On haemorrhage from the umbilicus after the separation of the funis / by John Manley.

  • Manley, John.
Date:
[1850]
Catalogue details

Licence: Public Domain Mark

Credit: On haemorrhage from the umbilicus after the separation of the funis / by John Manley. 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.

    1/10
    HAEMORRHAGE FROM THE UMBILICUS AFTER THE SEPARATION OF THE FUNIS. By JOHN MANLEY, M.D. Read on Thursday, January 24, 1850. Haemorrhage from the umbilical ves- sels occurring after the separation of the cord, is a subject which has either been entirely overlooked, or has only obtained a passing notice in systematic works on the diseases of infancy. My attention was drawn to this peculiar and comparatively rare accident by a case which came under my observation in the hitter end of October of the past year, while attending the patients of Mr. J. L. Worship, of Riverhead, Kent, during his temporary absence. The chi'd, a male, a fortnight old, had been bora after a natural labour, and had presented at its birth all the signs of health and strength: its parents were of the labouring class, and but poorly provided with the necessaries of life. 1 found that it had already for some days been affected in a marked manner with jaundice, the icterus neonatorum, for which small doses of the Hydrarg. c. Cret. had been administered. The symptoms of the jaundice were still very evident, and the dusky yellowness of the skin was general, and coukl not he mistaken for the colour of the in- tegument peculiar to new-boni children in a state of health. Moreover, the conjunctive presented a yellow tinge. The bowels were much relaxed during the first period of the disease ; the stools were frothy, and of a lightish hue, al- though not the decided clay colour of the fseces in the jaundice of adults. They, however, improved in appearance after- wards, and their number decreased con- siderably, the Hydrarg. c. Cret. already prescribed having been continued I omitted any attempt to examine tli£ urine and its colour, as also many other symptoms, as my whole attention was soon absorbed by an unusual and very embarrassing occurrence. At my first visit the mother called my attention to the presence on' the binder and body- linen of a few drops of blood, which evidently came from the navel: she assured me that the separation of the cord had taken place in the usual way, and at the usual time, about the fifth day, without any violence having been used. She had, however, soon after, observed the presence of some spots of blood on the linen, when changing and dressing the child. Upon examining the umbilicus, I found the circumfer- ence of it to have a natural appearance, but the fundus was filled with a dirty- looking substance, resembling the debris of cellular tissue mixed with blood: upon washing the part clean I perceived the blood to ooze more particularly from one spot: this I touched repeatedly with the nitrate of silver, hoping that this cauterization would be sufficient to arrest the bleeding. At my next visit, however, I found it had continued; I then made pressure, as well as the struggles of the infant would allow; the haemorrhage, however, went on, and evidently increased in quantity, to judge by the degree to which the linen was soiled with blood. I then began to experience much anxiety as to how the case might terminate. I repeated the cauterization with the nitrate of silver, applying it much more vigorously than the first time; I moreover enjoined the mother to keep up continual pressure with the thumb over the graduated compress, which I fastened over the navel as firmly as I could. The mother