Volume 1
A system of obstetric medicine and surgery : theoretical and clinical for the student and practitioner / by Robert Barnes and Fancourt Barnes.
- Date:
- 1884-1885
Licence: Public Domain Mark
Credit: A system of obstetric medicine and surgery : theoretical and clinical for the student and practitioner / by Robert Barnes and Fancourt Barnes. 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.
589/624
![case is less equivocal. The membranes were thickened, whitish, opaque, and villous on their inner surface, and traversed by very fine vessels. The woman had suffered pain and slight fever when four months pregnant. She was delivered at term of a live child. Thickening and opacity of the membranes are not uncommon. We have met with cases in which the mem- branes were so thick and tough that labour was arrested from this cause. The liquor amnii could not be discharged until an opening was made by puncture in the presenting pouch. The bands and strings occasionally found in the amniotic sac, strangling the foetal limbs, or making adhesions between the foetus and membranes or placenta, strongly suggest inflam- matory eflTusions. Dubois takes this view, and says adhesions cause monstrosities. Inflammation was described by Brachet (1828). He com- pared placentitis with pneumonia. Hennig says the decidual cells swell, and split into a network of connective tissue. Thus yellow or white septa force themselves between the villous masses. The villi, at first swollen, become compressed and fatty, as well as a great part of the placenta. On the foeta] sm-face effusions of blood and cysts form, and on the uterine surface brown-red knobs, which, wedge-like, with the apex downwards, penetrate between, the villi. Later it assumes the appearance of contracted granular liver (hepatisation), and thence leads to adhesions of the membranes or of the placenta to the uterus, and thus to disturbance of the placental stage of labour. The discoloured portions, seized by inflammation, shrink, harden to a red, then lemon-coloured, knob; the exudation, for the most part of strings of connective tissue, penetrates even into the substance of the uterus, so that it is difficult to detach the placenta. Or the exudation falls into pus; lobular abscesses form in the placenta (Chiari, Braun, and (Spaeth), whence liyeemia of the gravid woman or of the foetus may arise. The fatty and calcareous changes are of less importance. The gravid woman feels sometimes at the seat of the internal inflammation, for several weeks, or even months, a dull pain or burning ; if peritonitis uteri supervenes, a stabbing or tearing is felt on deep inspiration and in certain positions. In the villi inflammation causes first a gelatinous exuda- VOL. I. 0 0](https://iiif.wellcomecollection.org/image/b21980147_0001_0589.jp2/full/800%2C/0/default.jpg)
