Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West.

  • Charles West
Date:
1847
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Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West. 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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    he case reported by Dr. Grossi, the patient was still living-, and the symptoms rere by no means conclusive, while it is to be regretted that no attempts vere made to determine, by means of the stethoscope, whether certain move- ments perceived through the abdominal walls were really due to the presence if a foetus. A somewhat similar doubt attends the case which was under the ■are of MM. Jobert and Dubois, though the occurrence of pains resembling hose of labour at the end of the 9th month, affords a presumption in favour of conception having taken place, which did not exist in the case reported by Dr. Grossi. It seems somewhat doubtful whether the case of Dr. Yardley’s patient vas one of extra-uterine pregnancy, or of rupture of the womb towards the nd of gestation, from external violence, with escape of the foetus into the bdominal cavity. After 6 months of severe suffering, the patient regained er health; she gave birth to a dead child four years afterwards, and subse- uently miscarried thrice. During almost the whole of this time, the woman’s r.ealth was indifferent, and her sufferings were severe, till at the end of 15 ears the foetal bones made their escape through the rectum, after which, in like course of the ensuing five months, she completely recovered. The account iven by Dr. Craddock, refers to the dissection of a woman, in whose abdomen n extra-uterine foetus had resided for 22 years without impairing her health ; eath taking place eventually from pneumonia. Dr. Carganico’s patient died : f hemorrhage, produced by rupture of the cyst at 5f months. The anatomical retails are very incomplete, but it is stated positively that the placenta was : ttached to the peritoneum in the pouch between the uterus and rectum, and ot to the ovary. Dr. Mason’s patient died exhausted, 4 months after the atural end of pregnancy; a communication having formed between the cyst Mid intestines, as well as an opening through the abdominal walls. The >roman, whose history is recorded by M. Cerise, died after 15 hours of pain ■ke that of labour, occurring at the full term of pregnancy. The anatomical retails of the case are very imperfectly given, and the insertion of the placenta f not stated. In the cases of Drs. McCulloch, Whinery, Stevens, and Gotz, aastrotomy was performed. More than 18 years had elapsed since the natural 'rmination of pregnancy in the first case, more than 4 years in the second, i lore than 10 years in the third, but in the fourth case, the operation was performed at the end of 9 months, and a child was extracted, which survived pr two hours. The placenta was large, and so firmly attached to the fundus peri, that it was thought imprudent to attempt separating it. The patient ent on well for a few days, but the placenta becoming partially detached, .tal hemorrhage took place on the eighth day after the operation. The in- :rtion of the placenta was found to have been to the right ovary, and the Lght side of the fundus uteri. [These cases substantiate the general opinion lat gastrotomy, at the natural end of pregnancy, is attended with great peril, hile if restricted to patients in whom nature is, after the lapse of some time, j ideavouring to get rid of the foetus through the abdominal parietes, a success- pi issue may often be expected.] NATURAL LABOUB. j Dr. Simpson* expresses the opinion that galvanism does not exert any influ- I 'ice, either in originating or in increasing uterine action. The experiments ihich led him to this conclusion were made on six women, in whom he prefully noticed the duration of the labour-pains, and of the intervals between i ieir recurrence. He next repeated his observations with all the apparatus | >r galvanism prepared, but without establishing the contact, he then esta- I fished contact, and lastly, renewed his observations after removal of the jj ires. From these experiments he infers that when uterine action has seemed * Monthly Journal, July, lR4f>.