A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs.

  • Marc Colombat de L'Isère
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    development of the womb itself, would be in proof of the existence of extra-uterine pregnancy. However, the absence of the pulsations, like that of the active and passive motions of the child, are not conclusive proofs as to the life of the child, or even the fact of gestation. As the employment of the stethoscope, in this case, is to be looked upon rather as an obstetrical than as a medico-chirurgical exploration, we may properly dispense with more extended observations upon it, merely adding that the metroscope proposed by M. Nauche, for hear- ing the sounds and appreciating the movements that are to be distin- guished in the vagina and womb, is, in our opinion, a much less trustworthy means than the stethoscope, properly so called. [M. Colombat appears to me to have passed very hastily over his remarks upon auscultation'as an obstetrical resource, and it seems barely justice to the reader and to a distinguished gentleman, Dr. Evory Kennedy, of Dublin, to mention his work on the signs of pregnancy, a little volume that has added much to the facility of acting with prudence as well as knowledge in certain doubtful cases. The use of the stethoscope, or of immediate auscultation, is become a resource of the most indispensable kind in the conduct of labours, and in settling questions of pregnancy. It is not to be doubted that the use of the stethoscope may, in some cases at least, enable us to detect the sensible signs of pregnancy, if the child be alive, as early as the end of the fourth month of gestation. By its use, also, we may be very correctly determined as to our course of action, since it reveals with clearness the state of the child's circulation. Now, if we find that the pulsations of the child in utero are be- coming dangerously disordered, either by excessive precipitation of the heart's action, or extreme feebleness, irregularity or slowness of the same, it is mani- fest that we have possession of the means of deciding whether the security of the infant demands our intervention, in the way of some obstetrical operation, as the use of the forceps, &c. So, also, where, in a bad labour, we have repeatedly recognized the situation and activity of the foetal heart, if upon carefully seeking in vain for them in the same place, it being impossible for them to have changed their place, we have the elements of an opinion as to some operation of cephalotomy, &c, which we might have been highly inclined to perform, but from our respect to the rights of the fcetus—rights which cease with the cessation of its life. Doubtless, also, by means of aus- cultation, we may gain great light as to the diagnosis of position, to the saving for the patient much of that distress or pain that an exploration with the whole hand could not fail to give; an exploration now often unnecessary, by the gentler intervention of auscultation. In the diagnosis of pregnancy from dropsy, and various other forms of dis- ease, which, by their exterior physiognomy, so closely simulate several stages of gestation, the methods by auscultation are invaluable.—M.]