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CASES IN MIDWIFERY.
299
early months it is utterly impossible to fltience of active pains, so that this morning distinguish between a healthy and an hyda- it had become fully developed ; but the head tid pregnancy. Thus we cannot wonder had remained stationary the whole day, after very much that Dr. Chowne’s patient, when having nearly descended into the cavity of delivered of a 11 five months"’ growth, the pelvis. I found no heat of the vagina, and should present the symptoms above recited. there was ample moisture, with apparently sufI cannot, with Dr. Chowne and Dr. Reid, ficient space for the head’s descent, provided feel surprised that a lax state of the vagina it lay in a proper position ; but it was placed should precede the delivery, as in ordinary with the right ear directed to the pubis, and parturition ; I have myself seen two similar there was, moreover, now, and had been cases, of course attended by this state of the since the morning, an almost entire absence soft parts. Much less can I join Dr. Reid of uterine action ; no heat of skin existed ; in his assertion that these cases diminish the pulse 100, and small. I preferred the cauvalue of the areola as a symptom of preg- tious employment of the forceps in this case nancy. The woman, without doubt, had to the use of the ergot, it being a first labour, been pregnant. which I am of opinion should generally conI should answer the question proposed by tra-indicate the ergot, so valuable whenjudiDr. F. Bird, 11 IVas it really milk that was ciously employed. Having first satisfied secreted ?" by assuring him that it really was. myself that the bladder was empty, I sucDr. Chowne, indeed, acknowledges that he ceeded, by the use of my fingers, in shifting omitted to test it by the microscope, but it the position of the head so that the middle was rich and white, and differed in its cha- line of the face was brought to bear upon a racters on certain days." Besides, " a pupil point midway between the sacro-iliacjunctasted it, and found it very agreeable." tion and the centre line of the hollow of the Lastly, the object of introducing this case, sacrum. I then introduced the blades of the however charitable and humane, namely, common forceps, with counterparts, of equal the fear that a female dis’covered to have length and width, of their fenestrae ; but an these symptoms of recent delivery might be easy locking not being possible, I substicharged with destroying a child which was tuted, on the right side of the pelvis, the never born, might be met with the reply, that seat of the difficulty, a short blade, and the such a case could never occur under the super- locking was now effected without the least intendence of a medical jurist who knew his force. The stimulus of contact of the blades duty; for if summoned to examine a woman (which is a common effect) induced a stronger having all these symptoms he would not action. Drawing down during the presence of positively declare that she had been recently pain only, separating the handles, and resting, delivered of a child, but he would affirm con- as should always be done, in the absence of fidently that such a state of things could only the parturient throes, the delivery of a living be a consequence of previous sexual child was safely accomplished, in the course course. of a very few minutes. The placenta was Such is the common law respecting 11 de- afterwards removed without difficulty, by livery," cons:dered in a medico-legal point of Mr. L’Estrange. There was no beemorview. " So far," says Beck, "he can pro-, rhage ; the uterus contracted perfectly. nounce with safety, but if the question have Subsequently to the delivery the pulse sank a bearing on the charge of infanticide the from 100 to 80. On the following morning existence of the child should be proved." after some refreshing sleep, it numbered 76 (Elements of Med. Jurisp., 6th edit., p. 155.) beats, and the recovery of the patient was I am, Sir, your obedient servant, uninterrupted by a single bad symptom. Russell place, Fitzroy-square. W. C. Borough, Nov. 23, 1843. PERFORATION OF THE BLADDER. the
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inter-Ii
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CASES IN MIDWIFERY.
To the Editor of THE LANCET.
By JOHN HALL DAVIS, M.D., Physician to SiR,-The following case may prove suffithe Royal Maternity Charity. ciently interesting for insertion in your valuable Journal. I am, Sir, your obedient servant,
FORCEPS CASE.
T. E. RAWSON, Surgeon. THIS evening, March 9, 1842, at half-past Kegwortb, Leicestershire, nine o’clock, I was requested by my friend, Nov. 18-13. Mr. L’Estrange, to visit Mrs. A., aetat. 30, residing at Ferdinand-terrace, Camdentown, in labour with her first child. The Mary Bates, setat. 35, was taken suddenly liquor amnii had escaped at half-past eight, ill, on the evening of the 17th November, p.m., yesterday, and she was visited by Mr. whilst eating boiled milk. She complained L’Estrange at nine, p.m. The orifice of the of great faintness, sickness, and pain at the uterus had dilated gradually under the in- stomach, with burning sensation in the mouth ,
early months it is utterly impossible to fltience of active pains, so that this morning distinguish between a healthy and an hyda- it had become fully developed ; but the head tid pregnancy. Thus we cannot wonder had remained stationary the whole day, after very much that Dr. Chowne’s patient, when having nearly descended into the cavity of delivered of a 11 five months"’ growth, the pelvis. I found no heat of the vagina, and should present the symptoms above recited. there was ample moisture, with apparently sufI cannot, with Dr. Chowne and Dr. Reid, ficient space for the head’s descent, provided feel surprised that a lax state of the vagina it lay in a proper position ; but it was placed should precede the delivery, as in ordinary with the right ear directed to the pubis, and parturition ; I have myself seen two similar there was, moreover, now, and had been cases, of course attended by this state of the since the morning, an almost entire absence soft parts. Much less can I join Dr. Reid of uterine action ; no heat of skin existed ; in his assertion that these cases diminish the pulse 100, and small. I preferred the cauvalue of the areola as a symptom of preg- tious employment of the forceps in this case nancy. The woman, without doubt, had to the use of the ergot, it being a first labour, been pregnant. which I am of opinion should generally conI should answer the question proposed by tra-indicate the ergot, so valuable whenjudiDr. F. Bird, 11 IVas it really milk that was ciously employed. Having first satisfied secreted ?" by assuring him that it really was. myself that the bladder was empty, I sucDr. Chowne, indeed, acknowledges that he ceeded, by the use of my fingers, in shifting omitted to test it by the microscope, but it the position of the head so that the middle was rich and white, and differed in its cha- line of the face was brought to bear upon a racters on certain days." Besides, " a pupil point midway between the sacro-iliacjunctasted it, and found it very agreeable." tion and the centre line of the hollow of the Lastly, the object of introducing this case, sacrum. I then introduced the blades of the however charitable and humane, namely, common forceps, with counterparts, of equal the fear that a female dis’covered to have length and width, of their fenestrae ; but an these symptoms of recent delivery might be easy locking not being possible, I substicharged with destroying a child which was tuted, on the right side of the pelvis, the never born, might be met with the reply, that seat of the difficulty, a short blade, and the such a case could never occur under the super- locking was now effected without the least intendence of a medical jurist who knew his force. The stimulus of contact of the blades duty; for if summoned to examine a woman (which is a common effect) induced a stronger having all these symptoms he would not action. Drawing down during the presence of positively declare that she had been recently pain only, separating the handles, and resting, delivered of a child, but he would affirm con- as should always be done, in the absence of fidently that such a state of things could only the parturient throes, the delivery of a living be a consequence of previous sexual child was safely accomplished, in the course course. of a very few minutes. The placenta was Such is the common law respecting 11 de- afterwards removed without difficulty, by livery," cons:dered in a medico-legal point of Mr. L’Estrange. There was no beemorview. " So far," says Beck, "he can pro-, rhage ; the uterus contracted perfectly. nounce with safety, but if the question have Subsequently to the delivery the pulse sank a bearing on the charge of infanticide the from 100 to 80. On the following morning existence of the child should be proved." after some refreshing sleep, it numbered 76 (Elements of Med. Jurisp., 6th edit., p. 155.) beats, and the recovery of the patient was I am, Sir, your obedient servant, uninterrupted by a single bad symptom. Russell place, Fitzroy-square. W. C. Borough, Nov. 23, 1843. PERFORATION OF THE BLADDER. the
I.
inter-Ii
!
CASES IN MIDWIFERY.
To the Editor of THE LANCET.
By JOHN HALL DAVIS, M.D., Physician to SiR,-The following case may prove suffithe Royal Maternity Charity. ciently interesting for insertion in your valuable Journal. I am, Sir, your obedient servant,
FORCEPS CASE.
T. E. RAWSON, Surgeon. THIS evening, March 9, 1842, at half-past Kegwortb, Leicestershire, nine o’clock, I was requested by my friend, Nov. 18-13. Mr. L’Estrange, to visit Mrs. A., aetat. 30, residing at Ferdinand-terrace, Camdentown, in labour with her first child. The Mary Bates, setat. 35, was taken suddenly liquor amnii had escaped at half-past eight, ill, on the evening of the 17th November, p.m., yesterday, and she was visited by Mr. whilst eating boiled milk. She complained L’Estrange at nine, p.m. The orifice of the of great faintness, sickness, and pain at the uterus had dilated gradually under the in- stomach, with burning sensation in the mouth ,