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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![as the length of time in which nature perfected the cures, for in neither of them was there much assistance afforded by art. It would have been no way surprising if such accidents as these had ensued after a very severe labour, where there had been much straining, or where violence had been used, and injury done to the parts; but in the first of these cases I was well assured there had not been anything done that could be considered as at all likely to cause a rupture of the vessels j1 recourse to instrumental assistance. It appears that when the hemorrhage is exten- sive, the child's life is compromised; in two out of three of M. Naegele's cases, in which delivery was effected by the forceps, the children were born dead. Now, as we can almost always determine the life or death of the child by means of the stethoscope, and as it is desirable that as little pressure as possible should be made upon the soft parts of the mother in these cases, I think that when the foetal heart has ceased to be audible, it would be much safer and better to lessen the head, and extract with the crotchet instead of using the forceps. 2. When the tumour appears first after the birth of the child, we ought in the first instance to apply fomentations, poultices, or cold lotions, for the purpose of re- lieving the pain, but on no account to open the tumour immediately, because the risk of hemorrhage would be very great. My friend Dr. Johnson has mentioned to me a case in which the tumour was opened within twelve hours, and, notwith- standing that the vagina was plugged and every means used, it was with great diffi- culty that the hemorrhage was restrained. Some time should therefore be allowed to elapse before we make an incision; but inasmuch as an incised wound will heal more favorably than one the result of mortification of the outer skin, we may anticipate this occurrence, and after waiting some hours to give time for the coagulation of the blood, or, at any rate, the moment the cuticle vesicates, a free incision should be made into the tumour, and the fluid blood, with such of the coagula as are loose, allowed to escape. If the bleeding continue, it will be advisable to apply some styptic inside the cavity, or to fill it with charpie; if there be no bleeding, a poultice may be applied. It is better at first not to remove the adhering coagula, as they are a security against hemorrhage; but after a day or two a great portion of what remains may be scooped out, and the remainder will gradually soften and be removed by the poultices, ex- hibiting underneath healthy granulations, which speedily fill up the cavity. Nothing more will be necessary than constant poultices, sprinkled, if necessary, with a solu- tion of the chloride of lime; and if the granulations be too exuberant, a touch with the nitrate of silver. In no case does there seem to have been any trouble or difficulty in healing the wound, and more than one of the patients were delivered subsequently without a repetition of the accident.—Ed.] 1 [It is not easy to say from what vessels the hemorrhage proceeds. Dr. Dewees (Diseases of Females, p. 34) says: I am of opinion that the blood proceeds from vessels situated rather within the vagina; for those which come from the vaginal plexus, immediately behind the corpus spongiosum, are the most likely to suffer](https://iiif.wellcomecollection.org/image/b21030170_0535.jp2/full/800%2C/0/default.jpg)
