A Case of Idiopathic Peritonitis Complicating Labor

JAMES B. AYER
1876 Boston Medical and Surgical Journal  
January 25, 1876,1 was called to attend Mrs. C. D. B., aged thirtyseven years and nine months, in labor with her first child. A year previous she had had a miscarriage. For two years she had been debilitated, and during the five or six months preceding confinement she found that the slightest exertion fatigued her, and she was compelled to give up her daily walk for exercise. For the last two months she complained of being very feverish, and insisted upon opening the windows and doors, even on
more » ... and doors, even on the coldest days. At night she felt uncomfortable with an ordinary amount of bed-clothing. At times her breathing was very rapid. She had been jaundiced at frequent intervals since 1860. As far back as then she was told by physicians that her liver was much enlarged. Considering the age of the primípara, the labor was very easy. First head presentation. Child, weighing nine and one half pounds, was delivered in ten hours after the first pains. Placenta followed quickly, and the uterus contracted readily and firmly. The perinseum was ruptured slightly, but not enough to require serre-fines or sutures. During the labor . the patient frequently breathed rapidly and with difficulty. She complained of feeling very warm, and demanded that the doors should be open and the room kept cool. The temperature, taken a few minutes after delivery, was 100°; pulse 88. There were no after-pains, and she slept quietly the remainder of the night. January 26th, 8.30 A. M., five hours after delivery, I visited the patient and found her jaundiced and the abdomen tympanitic. When pressure was made at either side of the uterus, the patient experienced a slight amount of pain. She had had no chills nor vomiting. Pulse 90 ; temperature 100|°; respiration 35. During the day there were five dejections of a yellow color. Urine was passed readily, and showed no change in color. Patient took light diet well. At night the pulse was 94 ; temperature 100°. January 27th. Slept well last night, and is comfortable to-day. Pulse 90 ; temperature 101°; respiration 30. Heart and lungs examined and
doi:10.1056/nejm187605250942101 fatcat:l765nic7hfarbinditcfrgxfzq