Transactions of the County and City of Cork Medical and Surgical Society.

Catalogue details

Licence: Public Domain Mark

Credit: Transactions of the County and City of Cork Medical and Surgical Society. Source: Wellcome Collection.

27/82 (page 29)

of time is fatal to the infant,a and either causes rupture of the uterus, or contusion, inflammation, and sloughing of the vagina. But, besides the local injuries which the mother sustains, a twofold effect is produced upon her general system by protracted labour or severe suffering; for as each hour passes and leaves her undelivered, her courage fails, despondency and anxiety take its place, she cannot be persuaded that everything is right, and she begins to sink under a condition of the system similar to that which works the ruin of an army in retreat, and is best expressed by the words, “ demoralised, dispirited, and broken down.” Secondly.—The suffering itself exhausts the vital energies of the system, and saps the foundation of life. Nature has provided against the destruc¬ tive effects of acute suffering by entailing as its consequence a faint, which is, in point of fact, a mimic death, and often, we may believe, by blunting the sensibilities, arrests a progress towards real death. But there is no such relief from hard labour; its effect upon the nervous system continues unabated or increasing in intensity, until, even after the birth of the infant, the mother sinks from the nervous shock which super¬ natural labour has entailed. The first recorded death from parturition was caused by hard labour; we find it in the simple and affecting narra¬ tive of the death of Rachel (Genesis xxxv., 17 and 18) :—“And it came to pass, when she was in hard labour, that the midwife said unto her, Fear not; thou shalt have this son also. And it came to pass, as her soul was in departing (for she died),” &c., &c. Had the forceps been used in this case we may presume, from the experience of those who used it to terminate “ hard labour,” that the result would have been different.15 It would be very desirable to have some fixed rules to guide the student a See paper by Dr. Hamilton, of Falkirk, in tbe 2nd vol. Medico-Chirurgical Review for 1853. b See the statistics of Dublin Lying-in Hospital, as quoted by Drs. Johnston and Sinclair, and the result of the present practice compared with that of former years when the forceps was little' used. See also the result of Dr. Hamilton’s practice, before referred to ; of Dr. Lawrence, of Montrose ; of Dr. Ryan, of Dublin ; of Dr. Beatty, quoted by Churchill; of Mr. Crosse ; of Professor Simpson, Dublin Quarterly Journal, August, 1861, p. 60 ; of Dr. Swayne, British Medical Journal, September 6, 1862, &c., &c., all of whose practice is very different to that recommended by Ramsbotham and Murphy, the former of whom lays down, among his rules for the application of the forceps—“Countenance anxious ; pulse 120, 130, or 140 ; white, slimy, or dry brown tongue ; great tenderness of uterus ; green discharge ; heat and tumefaction of vagina,” and perhaps “head locked for four hours, and made no progress for six or eight; coffee-ground vomiting ; hurried breathing ; delirium, or coldness of extremities, all of which would warrant us in applying the forceps, even if labour had not lasted twenty- four hours, or even twelve.” It must be hard labour, indeed, that would cause these symptoms ; and it would be difficult to save the life of the patient if tbe practitioner was hard-hearted enough to allow them to commence.