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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    rule, that, during such a labour, for a period not exceeding thirty; hours, unless accidental circumstances occur, the patient will go on witli safety. By accidental circumstances are understood rupture of the uterus, puerperal convulsions, disease prior to the commence- ment of labour, preternatural presentation, and haemorrhage. It will be demonstrated, by a deduction from 11,695 cases, that the occurrence of any of the casualties in this lormidable list is so rare as not to affect the general reasoning. At the period ol first publication, it was the intention of the writer to have made that essay the first of a series on general subjects of midwifery; therefore, a number of facts not very strictly connected with the title of the paper were brought to- gether. The discontinuance of the Dublin Essays shortly after this publication, and the pressure of a harassing profession, have hitherto delayed the fulfilment of that intention. A republication, though in a somewhat different form, seems warranted by the reference of Mr Burns to the tables, in his Principles of Midwifery, page 242, in which, however, he has not sufficiently adverted to the end for which they were con- structed ; and by the repetition of Mr Burns's reference in Dr Merry man’s Synopsis. The terms tedious labour, when used in this paper, signify labour where the head ot the child presents, and a period ex- ceeding thirty hours elapses, from the commencement to the termination. Every practitioner of midwifery must acknow- ledge the importance of the treatment of this species of parturi- tion. In the various other embarrassing circumstances that occur to the accoucheur, the principles which should regulate his conduct are more fixed, and nearly demonstrable; and numerous well authenticated cases are on record to guide his judgment. When the patient’s sufferings are so long protract- ed, she and her friends become uneasy and anxious. The practitioner, unless he has reason to expect a speedy termina- tion of the case by the efforts of nature, will begin to feel ap- prehensions lest he should be under the necessity of having re- course to instruments. A moral question also, of very serious importance, sometimes comes under consultation, as cases occur where the means best calculated to relieve the parent are incompatible with the safety of the child. In choosing the time of affording extraordinary assistance, it should be kept in con- stant recollection, that even when some disproportion exists between the pelvis of the mother and head of the child, the long continued action of the uterus gradually compressing and elongating that part, will expel a living infant where either the