Placenta praevia / by G.M.B. Maughs.

  • Maughs, G. M. B. (George Madison Brown), 1821-1901.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Placenta praevia / by G.M.B. Maughs. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    have now attained a position in the treatment of these cases, where it is safe to predict that even this improved table of Dr. Barnes is fearful compared with the future; if indeed, the time has not arrived when it is scarcely excusable to let a woman lie merely because she has placenta praevia. Treatment: Observing, truly, that after the appearance of hfemorrhage in placenta praevia there was danger of its contin- uing or returning as long as the woman was pregnant; that no rehance could be placed in precautionary or conservative treat- ment, as it was only after the uterus was emptied of its contents that the haemorrhage ceased without fear of its returning, the older authors established an iron rule, which is given by Den- man, who says: “ It is a practice established by high and mul- tiplied authority, and sanctioned by success, to deliver women by art in all cases of dangerous haemorrhage, without confiding in the resources of the constitution.” Subsequent ages have but confirmed the practice stated by Denman, and the improve- ments have been, not to evade it, but in the manner of its per- formance, as the only safety to the woman, as it was then, is now, to empty the uterus. In all cases, then, of haemorrhage, when the cause is ascer- tained to be placenta praevia, whether in the sixth or ninth month, or at term, the uterus must be emptied, as no reliance can be placed in position on a hard mattress, cold, acididated drinks, opium, sugar of lead, cold applied to the vulna, plugging the vagina, etc., farther than they may be used as immediate expedients, looking to the speedy delivery of the woman, or promotive of this end; and the physician who would trust his patient to these, with the view of i)rolougiug gestation, is but trifling in the presence of a fearful danger. That we may the better api)reciate our certain, safe and speedy manner of terminating ])regnancy, let us glance at the steps by which it has been attained, through the labors of great and good men, whose highest ambition was to improve their pro- fession in the saving of human life and suffering. Guillemeau, the pupil of Ambrose Pare, following the teach- ings of his great master, advised delivery by the feet in all eases of dangerous Inemorrhage. His directions were to wait, if pos- sible, until the mouth of the womb was dilated or dilatable; if this was not possible, on account of the dangerous character of the Inemorrhage—a condition, unfortunately, frequently present