On insanity and certain nervous disorders / by Thomas More Madden.

  • Madden, Thomas More, 1838-1902.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: On insanity and certain nervous disorders / by Thomas More Madden. Source: Wellcome Collection.

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    after this time imagined that he was able to detect the sounds of the toetal heart and placental souffle. The time of her expected confinement at last arrived. The nurse took up her quarters in the house; some of the family came down from town to be present at the anxiously-looked-for event, and all her preparations baby linen, &c., were completed. No sign of labour, however, manifested Itself as week after week passed beyond the expected time. Her frierids got tired out, her family returned home, and she herself became exceed- ingly nervous and desponding, as her mother had died of dropsy at about her present age. But still she insisted as strongly as ever that she could feel the child's motions distinctly. .Such was the history of her case up to the time that I was asked to see her. On examination I found the breasts slightly enlarged, but soft and flaccid. The nipples were somewhat turgid; there was a well-marked areola, and the glandular follicles around the base of each were promi- nent. The abdomen was about as large as that of a woman at the end of the ninth month of pregnancy. But the uterus was small, as I dis- covered, when, with some difficulty, I succeeded in taking her attention off for the moment, and overcame the resistance offered to any manual examination of the uterus by the abdominal muscles, which were tense, rigid, and arched. There was resonance on percussion, the large intes- tines being enormously distended by flatulence, the movements of which she had taken for those of the fcetus. There was also a considerable quantity of fluid in the peritoneal cavity. The vagina was pale; the cervix and os uteri were low down, hypertrophied, and in a state of extensive granular ulceration. Her chagrin, when informed that her preparations were not necessary, for the present at least, was naturally very great. Her medical attendant now agreed with me in recommending change of air, sea bathing, and a combination of tonics and diuretics. Under this treatment the abdominal swelling and the symptoms of pseudocyesis disappeared with astonishing rapidity. The ulceration was treated with equal success, and her con- dition is now better than it has been for a long time. Case No. 4.—August 26th.—F. M., a clerk's wife, aged twenty-four, came to the dispensary to know what she should do to stop her changes, as she believed herself five months pregnant. She had had two children in three years since her marriage, and had on the present occasion suffered from all the symptoms she had before experienced when preg- nant—morning sickness, enlargement of the breasts and abdomen, «S:c., and had fainted, as she always had done, as she said, when she felt life in the child, a month previously. In this case, on examination, a large fibroid uterine tumour was discovered. Case No. 5.—^M. T., aged 29, a plethoric woman, three years married.