A compend of obstetrics : especially adapted to the use of medical students and physicians / by Henry G. Landis.

  • Landis, Henry G. (Henry Gardner), 1848-1886.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: A compend of obstetrics : especially adapted to the use of medical students and physicians / by Henry G. Landis. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    At what date are the important signs available ? 1. The foetal heart, rarely before the fourth month. 2. Ballottement, third to fifth month, but its failure may be due to want of skill and other causes, besides the absence of pregnancy. 3. The cessation of menstruation, usually after the time for the first period, or immediate. It is always a suspicious circumstance in healthy women previously regular, whether married or not. 4. The increased size of the uterus may almost always be made out by bimanual touch, at from four to six weeks. If at a second examination, a month later, a further symmetrical enlargement, at the usual rate, is noted, the fact of pregnancy is scarcely to be doubted. 5. The changes in the breasts may begin in the second month, but are rarely marked until the middle of pregnancy, which is true of most of the presumptive signs. What is the duration of pregnancy ? It is somewhat variable, but it is sufficiently accurate to regard it as continuing through ten menstrual periods, ten lunar months, or 280 days. What are the limits of variation ? From 245 to 300 days, with possibilities in either direction. What causes pregnancy to come to an end ? The important theories are— 1. Powers'. The uterus is a peristaltic tube, with circular fibres in the cervix acting as a sphincter. As the child grows, it presses upon this sphincter, and the sum of all successive irritations finally causes it to relax, and the uterus to expel the child. 2. King's. The uterus has a definite limit of growth. The foetus does not attain its limit of growth in utero, and therefore, distends the uterus when the latter stops growing. This irritates the uterine fibre and causes it to contract and expel its contents. 3. The foreign body theory. The womb is always irritated into contract- ing upon a foreign body, and the foetus becomes such a body at the end of pregnancy. There is probably truth in each view of the matter. Why is the ovum not a foreign body during pregnancy ? Because of the intimate vascular connections between the chorion and the uterine mucous membrane. How does the ovum become a foreign body ? By the fatty degeneration and atrophy of the connections between the ovum and uterus, which occurs during the last weeks of pregnancy.