Volume 2

A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst. Source: Wellcome Collection.

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

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    the constitution of the saliva, which deprived it of all digestive activ- ity, ])tyalin being entirely absent. The buccal mucous membrane is red ami tumid. The parotid and submaxillary glands are swollen and tender. The absence of fetor serves to distinguish the salivation inci- dent to pregnancy from the ptyalism of mercurial poisoning. The disorder commonly opposes an obstinate resistance to all methods of treatment. A generous diet, thc^ free exhibition of iron, and astrin- gent mouth-washes mitigate in some degree the severity of the symp- toms. Atropine' has been injectetl hypodermatically over the enliirged salivary glands, on account of its well-known effect on the chorda tvm- pani, with varying degrees of succes.s. Pilocarpine is of some value in certain cases. Iodide of potassium is in general contraindicated, on account of its effect in the causation of uterine contractions. In small doses, however, the remedy is often efficient. Bromide of potassium ^ is, of all remedies, probably the most reliable. Gingivitis.—Inflammation of the gums, commonly observed in con- nection with salivation, sometimes occurs in its absence. According to Pinard the disorder is commonly seen in multiparse rather tlian in primiparre. In 75 women—13 multipane and 32 primiparte—this dis- order was observetl thirty-one times among the former and fourteen times among the latter. The changes in the blofxl incident to pregnancy seem to play the chief rblc in the predisposition to this affection. The disorder is cha- racterized by redness, swelling, and retraction of the gums, which are tender and bleetl on pre.ssure. The teeth are often loosened in their sockets and their necks exposed to the altered .secretions of the buccal cavity, which are often acid. Mastication is frequently diflicidt and painful. Extreme attention to the hygiene of the teeth is indicated. It is a good plan to rub proci])itated chalk into the crevices betwt'cn the teeth at night before going to lx>d, and to allow the protective to remain. Astringent alkaline dentifrices jxdliate the .symptoms. Drugs exhib- ited per os, apart from the chalybejite tonics, exercise but little influ- ence on the couree of the affection, wdiich usually persists through the term of jircgnancv, and .sometimes through lactation. Constipation.—Constipation is a common, sometimes a troublesome, attendant upon gestation. In the majority of ca.ses the habit is formtHl long before the occurrence of pregnancy. During gestation the chief etiological factors are the defective innervation of the intestines, altera- tions in the inte.stinal secretions, and the changes in the anterior abdom- inal wall, w’hich interfere especially during the second half of ])regnancy with its functional activity in the act of defecation. The direct mechan- ical pressure of the gravid uterus upon the intestinal ma.ss is practically ’ Ebstein: Bert. klin. Wochenschr., 1873, No. 25. ’ Schramm : toe. cU.