Puerperal convulsions / by C. A. Lindsley ; read before the New Haven County Medical Society, April, 1858.

  • Lindsley, Charles A. (Charles Augustus), 1826-1906.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Puerperal convulsions / by C. A. Lindsley ; read before the New Haven County Medical Society, April, 1858. 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.

    6/20 (page 4)
    the arteries and veins; when the head of the foetus in the vagina has excited the reflex action of the expiratory muscles, causing with every pain, partial or entire closure of the glottis, interfering with the proper oxygenation of the blood in the lungs, obstructing its return from the luad, and often distending the veins of the head and neck until partial asphyxia occurs. Surely, if simple congestion can pro- duce convulsion, it is at such a time we should expect it. But such is not always the fact. The patient is often seized even before labor has commenced, or in the first stage when the circulation is undis- turbed, and there is as yet no excessive cerebral vascularity; and again, she may pass through the ordeal of the second stage unharmed, and be seized with the tits after the labor is concluded. Does not this fact alone sufficiently refute the generally received opinion that congestion of the brain is the chief cause? If congestion of the brain is the principal agent in the production of eclampsia, how can we explain this undisputed fact, that eclampsia occurs both before and after the most enormous congestion of that organ as frequently as during such congestion? Because engorge- ment of the vessels of the head is a constant symptom of the fit, it is not proof that it is the cause of the fit. Because after death from con- vulsion, sanguineous and serous effusion into the ventricles and between the membranes is found, it is not proof that such effusion was the cause of the convulsion. It is much more probable that both the engorgement and the effusion are in most cases results,—consequences of the disease,—and not the cause. Looking from another point of view, congestion of the brain is precisely what might be anticipated as an effect of the fit. During the attack almost every condition exists that would of the most inevitable necessity produce distension of the cerebral vessels and effusion. The fact is, gentlemen, observers have been looking through the wrong end of the glass ; they have seen every object distinctly, but they have misinterpreted them. In stating the case thus strongly, however, I do not wish to be understood as saying that congestion and effusion are never the cause of convulsion ; on the contrary, I believe that sometimes they are the cause. Now to illustrate exactly my idea I will suppose two instan- ces. If during the fierce exertions of the propulsive stage of labor, rupture of a blood-vessel occurs, producing by the effusion counter- pressure upon the medulla oblongata, and as a consequence convul- sions, the cause must undoubtedly be ascribed to the effusion. But if the patient is thrown into convulsion by irritation of the os uteri, and during the fit, rupture of a blood-vessel occurs with effusion into the