The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Francis H. Ramsbotham ; with notes and additions by William V. Keating.
- Francis Henry Ramsbotham
- Date:
- 1857
Licence: Public Domain Mark
Credit: The principles and practice of obstetric medicine and surgery : in reference to the process of parturition / by Francis H. Ramsbotham ; with notes and additions by William V. Keating. 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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![Spurious Pains.—But the presence of pain, even if it be periodical, is not always symptomatic of labour having begun; for towards the end of ges- tation, women are subject to pains in the loins and bowels, simulating true labour-pains in some respects, but not connected in any way with uterine action : hence they are called spurious or false pains. Sometimes they are confined in their situation, at others they are erratic ; sometimes they return at tolerably certain intervals: more frequently they are very irregular in their recurrence. They are often connected with d}^speptic symptoms, and sometimes attended with involuntary spasms of the diaphragm and abdominal muscles, which cause the woman to bear down and believe herself in labour. Occasionally, also, a copious watery secretion from the glands of the os uteri occurs, so as to give an idea that the membranes of the ovum have broken; at other times an involuntary gush of urine takes place under the pains, which has often been mistaken for the liquor amnii. If it be urine that passes, it may easily be distinguished by the odour; if a secretion from the glanduloe Nabothi, it will be observed to dribble away slowly, rather than to be evacuated with a sudden burst. False pains generally come on at night; and not unfrequently they will annoy the patient for wTeeks before the commencement of real labour, harass- ing her much by their severity, and preventing her obtaining any sound, refreshing sleep. At others, they appear only a few hours prior to the accession of true uterine action ; and in the principal number of instances they are wanting altogether. They are more frequently met with in pri- mary pregnancies than afterwards. Causes.—Both the seat and causes of false pains are very various. They may be situated in any of the pelvic or abdominal viscera, or in any of the muscles of the lower half of the trunk. Thus the iliaci interni, the psoas, the abdominal, or the external muscles of the back, may any of them be affected with spasm, consequent on too long a walk, or over-exertion, or fatigue of any kind; and these pains are not unlike the throes of parturi- tion. Organic disease of the kidneys or bladder, or a prolapsed state of the latter viscus below the cervix uteri, may also occasion the same distress. But the most frequent cause is irritation existing in the lower bowels, or an irregularity in the action of the intestinal canal throughout. Diarrhoea, the evolution of a large quantity of gas, and more particularly constipation, are, of all the many causes, those to which false pains may be most usually traced. [These false pains are in many cases the result of rheumatism of the uterus, and are often the cause of great distress and disappointment to the patient, who generally supposes herself in incipient labour. Vaginal exami- nations in these cases sometimes reveal to the touch a partially dilated os uteri for many days, and even weeks, before labour really supervenes. Such cases yield readily to opiate enemata and a constitutional treatment of the iodide of potash and tincture of aconite root.] Diagnosis.—It is only in sensation, however, that spurious pains bear any affinity to those of parturition. They differ in their seat, in the irregu- larity of their return and duration, and in their intensity not progressively increasing; moreover, they are seldom attended by any of the other symp- toms which usually accompany the pains of labour. False pains, then, may be distinguished by their situation: instead of commencing at the lower part of the loins, and being extended to the abdomen and thighs, they are probably felt higher up in the back, or towards one or other side;—by their shifting their position: it is seldom that they are constant to one spot; they](https://iiif.wellcomecollection.org/image/b21007135_0168.jp2/full/800%2C/0/default.jpg)
