Licence: Public Domain Mark
Credit: On puerperal mania / by Thomas More Madden. 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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![Her pulse was rapid, there was no abdominal tenderness. She con- tinued' in this state despite all treatment till April 3rd, when the delirium suddenly and entirely abated; she became quite calm, and was sensible of her previous condition : but next morning. April 4th, she was found in a state of collapse and unconscious at the time of the morning visit, and she died the same day at 11.30 a.m. Case 3.—S. R—, set. 19, first ])regnancy, was delivered of a living female child after a natural labour of nineteen hours, of which only two were occupied by the second stage. She was confined on the 7th of July, and went on well until the evening of the 13th, when she was suddenly attacked by hysterical mania for ■which no exciting cause could be ascertained. Antispasmodics and sedatives were administered, she recovered perfectly, and was dis- charged convalescent on the 15th. Case 4.—A primipara, set. 20, who had been married a year pre- viously to a man of very inferior station to her own, and had sud- denly passed from a condition of affluence and comfort to one of poverty and privation, was delivered in No. 7 ward, on the 4th of June, 1868, of a male child, after a very easy labour, having been less than half an hour in the second stage. On the 6th she com- plained of slight uterine pain and her pulse was accelerated. Dr. Denham saw her, and ordered two grains of Dover's with one grain of dried soda and two grains of grey powder every third hour. On the 9th she had castor-oil and turpentine draught, but as diarrhoea came on she was ordered an astringent mixture. On the 10th she was again placed on turpentine for the same reason as before, and that evening she became excited in manner, manifested a strong aversion to the child and to her husband, for whom she expressed the greatest contempt and dislike, although he was a very fond and indulgent husband, and expressed the most kiudly affection for one of the pupils and myself to him when he came to visit her. She did not sleep on the night of the 12th, 13th, and 14tii, although opiates were administered to her. She gradually became worse, and on my visiting the ward on the 14th I found her exceedingly loqua-i cious and excited. She informed me that she was a great deal better, having relieved herself by giving the child who had been incau- tiously left with her a right good smacking, as she expressed it. The child was taken from her and anodynes prescribed. On the 4th the mania was now very violent, she attem])ted to escape from the hospital, and her incessant shouting resounded through the corridor. She was removed to a separate ward, and placed on tartar emetic and Acetum opii in small doses every second hour. This treatment was continued for two days without any improvement, and on the 16th she was sent to the Richmond Lunatic A.sylum, where she remained for six weeks, at the expiration of which she](https://iiif.wellcomecollection.org/image/b22298782_0017.jp2/full/800%2C/0/default.jpg)
