Volume 1

Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin. Source: Wellcome Collection.

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

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    pushed clown to the cervix, the instrument withdrawn, and the number registered on the blade gave us the measurement of tlie uterine cavity. In a number of instances, in primipara?, and in particular where there existed a granular condition of the cervix, the withdrawal of the hyster- ometer has been followed by a slight bloody discharge; but this discharge has always been little, and has ceased in a few minutes, except in three or four cases Avhere it lasted three or four hours. But even in these cases the examination in no wise injured the woman, for all those measured left the bed in a few hours without either pain or hemorrhage. Sinclair and Milsom never met with any accident following the use of the hysterometer. [The experiments of Milsom in the same direction are tabulated here, but, since they agree in the main with those of Sinclair and of Charpen- tier, we omit them.—Ed.] Finally, Milsom has studied the influence of the duration of labor, of miscarriage, and of premature delivery, and he admits that the duration of labor does not appear to have much influence on the progress of invo- lution. It is established, however, that where labor has lasted less than twelve hours, involution is slightly quicker than where the act of labor has been longer; the daily diminution being 0.5 in the first instance, and 0.42 to 0.46 in the second. As to the influence of premature labor at seven or eight months, it does not seem to be considerable. Involution, nevertheless, is a trifle retarded and it does not progress with such regularity. As to the duration of involution, it is longer than is generally stated, and the experiments of Sinclair, of Milsom, and of ourselves, justify the statement that in women who do not nurse it requires a mean interval of seven to eight weeks, and from ten to twelve in those who do. We are speaking, of course, of cases where this involution has not been retarded by any pathological factor. Involution is not accomplished after a similar fashion in primipara3 and in multiparge. While in primiparae it proceeds, as it were, insensibly, in multiparas it is accompanied during the first few days by painful uter- ine contractions which are called after-pains. We cannot accept the opin- ion of Bouchacourt, who considers these pains absolutely independent of uterine retractility. Eetractility and contractility, although they are special and independent properties of the uterus, are nevertheless con- Joined, at least during the first twenty-four hours after delivery, and altheugh the retractile property predominates, contractility still re- mains a factor during this period, and even longer in certain cases; and, while these contractions are painless in primipara?, they are always the reverse in multiparae, so painful that some women bear them less patiently than they do the pains of labor. They are, notwithstanding, of a similar nature—they are due to uterine contraction. They are painful, intermit- tent, accompanied by change of form and of consistency of the uterus.