Essays on the puerperal fever and other diseases peculiar to women : Selected from the writings of British authors previous to the close of the eighteenth century / Ed. by Fleetwood Churchill.
- Fleetwood Churchill
- Date:
- 1849
Licence: Public Domain Mark
Credit: Essays on the puerperal fever and other diseases peculiar to women : Selected from the writings of British authors previous to the close of the eighteenth century / Ed. by Fleetwood Churchill. 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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![At first I was inclined to think that the case might be an hernia, whose contents, though they were kept up by the uterus, while in its enlarged state, were now fallen down so soon as this had been suffered to collapse; and considering the poor woman's situation at any rate as uncommon and alarming, I sent for Dr. Cleghorn and the gentleman who had delivered her. By the time that these gentlemen came, which was about an hour, the swelling had acquired the size of a new-born child's head, was exceedingly painful and hard, and extending itself to the perineum, had a most frightful aspect, as the skin was grown livid. The case being new, none of us could well ascertain the true nature of this tumour, but having directed the application of stupes, wrung out of a spirituous fomenta- tion, we agreed to see her again in the evening. At the second visit we found the pain nothing abated,1 but so great as to require artificial aid to extract the child, whether the tumour has burst or not. When the tumour is at, or rather within, the orifice of the vulva, it might possibly (and, indeed, appears to have been in two or three cases) mistaken for the bag of the waters ; but a careful examination will guard against this error. More frequently, however, the tumour appears after labour, sometimes immedi- ately ; in other cases, as Dewees remarks, after a short interval. It does not require either a difficult or tedious labour for its production; in many instances, the labour has been short and easy, as in Dr. Macbride's cases; but we must admit that with the predisposition (whatever it be) existing, there would be more probability of its occurrence in the former cases. The effusion may occupy one labium or both; in some cases it extends down- wards to the perineum ; in others, inwards into the pelvis, and the amount will vary- according to the distensibility of the surrounding tissues. When the tumour is rup- tured soon after its formation, the hemorrhage may be uncontrollable and unlimited. The aspect of the disease is very alarming; the size of the tumour, often as large as a child's head, its red or purple colour, and the agonizing pain, together with its occurrence at a time when all appears going on favorably, is calculated to produce a formidable impression.—Ed.] 1 [In all the cases on record, the pain appears to have been very great, augmenting with the increase of the tumour, until relief is obtained by its rupture; and if this be long deferred, the constitution sympathises, and a high degree of febrile excite- ment is the result. Dr. Dewees remarks : Should the parts not give way, the pain arising from distension is unceasing and truly agonizing; fever of a very active kind is quickly kindled, delirium sometimes attends, and the woman's life becomes severely threatened. Her sufferings are also augmented by retention of urine, as its passage is prevented by the tumour pressing firmly against the meatus externus of the urethra. The patient can lie only upon her back, with her knees drawn up, and her thighs widely separated. She cannot bear the pressure of the bedclothes, no* the lightest applications; therefore it is in vain to offer relief till the distended parts](https://iiif.wellcomecollection.org/image/b21030170_0531.jp2/full/800%2C/0/default.jpg)
