Abdominal and uterine tolerance in pregnant women : as shown by the low rate of mortality under severe lacerated and other wounds, the result of direct violence / by Robert P. Harris.

  • Harris, Robert P. (Robert Patterson), 1822-1899.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Abdominal and uterine tolerance in pregnant women : as shown by the low rate of mortality under severe lacerated and other wounds, the result of direct violence / by Robert P. Harris. 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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    vate records of our country practitioners, but the two examples serve to show that they have very different nervous systems to deal with, from what we usually find in women brought up in our large cities. In considering the subject of horn-lacerations of the abdomen, we are obliged to divide it into two heads: one form of injury being con- fined to the abdominal wall of the pregnant woman, while the other includes both it and the uterus, the latter being the more dangerous of the two casualties, in consequence of the additional risk of the uterine rent, which is of itself the more serious injury of the two. Where a pregnant woman has nearly reached the full term of utero-gestation, when the uterus is in contact with the abdominal wall, and the lower part of the abdominal protrusion gravitates toward a horizontal line, the thrust and tossing motion of the horn is, in nearly all cases, made to in- flict a ccelio-hysterotic rip. But where the pregnancy is at six or seve.i months, the protected position of the uterus and the form of the abdo- men favor the escape of the former in the character of the injury. The accompanying tabular record presents several very remarkable cases in which not only did the uterus of the pregnant woman escape being opened by the horn, but the woman also escaped the induction of premature labor as a result of the injury. Some of these casualties have very frightful records, and the results of treatment were scarcely such as must have been looked for by the surgeons in charge; in fact, in some instances the relatives were warned to expect death, when re- covery afterward took place. The most remarkable and interesting of all the varieties of horn- laceration in pregnant women is that which, from its nature, may be classed as Caesarean, of which the number of examples and the low record of mortality are beyond what might be conjectured. In view of the fact that in but one case of this class was the uterine wound sutured, and in no case was the obstetrical treatment truly aseptic, it is almost incredible that there should have been but four deaths among fourteen subjects; that two of the four dead women should have left children that are now living in the States of New York and Missouri, and that in four cases both the mother and child should have lived. We have endeavored, in the seven cases where the children lived, to ascertain whether they subsequently died at an early age, or grew to maturity. Five of these children were boys, one was a girl, and the sex of the seventh was not given. One boy lived to be a man over fifty years old; one is now forty-one; a third is nearly twenty-five; a fourth was lost sight of when a lad ; the fifth died at nine months ; and the girl is now ten years old. Four of the seven mothers recovered, and three are known to have survived a number of years; in fact, one now lives, after a period of forty-one years, and her son likewise. Abdominal and uterine tolerance will be found at their maximum in