Memoir on the spontaneous expulsion and artificial extraction of the placenta before the child in placental presentations / by James Y. Simpson.
- James Young Simpson
- Date:
- [1846?]
Licence: Public Domain Mark
Credit: Memoir on the spontaneous expulsion and artificial extraction of the placenta before the child in placental presentations / by James Y. Simpson. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![S8 ])lacenta was, in all probability, inconsiderable, or altogether arrested, as it was not deemed necessary to expedite delivery, though the placenta was thrown off several hours before the infant was born; in the fourth case, the narrator (Mercier) distinctly at- tests, that the whole loss of blood was not greater than with an ordinary labour; in the fifth case, there was, to use Dr Raras- botham's own expression, no flooding after the placenta was de- tached, and there had been none for some time previously; in the sixth case, (Mr Wood's), the hemorrhage completely ceased after the total separation of the place;ita; and in the seventh case, (Mr Tindal's), the same fact was observed. In these two last cases, though botli patients sunk principally from the effects of hemor- rhage, yet in both of them that hemorrhage had occurred antece- dently to the detachment of the placenta; the mischief, in so far as the flooding was concerned, was done before that detachment took place; in neither of them did the peculiarity of the complete separation of the placenta occur until the case was already so far hopeless, from the antecedent discharge, and, indeed, so far from being injurious, the separation of the placental mass would, on the very contrary, by its immediately arresting flooding, seem to have been salutary, though unfortunately in each too late to save. On the other hand, there occurred, in the course of these seven fatal cases, circumstances and complications amply adequate to ac- count for the deaths of the mothers, quite independently of the sepa- ration of the placenta, or of any flooding or other possible accident connected with that separation. In Mr Hay's case, the patienfs death was evidently the result of the strong excitement and inju- ries to which she was subjected on the ninth day after delivery. Walter, as we have seen, attributes the attack of the disease, ( purpura alba, or mihary fever), of which his patient died, to her own indiscretion. In Dr Merriman's and Mercier's cases, puer- peral fever and peritonitis were the causes of the fatal issue,—a disease that too often occurs independently of any morbid compli- cation whatever, during labour. Mercier s patient had, though there was no accompanying flooding, become so exhausted, and the expulsive powers so inefficient, by the time he saw her, that instru- mental delivery was deemed necessary. In Dr Ramsbotham's case, (an arm presentation) the child was delivered by evisceration of the chest and abdomen, an operation in itself sufficiently dan- gerous, and never employed except when turning even is impos- sible; and, in the present instance, it had its difficulties much en- hanced by the rigid state of the os uteri. Lastly, in Mr Tindal's and Mr Wood's cases, extraction of the infants by version was had recourse to, at a time when the mothers were already greatly exhausted, and little able to withstand the additional sliock of such an operation. Thus in two of the fatal cases, (Mr Hay's and Dr Merriman's), the delivery was effected by the natural pains i and the cause of death in each was apparently independent of any](https://iiif.wellcomecollection.org/image/b21470595_0038.jp2/full/800%2C/0/default.jpg)
