Editorials and Medical Intelligence

1861 Boston Medical and Surgical Journal  
some pain in the back, lasting a short time and then subsiding. The operation of the preceding day was now repeated, and the membranes . somewhat more extensively detached. On neither of these occasions did she appear to suffer any increased fatigue or much inconvenience from my interference. I now concluded to await the effect of the efforts already made. The remedies used prior to May 1st had been discontinued, the only means since employed being such as were likely to promote, as far as
more » ... ote, as far as possible, the patient's comfort, sustain her strength, and procure rest at night. There were no indications of approaching labor, other than occasional pains in the back, until Sunday night, May 5th. At my visit on Monday morning, I found that labor pains had commenced during the night, and that the liquor amnii had been discharged towards morning. On placing the ear over the abdomen, could hear the tick of the foetal heart. Presentation by the vertex. During the forenoon the os uteri continued to dilate slowly, the pains being feeble and occurring at long intervals. At 3 o'clock, P.M., there being full dilatation, but no expulsive power, 1 applied the forceps. The child, a female, was stillborn. The cord was much shrunken. Considerable foetid gas followed. Shortly afterwards, the breech of a second child was presenting ; when within convenient reach, its delivery was assisted by the application of the blunt hook. This was also a female and stillborn ; the upper portion of its body, when born, was enveloped in the membranes, with the placenta resting on its head like a cap. The other placenta soon followed, the two not being united in this instance. No haemorrhage ensued. The mother was much exhausted, but was able to talk, and take some stimulants which were directed for her. The pulse was distinct at the wrist, and there was no fainting. In the course of an hour I left her, and returned after about two hours' absence. Was informed that she had had some sleep. Found her in a state of stupor, from which she would arouse when spoken to, and then relapse. She at length became comatose, and died at 7 o'clock in the morning. No post-mortem examination was allowed.
doi:10.1056/nejm186106270642105 fatcat:sukb7fog7zdnjc23gybzvpcjtq