THE EDITOR’S PREFACE.
This System of Midwifery, complete in itself, was published in London, as a part of Dr. Tweedie’s “Library of Medicine.” The first series of the Library, that on “Practical Medicine,” recently completed, has been received with extraordinary favour on both sides of the Atlantic, and the character of the publication is fully sustained in the present contribution by Dr. Rigby, and will secure for it additional patronage.
The late Professor Dewees, into whose hands this volume was placed, a few weeks before his death, in returning it, expressed the most favourable opinion of its merits; and the judgment of such high authority renders it supererogatory to add a word farther of commendation.
It is only necessary for the editor to say that the production of the author is so complete as to have rendered his labour a light one. He has restricted himself mainly to such additions and references as he conceived would render the work more useful to American practitioners. The object of the publication being to present the most condensed view of each subject, he believed it to be inexpedient to depart from the plan by making extensive additions, and entering into the discussion of controversial points, most of which are of minor practical importance.
CONTENTS.
| Introduction, | [Page 13] |
| [PART I.] | |
| THE ANATOMY AND PHYSIOLOGY OF UTERO-GESTATION. | |
| [CHAPTER I.] | |
| THE PELVIS. | |
| Ossa innominata.—Sacrum.—Coccyx.—Distinction between the male and femalepelvis.—Diameters of the pelvis.—Pelvis before puberty.—Axes.—Inclination, | [15] |
| [CHAPTER II.] | |
| FEMALE ORGANS OF GENERATION. | |
| Internal and external.—Ovaria.—Ovum.—Corpus luteum.—Fallopian tubes.—Uterus.—Vagina.—Hymen.—Clitoris.—Nymphæ.—Labia, | [22] |
| [CHAPTER III.] | |
| DEVELOPMENT OF THE OVUM. | |
| Membrana decidua.—Chorion.—Amnion.—Placenta.—Umbilical cord.—Embryo.—Fœtal circulation, | [48] |
| [PART II.] | |
| NATURAL PREGNANCY AND ITS DEVIATIONS. | |
| [CHAPTER I.] | |
| SIGNS OF PREGNANCY. | |
| Difficulty and importance of the subject.—Diagnosis in the early months.—Auscultation.—Changesin the vascular and nervous systems.—Morning sickness.—Changesin the appearance of the skin.—Cessation of the menses.—Areola.—Sensationof the child’s movements.—“Quickening.”—Auscultation.—Uterinesouffle.—Sound of the fœtal heart.—Funic souffle.—Sound produced by themovements of the fœtus.—Ballottement.—State of the urine.—Violet appearanceof the mucous membrane of the vagina.—Cases of doubtful pregnancy.—Diagnosis of twin pregnancy, | [80] |
| [CHAPTER II.] | |
| TREATMENT OF PREGNANCY. | |
| Sympathetic affections of the stomach during pregnancy.—Morning sickness.—Constipation.—Flatulence.—Colickypains.—Headach.—Spasmodic cough.—Palpitation.—Toothach.—Diarrhœa.—Pruritus pupendi.—Salivation, | [101] |
| [CHAPTER III.] | |
| SIGNS OF THE DEATH OF THE FŒTUS. | |
| Difficulty of the subject.—Signs before labour.—Motion of the fœtus.—Sound ofthe fœtal heart.—Uterine souffle.—Signs during labour where the head presents—wherethe face, the nates, the arm, or the cord, present.—Fetid liquor amnii.—Discharge of meconium, | [107] |
| [CHAPTER IV.] | |
| MOLE PREGNANCY. | |
| Nature and origin.—Varieties.—Diagnostic symptoms.—Treatment, | [112] |
| [CHAPTER V.] | |
| EXTRA-UTERINE PREGNANCY. | |
| Tubarian, ovarian, and ventral pregnancy.—Pregnancy in the substance of the uterus, | [117] |
| [CHAPTER VI.] | |
| RETROVERSION OF THE UTERUS. | |
| History.—Causes.—Symptoms.—Diagnosis.—Treatment.—Spontaneous terminations, | [126] |
| [CHAPTER VII.] | |
| DURATION OF PREGNANCY, | [136] |
| [CHAPTER VIII.] | |
| PREMATURE EXPULSION OF THE FŒTUS. | |
| Abortion.—Miscarriage.—Premature labour.—Causes.—Symptoms.—Prophylactic measures.—Effects of repeated abortion.—Treatment, | [141] |
| [PART III.] | |
| EUTOCIA, OR NATURAL PARTURITION. | |
| [CHAPTER I.] | |
| STAGES OF LABOUR. | |
| Preparatory stage.—Precursory symptoms.—First contractions.—Action of thepains.—Auscultation during the pains.—Effect of the pains upon the pulse.—Symptomsto be observed during and between the pains.—Character of a truepain.—Formation of the bag of liquor amnii.—Rigour at the end of the firststage.—Show.—Duration of the first stage.—Description of the second stage.—Strainingpains.—Dilatation of the perineum.—Expulsion of the child.—Third stage.—Expulsion of the placenta.—Twins, | [156] |
| [CHAPTER II.] | |
| TREATMENT OF NATURAL LABOUR. | |
| State of the bowels.—Form and size of the uterus.—True and spurious pains.—Treatmentof spurious pains.—Management of the first stage.—Examination.—Positionof the patient during labour.—Prognosis as to the duration of labour.—Dietduring labour.—Supporting the perineum.—Treatment of perineallaceration.—Cord round the child’s neck.—Birth of the child, and ligature ofthe cord.—Importance of ascertaining that the uterus is contracted after labour.—Managementof the placenta.—Twins.—Treatment after labour.—Lactation.—Milkfever and abscess.—Excoriated nipples.—Diet during lactation.—Management of lochia.—After-pains, | [169] |
| [CHAPTER III.] | |
| MECHANISM OF PARTURITION. | |
| Cranial presentations—first and second position.—Face presentations—first and second positions.—Nates presentations, | [199] |
| [PART IV.] | |
| MIDWIFERY OPERATIONS. | |
| [CHAPTER I.] | |
| THE FORCEPS. | |
| Description of the straight and curved forceps.—Mode of action.—Indications.—Rulesfor applying the forceps.—History of the forceps, | [216] |
| [CHAPTER II.] | |
| TURNING. | |
| Turning.—Indications.—Circumstances most favourable for this operation.—Rulesfor finding the feet.—Extraction with the feet foremost.—Turning with the natesforemost.—Turning with the head foremost.—History of turning, | [230] |
| [CHAPTER III.] | |
| CÆSAREAN OPERATION. | |
| Indications,—Different modes of performing the operation.—History of the Cæsarean operation, | [243] |
| [CHAPTER IV.] | |
| ARTIFICIAL PREMATURE LABOUR. | |
| History of the operation.—Period of pregnancy most favourable for performing it.—Description of the operation, | [250] |
| [CHAPTER V.] | |
| PERFORATION. | |
| Variety of perforators.—Indications.—Mode of operating.—Extraction.—Crotchet.—Embryulcia, | [256] |
| [PART V.] | |
| DYSTOCIA, OR ABNORMAL PARTURITION. | |
| [CHAPTER I.] | |
| FIRST SPECIES OF DYSTOCIA. | |
| Malposition of the child.—Arm or shoulder the only faulty position of a full-grownliving fœtus.—Causes of malposition.—Diagnosis before and during labour.—Resultswhere no assistance is rendered.—Spontaneous expulsion.—Malpositioncomplicated with deformed pelvis or spasmodically contracted uterus.—Embryulcia.—Theprolapsed arm not to be put back or amputated.—Presentation ofthe arm and head.—Presentation of the hand and feet.—Presentation of thehead and feet.—Rupture of the uterus.—Usual seat of laceration.—Causes.—Premonitorysymptoms.—Symptoms.—Treatment.—Gastrotomy.—Rupture in the early months of pregnancy, | [264] |
| [CHAPTER II.] | |
| SECOND SPECIES OF DYSTOCIA. | |
| Size and form of the child.—Hydrocephalus.—Cerebral tumours.—Accumulationof fluid and tumours in the chest or abdomen.—Monsters.—Anchylosis of the joints of the fœtus, | [281] |
| [CHAPTER III.] | |
| THIRD SPECIES OF DYSTOCIA. | |
| Difficult labour from faulty condition of the parts which belong to the child.—Themembranes.—Premature rupture of the membranes.—Liquor amnii.—Umbilical cord.—Knots upon the cord.—Placenta, | [286] |
| [CHAPTER IV.] | |
| FOURTH SPECIES OF DYSTOCIA. | |
| Abnormal state of the pelvis.—Equally contracted pelvis.—Unequally contractedpelvis.—Rickets.—Malacosteon, or mollities ossium.—Symptoms of deformedpelvis.—Funnel-shaped pelvis.—Obliquely distorted pelvis.—Exostosis.—Diagnosisof contracted pelvis.—Effects of difficult labour from deformed pelvis.—Fracture of the parietal bone.—Treatment.—Prognosis, | [292] |
| [CHAPTER V.] | |
| FIFTH SPECIES OF DYSTOCIA. Obstructed Labour from a Faulty Condition of the Soft Passages. | |
| Pendulous abdomen.—Rigidity of the os uteri.—Belladonna.—Edges of the osuteri adherent.—Cicatrices and callosities.—Agglutination of the os uteri.—Contractedvagina.—Rigidity from age.—Cicatrices in the vagina.—Hymen.—Fibrousbands.—Perineum.—Varicose and œdematous swellings of the labia andnymphæ.—Tumours.—Distended or prolapsed bladder.—Stone in the bladder, | [308] |
| [CHAPTER VI.] | |
| SIXTH SPECIES OF DYSTOCIA. Faulty Labour from a Faulty Condition of the expelling Powers. | |
| I. Where the uterine activity is at fault—functionally or mechanically—from debility—derangementof the digestive organs—mental affections—the age and temperamentof the patient—plethora—rheumatism of the uterus—inflammation ofthe uterus—stricture of the uterus.—Treatment. II. Where the action of theabdominal and other muscles is at fault.—Faulty state of the expelling powers after the birth of the child.—Hæmorrhage.—Treatment, | [324] |
| [CHAPTER VII.] | |
| INVERSION OF THE UTERUS. | |
| Partial and complete.—Causes.—Diagnosis and symptoms.—Treatment.—Chronic inversion.—Extirpation of the uterus, | [345] |
| [CHAPTER VIII.] | |
| ENCYSTED PLACENTA. | |
| Situation in the uterus.—Adherent placenta.—Prognosis and treatment.—Placenta left in the uterus.—Absorption of retained placenta, | [354] |
| [CHAPTER IX.] | |
| PRECIPITATE LABOUR. | |
| Violent uterine action.—Causes.—Deficient resistance.—Effects of precipitatelabour.—Rupture of the cord.—Treatment.—Connexion of precipitate labour with mania, | [361] |
| [CHAPTER X.] | |
| PROLAPSUS OF THE UMBILICAL CORD. | |
| Diagnosis.—Causes.—Treatment.—Reposition of the cord, | [368] |
| [CHAPTER XI.] | |
| PUERPERAL CONVULSIONS. | |
| Epileptic convulsions with cerebral congestion.—Causes.—Symptoms.—Tetanicspecies.—Diagnosis of labour during convulsions.—Prophylactic treatment.—Treatment—Bleeding.—Purgatives.—Apoplecticspecies.—Anæmic convulsions.—Symptoms.—Treatment.—Hysterical convulsions.—Symptoms, | [376] |
| [CHAPTER XII.] | |
| PLACENTAL PRESENTATION, OR PLACENTA PRÆVIA. | |
| History.—Dr. Rigby’s division of hæmorrhages before labour into accidental andunavoidable.—Causes.—Symptoms.—Treatment.—Plug.—Turning.—Partial presentation of the placenta.—Treatment, | [393] |
| [CHAPTER XIII.] | |
| PUERPERAL FEVERS. | |
| Nature and varieties of puerperal fever.—Vitiation of the blood.—Different speciesof puerperal fever.—Puerperal peritonitis.—Symptoms.—Appearances afterdeath.—Treatment.—Uterine phlebitis.—Symptoms.—Appearances after death.—Treatment.—Indications.—Falseperitonitis.—Treatment.—Gastro-bilious puerperal fevers.—Symptoms.—Appearances after death.—Treatment.—Contagiousor adynamic puerperal fevers.—Symptoms.—Appearances after death.—Treatment, | [415] |
| [CHAPTER XIV.] | |
| PHLEGMATIA DOLENS. | |
| Nature of the disease.—Definition of phlegmatia dolens.—Symptoms.—Duration ofthe disease.—Connexion with crural phlebitis.—Causes.—Connexion between thephlegmatia dolens of lying-in women and puerperal fever.—Anatomical characters.—Treatment.—Phlegmatia dolens in the unimpregnated state, | [463] |
| [CHAPTER XV.] | |
| PUERPERAL MANIA. | |
| Inflammatory or phrenitic form.—Treatment.—Gastro-enteric form.—Treatment.—Adynamic form.—Causes and symptoms.—Treatment, | [473] |
| Index, | [483] |
A SYSTEM OF MIDWIFERY.