On the symptoms, causes, and treatment of puerperal insanity / by James Reid.

  • Reid, James
Date:
[1848]
Catalogue details

Licence: Public Domain Mark

Credit: On the symptoms, causes, and treatment of puerperal insanity / by James Reid. Source: Wellcome Collection.

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    menstruation, but never except at those times. Her husband thinks they were of an hysterical character, but from the description of a near relative, there can be no doubt that they were of an epileptic nature. Latterly, too, they had become more decided, and of longer duration. On first seeing the patient, she was tranquil, but had an expression of anxiety, the pulse was rather quick, but soft, the tongue clean, no jpain in the head, bowels inclined to constipation, but easily acted on by medi¬ cine. She had had little or no sleep for the last two nights, and not much during the past week. She had suddenly awakened her husband three nights since, to inform him that it had been notified to her by the Bible, that she should die in her approaching confinement, and that she was an instrument chosen of God for some great purpose. This, she repeated on our visit, in a mysterious manner, but could give no further explanation, her manner being placid, but accompanied by a peculiar expression of the eyes. As the want of sleep appeared to be the principal symptom requiring attention, we decided upon giving half a grain of acetate of morphia at bed-time, and a gentle aperient in the morning; the diet to be light and nutritious. At our next meeting, on the 30th, we found the patient quite calm; she had enjoyed much refreshing sleep during the night; the pulse was soft and natural; there was no pain in the head whatever, and she did not recollect the delusions of the previous day. She said that she felt perfectly comfortable in every respect, except that she was troubled by slight recurrent pains in the abdomen, which it was considered might be caused either by the aperient, or by the commencement of labour. Mr. Hugman found no evidence, however, of the latter fact on examining the os-uteri. The patient was now apparently in so improved and favourable a con¬ dition, that it was thought unnecessary that I should again see her, unless any change for the worse should occur; but it was understood that she was never to be left alone, and that great additional care was to be taken of her during, and after her labour. In the night, however, decided epileptic paroxysms attacked the patient, and in the afternoon of the next day recurred with great violence and frequency. Blood was abstracted from the arm by Mr. Hugman, leeches applied to the temples, cold lotions to the head, hot bottles to the feet, mustard cataplasms to the calves of the legs, but without any advantage. Owing to my being engaged elsewhere, I was unable to meet Mr. Hugman until eleven, p.m., but the patient was at that time moribund, having been unconscious for several hours, the pupil not acted on by strong light, and the convulsive paroxysms recurring with violence every few minutes, until death took place at half-past one, A.M., with¬ out any further signs of labour being observed. The following is a case of puerperal mania which occurred in the General Lying-in Hospital, for the notes of which I am indebted to Mr. Smith, the house-surgeon at that period :— H. C., aged 22, of dark complexion, with black hair, was delivered of her first child on the 14th of March, 1847. She had enjoyed good E
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