The pathology and treatment of childbed : a treatise for physicians and students. ... From the second German edition with many additional notes by the author / by Dr. F. Winckel; translated by James R. Chadwick.

Date:: 1876

Credit: The pathology and treatment of childbed : a treatise for physicians and students. ... From the second German edition with many additional notes by the author / by Dr. F. Winckel; translated by James R. Chadwick. 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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$Idioixdliic 'puer'peral mania after severe hemorrhage. {Rostocker Anstaltsjournal., Ko. 560, 1857.] P., 29 years old, pregnant for the second time. As a child, feeble; later, suffered at menstrual epochs from pain in the abdomen, lower part of back, with general feverishness. She had menstruated every four weeks, the flow being usually quite profuse for about six days. During the summer the menses appeared but once or twice. After the flrst conflne- ment the menses were quite normal. The first labor and childbed were normal; she nursed her child, getting up on the third day. During the second gestation there were fluor albus and excoriations of the vulva. Patient was a blonde, of me- dium stature, well built, hut pallid; suffered from oedema lahiorum; was confined December 1, 1857. The first stage lasted about twelve hours, the pains being rather weak; the second stage lasted one hour, and was followed immediately by a profuse hemorrhage, in consequence of which the placenta was forcibly removed, the hand passed around the inner sur- face of the wound, and, later, repeated injections of vinegar and water made into the uterine cavity. The hemorrhage lasted forty minutes, the quantity of blood lost being estimated at above 34 lbs. The woman was greatly blanched, but re- tained consciousness; the pulse was small, and scarcely to be felt. Dec. 2, condition fair. Dec. 3, metcorismus ; at night, rigor, fever. Dec. 5, evening, considerable intolerance to light, tliough both eyes appeared perfectly healthy. Dec. 7, intc^er- ance to light disappeared ; strength increasing. Dec. 8, had a poor night, child being restless. At 4 A. M. she broke out in a series of loud but unintelligible conqdaints, speaking in a sad, pathetic tone, and made several attempts to get out of bed. Dec. 9, symptoms continued. She was in a state of ex- citement, owing to the death of another woman recently con- fined. A regular attack of mania set in at 9 A. M., the patient striking out^with her hands, springing out of bed, crying out, etc. In sad tones she predicted that her death was near; the attack lasted an hour. P. 90-96. Urine, drawn by means of catheter, was quite pale, faintly acid ; contained no albumen. During the evening she continued to indulge in loud talk, and, for fear of poison, would take neither food nor medicine. Dec. 11, passed a restless night, talking in a low tone, I’efer- ring to her sins and impending death. Dec. 12, quieter. Dec. 13, an attack of mania, in which the patient made fearful outcries. She was rendered quieter b}'^ the use of inorphine. Evening, a new attack of so great severity that it became necessary to put her in a strait-jacket. Dec. 14, morning, a fresh attack of mania. She was transferred to the btate$