The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    degree, and consequently more liable to be confounded with other kinds of pain. The principal conditions under which labor-like pain may be observed will now be mentioned. In loomen lolio have never menstruated^ the presence of hypo- gastric pain of the kind in question would make us suspect closure of the hymen, of the vagina, or of the os uteri, and that the men- strual fluid, although secreted, could not be expelled. In cases of this kind, the pains at first felt are slight in degree; but as month after month passes without relief, they become more severe, and are finally of the most intense character. The enlarged uterus is usually then to be felt above the pubes. In women who have menstruated^ the presence of hypogastric pain recurring at intervals, sharp while it lasts, and leaving the patient free from pain in the intervals of the paroxysms, would give the idea of the presence of abortion. This idea would be substantiated, or the reverse, by the collateral evidence obtain- able. If the patient had passed over one or more periods Avithout menstruating as usual, and if the pains above described were ac- companied by a discharge of blood from the vagina, this would render the suspicion of abortion so strong as to necessitate not only an examination per vaginani, but also a careful inspection of the matters discharged. Great caution should be exercised in ex- pressing any conclusion on such a question, and a conclusion is only possible after a careful scrutiny of the facts elicited. In abortion occurring before the third month, the collateral facts do not so unmistakably point out the nature of the case as in instances of abortion occurring later. Respecting an abortion taking place at four, five, or six weeks, for instance, it would be exceedingly diflBcult for the practitioner to affirm positively that the case was one of abortion, unless he were fortunate enough to secure the ovum itself. Menstrual Retention occurring subsequentli/ to more or less regular performance of the Menstrual Fuoictioii.—In these some- what rare cases, labor-like pains may be present. These cases only diifer from those alluded to in previous pages (see Pain during Menstruation) in this, that the secretion escapes with difficulty in the one instance, and does not escape at all in the other. The pain is alike in both, and the other attendant phe- nomena are almost identical. In cases of Peri-uterine Hcematocele, labor-like pains are usually observed. They either precede the occurrence of the hemorrhage,