Further observations on chloroform in the practice of midwifery / by Edward W. Murphy.

Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Further observations on chloroform in the practice of midwifery / by Edward W. Murphy. Source: Wellcome Collection.

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

    17/44 page 17
    Case VII.—Natural Labour; Third Child; Chloroform. A lady, who had previously resided in the country, came up to London, pregnant of her third child. She had heard very contradictory opinions about chloroform, but was resolved to use it, if I thought it right. . Labour commenced May 5, 1849, in the afternoon, severe pains coming on at intervals of about fifteen minutes. In the evening they were more frequent and pro- longed, and towards night assumed the character of bearing pains; the os uteri was about one-half dilated. Her pains were rapidly increasing in their ; severity ; and although my patient possessed great fortitude, and could well command her feelings, she could not patiently endure these pains. . I then gave her chloroform. She experienced immediate relief, and was quite conscious of the difference it made : the pains were not removed, but were muffled by the chloroform. At first I thought that the action of uterus was influenced i by it, because the intervals of the pains were lengthened ; but this was soon 1 proved to be only a temporary effect. The os uteri was soon completely dilated, and she was delivered of a fine boy within two hours from the time she inhaled chloroform. During the last expulsive pains the full effect of ; chloroform was induced : she lay asleep while the child was being born, and did not awake for five minutes after her delivery. The placenta was expelled i within that time. She recovered more rapidly than after her former labours. About three drachms of chloroform were used. Case VIII.—Natural Labour; First Child; Chloroform. A lady, whom 1 was engaged to attend, was taken in labour of her first child, September 3, 1849. Pier pains did not become active until night, dur- ing the whole of which she was kept awake by sharp grinding pains. She bore them, however, with great fortitude, and made little complaint. Towards morning they increased considerably in severity; and having made an examina- tion about seven o’clock a.m., I found the os uteri more than half dilated, the membranes entire, the cervix, rather rigid, but quite free from tenderness. Labour was suffered to proceed for some time longer, without interference. Strong pains returned every three minutes, becoming more and moi’e severe. At eight o’clock 1 commenced to use chloroform. The intensity of suffering was immediately diminished, she experienced great relief, the intervals be- tween the pains were lengthened to five and to ten minutes—that interval was spent in the most perfect repose, and freedom from the aching that previously occupied it. Although the intervals were thus increased, nevertheless the dila- tation of the uterus advanced much more rapidly than I expected; it was com- pleted about nine o’clock, and soon after the head descended to the perineum. As the head passed, the patient groaned with the pain ; when it ceased, she slept until the next pain woke her up. When the head was passing the vulva, she seemed to a certain extent unconscious. The consciousness was that of a sleeping person, who will change their position, and avoid what may render them uncomfortable, without having the least recollection that they had done so. Thus my patient bore down and groaned with her pain, but the moment it ceased, slept. The head remained on the vulva about ten minutes, and then passed out with the same groan, but without any of the usual expressions of agony. The moment the head was born, she remained asleep, which was not disturbed by the passage of the body and limbs of the child. The uterus con- tracted perfectly after the birth of the child, and expelled the placenta in about five minutes. In ten minutes after the child was born she awoke, and heard it cry. She was not conscious of its birth. The child was born a few minutes before ten o’clock a.m. When the first vaginal examination was made, about three hours before, I did not expect that labour would be concluded until the afternoon ; the cervix and os uteri pre- sented the character that I know requires a considerable time before it is com- pletely dilated. I was, therefore, very agreeably surprised to find the dilata- tion advance rapidly after the patient inhaled chloroform—it was completed m less than an hour ; and in another hour the child passed through, and was expelled from the pelvis. Four drachms of chloroform were used.
    digitised image 1
    digitised image 2
    digitised image 3