Further observations on chloroform in the practice of midwifery / [Edward William Murphy].

  • Murphy, Edward W. (Edward William), 1802-1877.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Further observations on chloroform in the practice of midwifery / [Edward William Murphy]. Source: Wellcome Collection.

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    imperfectly at first; no effect was observed ; at length she inhaled freely, and became calm; there was no effect whatever observed from chloroform, but quiet. . . With regard to the progress of the labour, the facts were of great interest: the pains rapidly increased; the show, which at first was very small indeed, became abundant, and of the true character; the os uteri rapidly dilated; the waters came away ; and the child was born alive twenty-five minutes past three o’clock, about an hour and twenty minutes after the first use of chloroform.”^ In the next case (XLIV.), chloroform was given in the second stage of labour; a sound sleep, accompanied with loud and deep snoring, occupied the intervals of the pains; and the pains were not at all noticed by the patient. I note this especially^ because of the rapidly increased force of the contractions, while under the fullest effect of chloroform^'’ In case XLV., the womb acted with in¬ creasing energy in every succeeding contraction” ^ after chloroform had taken its effect. In case LVIII., “ at times unconsciousness and insensibility were complete, and it was during these that the uterine action was strongest and most efficaciousDr Channing relates five cases where hemorrhage occurred. In the first (Case XVIII.), it took place before chloroform was administered; none occurred afterwards. In the second (Case XXXVII.), it happened an hour after delivery^ not externally, but into the cavity of the uterus. In the third (Case LXVII.), the patient had hemorrhage in her previous labours after the birth of her child; the same hap¬ pened in this, the placenta was adherent and obliged to be removed; but there was no difiiculty in securing a perfect contraction of the uterus; the womb was in fact already contracted upon the placenta, closely adapting itself to tlie inequalities it presented. The fourth case inhaled sulphuric ether; the child and placenta were safely delivered, but soon after she looked pale, and felt faint; on exami- ^ nation, the womb was found very large, and filled with firm coagula. Dr C. at once emptied it of the coagula; it contracted promptly and firmlyand no further hemorrhage took place. In the fifth case, the ])atient, who was in labour of her fourth child, inhaled about two drachms of chloroform in half-drachm doses. During the whole time there was no loss of consciousness, and only just so much insensibility as to render labour comfortable;” the walls of the abdomen were unusually thick, very pendulous, and so loose and uncontractile, that Dr Channing could fold them very easily over each other; the uterus, however, contracted firmly, and expelled the placenta, but hemorrhage soon took place; and the loss in a short time was very great. By careful management the patient recovered. Upon this case. Dr Channing further remarks, ‘‘A year ago or more this woman had been seized in the unimpregnated state with severe 1 Etherisation in Child-birth (Channing), p. 233. 2 Op. cit., p. 234. ^ Ibid., p. 2.56.