On the severe and obstinate forms of vomiting during the latter months of pregnancy / by Charles Clay.

  • Charles Clay
Date:
[between 1800 and 1899]
Catalogue details

Licence: Public Domain Mark

Credit: On the severe and obstinate forms of vomiting during the latter months of pregnancy / by Charles Clay. Source: Wellcome Collection.

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    is perfectly useless to trouble the patient with medicines, as they only add to instead of diminish the severity of the symptoms. This peculiar condition of the os and cervix is not often noticed in the post mortem examination of cases ending fatally; and this because death is mostly preceded by premature labour, and the loss of blood consequent on that, alters the condition of the os so much as easily to escape detection. There are, I believe, some few cases recorded where another and very different peculiarity exists; that is, when the attacks of vomiting come on when the patient is laid down, consequently most frequently in bed : such a condition is, however, extremely rare, and could not arise from any congestion of the os and cervix, but probably from some partial congestion of the uterine structure at or near the fundus uteri. I had a case or two some years ago of this description whicli had this character, as no tenderness was discovered at the os, but great pain and tenderness were found on the slightest pressure on the fundus uteri, accompanied by an aggravation of symptoms whenever the test of pressure was applied : these cases were soon relieved by stupes of warm turpentine and water, and the loss of a few ounces of blood from the arm. The cases here recorded serve to show the obstinate character of the malady; that little relief is to be expected from medicine or diet; that the seat of mischief is not, as it has generally been conceived, at the stomach, but at the os and cervix; the stomach merely acting sym¬ pathetically, whilst the condition of uterine structure at the os is that of congestive inflammation. • If my views are correct they are sufficiently explanatory why so little good ^has ever been effected by medicine in these obstinate cases; and also explain the fact of no apparent cause discoverable after death to account for the severe symptoms during life beyond the sinking from mere starvation. In such cases nature herself seems to me to indicate the seat of mischief, and suggests the proper remedy by exciting the stomach to sympathetic action, that very act alone controulling in some measure the progress of the inflammatory attack, and preventing the local from becoming general inflammation; and lastly by premature labour occurring spontaneously, if not artificially induced. The treatment of such cases has hitherto been so contradictory and unsatisfactory as to justify the opinion that the real cause has not been sufficiently attended to, consequently there can be no impropriety in directing attention to a plan of procedure that is apparently based on reasonable grounds. The cases related were similar in all their leading features, and the treatment of the last would in all probability have succeeded in the fatal case if adopted in sufficient time ; local bleeding suggests itself to me as the most probable means of relief we have at command, but that must be assisted by causing as little pressure on the
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