Cases of acute leucocythemia in connexion with pregnancy / by Robert Paterson, M.D.

  • R.H. Paterson
Date:
1870
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Licence: Public Domain Mark

Credit: Cases of acute leucocythemia in connexion with pregnancy / by Robert Paterson, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    '1 pregnancy,—that we have the means of determining the exis- * tence of this disease, even when the splenic tumour is not recog- nisable, or does not exist. I hope to be able to point out certain . symptoms which will lead the practitioner to suspect this* disease ; and I can also refer him to a simple and certain means- of verify- ing his diagnosis, viz., by means of the microscope; so looking to^ certain symptoms during the latter months of pregnancy, and ascertaining the state of the blood in the field of the microscope, much may be done in such cases to improve the condition of the circulating fluid before labour; to avoid that haemorrhage which always accompanies labour under such circumstances, and which hastens the unhappy termination; and afterwards stimulate and nourish the system to a favourable result. To be aware of such a state of the circulating fluid beforehand is to be forearmed : the con- dition of that fluid, if it cannot be actually improved, may be prer vented from increased degeneration by certain agents. Haemorrhage during and after labour may be, if not avoided, much modified ; and the condition of the circulating fluid rapidly improved afterwards. But if we wait for splenic or other glandular enlargements, we wait too long; they are in this class of cases recognisable only when the case is hopeless, and when they are assuming such rapid de- velopment as to lead to a speedy and fatal termination. The first case I am about to relate—that of Mrs S.—was the first that had occurred to me in practice, and I candidly admit I was quite unaware either of its nature or danger. Mrs S., set. 20, an exceedingly robust and healthy young woman, married, and three months afterwards became pregnant. I was asked to see her several times during her early pregnancy, in con- sequence of severe sickness and vomiting and other symptoms, all referable to that state. These symptoms, however, gradually passed away, she enjoyed good health, was plump and well-coloured, and able for the usual amount of exercise. I was again asked to see her, about one month before her confinement. She had then a very sallow look, with hollow eyes, and rather rapid pulse (90); but I was assured that she felt quite well,—that although some- times slightly feverish at night, and languid in the morning, she generally felt well and in good spirits; the urine exhibited no trace of bile. The labour came on at the time expected, and was natural, the uterine contractions were vigorous, and she was delivered of a healthy male child, ten hours after the commencement of labour. Very troublesome and persistent haemorrhage followed the expulsion of the placenta, which, however, was readily controlled by repeated doses of secale cornutum. For three days she continued to improve, and milk was secreted, the lochial discharge was scanty, and her pulse was high, but her condition at the end of this period was satis- factory. About the sixth day a marked change to the worse took