A system of midwifery : By Edward Rigby ... / With notes and additional illustrations.
- Rigby, Edward, 1804-1860.
- Date:
- 1841
Licence: Public Domain Mark
Credit: A system of midwifery : By Edward Rigby ... / With notes and additional illustrations. 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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![vering till the last, knowing from experience that we every now and then succeed even at this late hour in rescuing our patient.* Uterine Phlebitis. In describing the other species of inflammatory puerperal affection, wThich we have designated by the title of uterine in- flammation or phlebitis, and which we conceive arisesl in most instances, from the presence and absorption of putrid matter in the uterus, we shall merely confine our description to the early part of the disease, because, as it invariablv terminates in peri- totinis if not stopped at an early period, it will be unnecessary to go over this part of our subject again. Symptoms. This affection generally makes its appearance on the second, third, or fourth day after labour, and varies consi- derably in its mode of attack. In some cases it will be observed to come on suddenly, with scarcely any premonitory symptoms. The patient is suddenly seized with severe griping pain in the lower part of her abdomen, generally extending more or less to one side, and usually preceded by a smart shivering fit, which is followed by intense headach. On examining the abdomen, the uterus is hard, larger than natural, and excessively painful to the touch; the pulse quick and usually small; the tongue covered with a thin white fur, becoming brown and thicker towards the back part; the countenance anxious. With all this, the abdomen is neither hard nor painful upon moderate pressure; not even over the uterus itself do wre produce pain, until we begin to press so hard, that the organ becomes plainly distinguishable to the hand through the soft integuments. The lochia has either not appeared at all, or has been suddenly suppressed; and in all probability, the secretion of milk has followed a similar course. Or the disease may commence in a much more gradual man- ner. The after-pains are observed to increase in severity and duration, producing a considerable degree of pain over the whole abdomen, but especially the uterus, which, during the paroxysms, is harder than in the intervals. The pains are increased by the slightest pressure, if suddenly applied ; but, if gradually increased, the patient will bear a considerable degree of pressure, not only without complaining, but will even remark that the pain is, as it were, benumbed by it; if the hand be now suddenly removed, very severe suffering is produced. The pains become more and more constant, until they assume the uniform character of in- flammation of the uterus, as already described, when the disease makes its attack suddenly. If the disease be not checked in its * [A very interesting account of puerperal peritonitis, as it prevailed in the Pennsylvania Hospital in 1833, is given by Professor H. L. Hodge, in the Ameri- can Journal Med. Sc.t for August, 1833, p. 325, et seq.—Ed.]](https://iiif.wellcomecollection.org/image/b21006362_0446.jp2/full/800%2C/0/default.jpg)
