An introduction to the practice of midwifery / by Thomas Denman.

Date:
1824
Catalogue details

Licence: Public Domain Mark

Credit: An introduction to the practice of midwifery / by Thomas Denman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    who become maniacal in childbed, always recover This opinion, I presume, extends only thus far, that if they live, they always re- cover their faculties, the distemper proceeding from disordered functions and not from an organic disease; but I have seen several women die during their maniacal state, and not long after the ac- cession of the disorder. Their death has sometimes appeared to be owing merely to the vehemence and continuance of their exertions, which it seemed impossible to moderate. The time when this disorder appears is different; in some cases a few days after delivery, in others about a fortnight or longer, or in the manner before mentioned. All women soon after delivery are either more irritated, or more subject to irritation, than they perhaps are at any other time; and hence chiefly arose the necessary custom of keeping them quiet, and secluding them for a certain time, from the chance of meeting with such occurrences as might disturb them. I have known more than one instance of a lying-in woman in a very irritable state, but with perfect composure of mind, becoming at once deranged by some fright or mischief apprehended to herself or child, or from some dismal story related to her; who might have escaped, had she been managed with circumspection. It is impos- sible to describe how much of the prevention and cure of these and other complaints depends on the judicious conduct, gnd proper man- ners of their attendants. As to the delineation or history of maniacal disorders, under any circumstance, this does not seem necessary, if it were practicable; because the name does not depend on a symptom, or a single act, unless it were an outrageous one indeed; but often upon the con- struction put upon general, or frequently repeated unusual con- duct, varying in degree and outward form in every individual pa- tient. For these reasons, it is not surprising, that in some cases there should be a difference of opinion as to the actual existence of the disorder, even among men of experience; or that, on the first interview, it is often impossible to give an opinion which could be supported. The difficulty of deciding is also very much increased, by the difference in the conduct of the patient at particular times; for even in very bad cases there are generally lucid intervals, or a reasonableness except on certain subjects, when the disorder would not be suspected. Yet, if we once conclude a patient to be maniacal, which we were unwilling to suspect, and still less willing to announce, a review of the preceding circumstances com- monly exhibits pretty clear proofs of the gradual progression of the disorder. On the attack of every complaint of this kind, from the exertions of the patient, and the tumultuous derangement of her mind, the