A manual of midwifery / by Alfred Meadows.

  • Alfred Meadows
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A manual of midwifery / by Alfred Meadows. Source: Wellcome Collection.

    496/528 (page 472)
    the symptoms are then very much those of ordinary puerperal peritonitis. Dysuria is a frequent symptom. In rare and exceptional cases the disease is subdued, and the patient recovers; sometimes an abscess forms somewhere in connexion with the uturus, and sometimes, though very rarely, gangrene or sloughing takes place. Occasionally the uterine appendages are the seat of in- flammation, involving either the ovaries, the Fallopian tubes, or the broad ligaments. In these cases there are the same general phenomena as in the ordinary peritoneal form, but they are usually less severe, and the pain when present, is confined to one or other side, where also there will be found tenderness on pressure. A. vaginal exami- nation will show, probably, that the uterus is not unduly sensitive, but there will be tenderness on one side, with, perhaps, some swelling or even fluctuation in that part, for suppuration is not an uncommon event in these cases, especially when the broad ligament or ovary is the part affected. Where the veins of the uterus are inflamed (uterine phlebitis), the symptoms generally commence suddenly, and often within a few hours after labour. They begin with rigors, followed by headache, suppression of the lochia and milk, quick pulse, hot skin, a dry brown tongue, thirst, and vomiting. There is generally little or no pain in the abdomen, unless the uterus is firmly and suddenly pressed. The symptoms which follow are re- ferable to the absorption of pus into the circulation, and they are usually of a more aggravated character than is common to the other forms of inflammatory puerperal fever. There is scarcely an organ in the body which may not become affected in some way—the lungs, hver, kidneys, and joints may all be the seat of inflammation iiinl ctbsct^ss The only remaining structure which is liable to specific inflammation during the puerperal state is the uterine lymphatic system. This is exceedingly rare, and, according to Dr. Churchill, the local symptoms are very obscure, and the constitutional ones quite as severe as m uterine phlebitis, and, in the present state of our knowledge, not to be distinguished from them. The secondary lesions also resemble those in phlebitis. When a fatal issue supervenes, the period at which death takes place in any of the above forms varies a good deal in different cases, and is subject to many conditions