Monthly retrospect of the medical sciences : February to December 1848 / edited by Alexander Fleming and W.T. Gairdner.

Date:
MDCCCXLVIII [1848]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : February to December 1848 / edited by Alexander Fleming and W.T. Gairdner. Source: Wellcome Collection.

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    knowledge of the patient. She awoke in five minutes, hearing its cry. “ The pla¬ centa came away entire in ton minutes, whereas in all her pi’evious labours she had always either hour-glass contraction, or re¬ tention from other causes. The uterus con¬ tracted well and continued so; the pa¬ tient had no bad symptom, either vomit¬ ing or headach. In all, I used only one drachm” (ounce?).—Lancet, p. 604, Dec. 4, 1847. Other successful cases of the use of chloroform in natural labour, are recorded by Dr Lansdown {Lancet, January 1, 1848), Dr Protheroe Smith {Lancet, No¬ vember 27, 1847), Dr Rigby {Medical Times, December 11, 1847), &c. 27.'— Objections made to the Use of Chloroform in Labour_Some communi¬ cations have been published in the medi¬ cal journals, fulfilling Dr Simpson’s state¬ ment, that the use of chloroform in midwifery would of course meet with all “ due and determinate opposi¬ tion ” from some members of the profes¬ sion. Mr Grean of London {Medical Times, December 18) avows, “ amongst the higher classes a general disgust for the use of either ether or chloroform is manifesting itself,” and “ great numbers have already expressed their abhorrence of the .system of being relieved from pain !!” The same writer states Ms be¬ lief, that its relaxing elFects upon the peri¬ neum and soft parts can be of no use in first labours ; for “ in first deliveries (says he) much more impediment is found in the pelvic hones and rigidity of joints, as evidenced in the labours of those advanc¬ ed in years; and as pressure alone is able to cause these parts (the bones and joints) to yield, I do not see that much advantage can be gained by any relaxation that may be imparted to the soft parts.” Such groundless assertions as the above we pass over without remark. Dr Barnes of London {Lancet, Decem¬ ber 25, 1847) insists, that the pains of labour, and the modifications of cry which the agonies of the patient force from her, are useful to show the progress of the labour, and that they thus afford us “ valu¬ able assistance in diagnosis and treat¬ ment and that, therefore, he is not to be “ dragooned” into the practice of per¬ mitting his patients to pass through the process of parturition without their ex¬ hibiting to him the usual signs of torture. [We would suggest to Mr Barnes, that all this diagnosis could be far more easily and certainly made out by what every man employs, the usual tactile examina¬ tion, and we would further suggest to him. that such means would be much more hu¬ mane. Ideas like those of Mr Grean and Mr Barnes, will read strangely some ten years hence.] 28. —Chlorofoi-m in difficult Parturition, By Dr Murphy.—E. G-, set. thirty- six, has already borne six children. All her labours were extremely protracted. In the present, her seventh confinement, labour commenced, Nov. 24, at six o’clock A.M. “ About eleven o’clock on the fol¬ lowing day (says Dr Murphy) I saw her, and found the os uteri nearly dilated, the vagina moist and cool, the head above the brim of the pelvis, the conjugate measure¬ ment of which was only two inches and a half. I felt satisfied that the head of the child could not descend into the pelvis ; but allowed labour to proceed, in order to ascertain whether it might enter the brim sufficiently to be extracted by the forceps.” After being thirty-eight hours in labour, with very strong and regular pains, no change took place in the position of the head. The inhalation of chloroform was then commenced, and quiet sleep was induced. Dr Murphy then perforated the head. When the perforator was withdrawn, the bones of the cranium over¬ lapped each other, so that it was difficult to introduce the crotchet. After several mancEuvres and vain efforts in traction, the head was at last made to pass the brim of the pelvis. At half-past nine o’clock P.M., the child was born, thirty-nine and a-half hours after the commencement of labour. The placenta was expelled in about ten minutes without any hemorr¬ hage. Her convalescence was steady and rapid, a “ contrast to her previous confinement, from which she did not completely recover for some months.”—Dr Murphy, Lancet, p. 653, Dec. 18, 1847. 29. —Ovarian Tumour impeding the pas¬ sage of the Child’s head. By Mr Hicks. —Mr Richard Hicks, surgeon, London, was called to Mrs P., who had been in lingering labour for twelve hours. Upon examining, he found a large tumour, which he supposed to be fibrous and ovarian, lying in the posterior part of the pelvis in such a manner as to preclude the pos¬ sibility of the child’s head passing without craniotomy. This operation was imme¬ diately performed, and then the inhalation of chloroform commenced (Mr H. could not procure any of it sooner). Dr Murphy delivered the infant with some difficulty. Chloroform was again administered du¬ ring detachment of the placenta, which was adherent. Mr Hicks remarks, that
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