In pregnancy, the uterus is always affected with that grade of morbid action which I formerly called inflammation. This is evident from its exhibiting all its usual phænomena in other parts of the body. These are,
1. Swelling, or enlargement.
2. Hæmorrhage. The lochia are nothing but a slow and spontaneous bleeding performed by nature, and intended to cure the inflammation of the uterus after parturition.
3. Abscesses, schirri, and cancers. It is true, those disorders sometimes occur in women that have never borne children. In these cases, they are the effects of the inflammation excited by the menstrual disease.
4. A full, quick, and tense or frequent pulse; pain; want of appetite[63]; sickness at stomach; puking; syncope; and sometimes convulsions in every part of the body.
5. Sizy blood. This occurs almost uniformly in pregnancy.
6. A membrane. Dr. Scarpa has proved the membrana decidua, which is formed during pregnancy, to be in every respect the same in its properties with the membrane which is formed upon other inflamed surfaces, particularly the trachea, the pleura, and the inside of the bowels. Thus we see all the common and most characteristic symptoms and effects of inflammation, in other parts of the body, are exhibited by the uterus in pregnancy.
These remarks being premised, I proceed to remark, that blood-letting is indicated, in certain states of pregnancy, by all the arguments that have been used in favour of it in any other inflammatory disease. The degree of inflammation in the womb, manifested by the pulse, pain, and other signs of disease, should determine the quantity of blood to be drawn. Low diet, gentle purges, and constant exercise, are excellent substitutes for it, but where they are not submitted to, blood-letting should be employed as a substitute for them. In that disposition to abortion, which occurs about the third month of pregnancy, small and frequent bleedings should be preferred to all other modes of depletion. I can assert, from experience, that they prevent abortion, nearly with as much certainty as they prevent a hæmorrhage from the lungs: for what is an abortion but a hæmoptysis (if I may be allowed the expression) from the uterus? During the last month of pregnancy, the loss of from twelve to twenty ounces of blood has the most beneficial effects, in lessening the pains and danger of child-birth, and in preventing its subsequent diseases.