Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West.

  • Charles West
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West. Source: Wellcome Collection.

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    the case reported by Dr. Grossi, the patient was still living-, and the symptoms were by no means conclusive, while it is to be regretted that no attempts were made to determine, by means of the stethoscope, whether certain move¬ ments perceived through the abdominal walls were really due to the presence of a foetus. A somewhat similar doubt attends the case which was under the care of MM. Jobert and Dubois, though the occurrence of pains resembling those of labour at the end of the 9th month, affords a presumption in favour of conception having taken place, which did not exist in the case reported by Dr. Grossi. It seems somewhat doubtful whether the case of Dr. Yardley5s patient was one of extra-uterine pregnancy, or of rupture of the womb towards the end of gestation, from external violence, with escape of the foetus into the abdominal cavity. After 6 months of severe suffering, the patient regained her health; she gave birth to a dead child four years afterwards, and subse¬ quently miscarried thrice. During almost the whole of this time, the woman’s health was indifferent, and her sufferings were severe, till at the end of 15 years the foetal bones made their escape through the rectum, after which, in the course of the ensuing five months, she completely recovered. The account given by Dr. Craddock, refers to the dissection of a woman, in whose abdomen an extra-uterine foetus had resided for 22 years without impairing her health ; death taking place eventually from pneumonia. Dr. Carganico’s patient died of hemorrhage, produced by rupture of the cyst at 54 months. The anatomical details are very incomplete, but it is stated positively that the placenta was attached to the peritoneum in the pouch between the uterus and rectum, and not to the ovary. Dr. Mason’s patient died exhausted, 4 months after the natural end of pregnancy; a communication having formed between the cyst and intestines, as well as an opening through the abdominal walls. The woman, whose history is recorded by M. Cerise, died after 15 hours of pain like that of labour, occurring at the full term of pregnancy. The anatomical details of the case are very imperfectly given, and the insertion of the placenta is not stated. In the cases of Drs. McCulloch, Whinery, Stevens, and Gdtz, gastrotomy was performed. More than 18 years had elapsed since the natural termination of pregnancy in the first case, more than 4 years in the second, more than 10 years in the third, but in the fourth case, the operation was performed at the end of 9 months, and a child was extracted, which survived for two hours. The placenta was large, and so firmly attached to the fundus uteri, that it was thought imprudent to attempt separating it. The patient went on well for a few days, but the placenta becoming partially detached, fatal hemorrhage took place on the eighth day after the operation. The in¬ sertion of the placenta was found to have been to the right ovary, and the right side of the fundus uteri. [These cases substantiate the general opinion that gastrotomy, at the natural end of pregnancy, is attended with great peril, while if restricted to patients in whom nature is, after the lapse of some time, endeavouring to get rid of the foetus through the abdominal parietes, a success¬ ful issue may often be expected.] NATURAL LABOUR. Dr. Simpson* expresses the opinion that galvanism does not exert any influ¬ ence, either in originating or in increasing uterine action. The experiments which led him to this conclusion were made on six women, in whom he carefully noticed the duration of the labour-pains, and of the intervals between their recurrence. He next repeated his observations with all the apparatus for galvanism prepared, but without establishing the contact, he then esta¬ blished contact, and lastly, renewed his observations after removal of the wires. From these experiments he infers that when uterine action has seemed Monthly Journal, July, 1845.