now that its true nature, founded on a sound pathology, is better understood, these names have been abandoned. Drs. Robert Lee, Vel- peau, and others, have shown very conclusively that this affection con- sists essentially in infhimmation of the crural and iliac veins. It can not, I think, be said that phlegmasia alba dolens is a frequent disease, and yet it is one of importance for you to understand. It may present itself under four different conditions: 1st, and most frequently, in the partu- rient woman; 2d. During pregnancy; 3d. In the unmarried female; 4th. In the male sex. Well authenticated examples of the latter have been recorded. You can readily understand, with our present knowledge of its pathology, why an oedematous condition of the limb should be the accompaniment of this disease; for it is well known that oedema is often- times the result of some mechanical obstruction in the venous circular tion, and one of the very first effects of the disease in question is the arrest of the circulation in the femoral vein, which not only gives rise to tumefaction of the limb, but is at the same tin\e the cause of acute suf- fering. Another familiar example of oedema ensuing from obstructed venous circulation is furnished by pregnancy; here, the enlarged womb, pressing on the veins, interrupts the free passage of blood, and hence the enlarged limbs so frequently the attendants upon gestation. Causes.—In parturient women, this disease is to be referred to the various influences brought to bear in connection with the process of child-birth; the unskillful use of instruments, too early getting up aftei$

Clinical lectures on the diseases of women and children / by Gunning S. Bedford.

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