Observations on the management of tedious labour, with an account of the number of cases that occurred in the Lying-In Hospital, Dublin, from November 1800 to the 31st July 1816 / by John Breen.

  • Breen, John.
Date:
1819
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the management of tedious labour, with an account of the number of cases that occurred in the Lying-In Hospital, Dublin, from November 1800 to the 31st July 1816 / by John Breen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    are cases in Smellie, where he appears not so anxious about drawing off the water as 1 would tliink it prudent to be ; but, ■in his cases, it will be observed, that the secretion went on re- gularly, which 1 conceive to be a matter of the greatest import- ance. A violent rigor coming on after labour has lasted 29 or 30 hours, I conceive to be a sign that inflammation is about to set in ; if no other unfavourable symptom be present, I would not think it to be a sufficient cause for instantly ceasing to trust to nature, but on the occurrence of this symptom we should watch the slightest changes of our patient with the greatest attention. The alterations of countenance, I conceive, furnish a very im- portant criterion in the treatment of tedious labour. It is diffi- cult, if not impossible, to give any rules on this head, more than to recommend an attentive observation of the slightest variation, or tendency to the sinking of countenance. Violent and acute inflammation, characterized by severe and unceasing pain, with vomiting, occasionally occur. There are two cases noted as oc- curring amongst the 11,695; in each it took place within twen- ty-four hours from the commencement of labour; in both, la- bour was so far advanced as to allow immediate delivery by in- struments ; each case terminated unfavourably, and the cause of death in one was ascertained by dissection. To support the courage and confidence of the patient, consti- tutesahighlyusefulandimportantpart ofthedutyofan accoucheur, in his attendance on a tedious labour. 1 would conclude, that, where the secretions go on regularly, light food is taken in suffi- cientquantity tosupport the strength, and remains on the stomach; the pulse and countenance continue good ; vomiting is not vio- lent ; the vagina is well lubricated with mucus ; and uterine ac- tion causes the slightest advance of the child. It is astonishing for what a length of time we may trust to nature, and what difficulties the long continued action ot the uterus will surmount. The parts being protected by mucus, is a matter of considerable importance, as this secretion prevents local injury and inflam- mation. No artificial application appears to me of much con- sequence in supplying this defect of sedition. Emollient injec- tions thrown up the rectum, tend both to promote the secretion here mentioned, and to increase uterine action. When some disproportion exibts between the pelvis and child’s head, to- gether with this tendency to local inflammation, manifested by him in the Medical and Physical Journal for December 1805, Vol. XiV. ap- pears well calculated to obviate this inconvenience.