A System of Obstetric Medicine and Surgery (Volume 1); Theoretical and Clinical for the Astudent and Practitioner (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1885. Excerpt: ... tion with signs of general depression, it indicates internal haemorrhage, with retention of clot, the serous element being squeezed out and flowing externally. These are the local signs. The general signs are scarcely less marked. Bleeding often goes on insidiously, the woman not complaining. But this calm may be illusory. In extreme cases a degree of shock, of collapse, is conspicuous; the face is pale, white, waxy, and cold; the whole surface is cold, the pulse is frequent, feeble, thready, sometimes not to be felt. Hales established that the pulse became more frequent by haemorrhage. Marey showed that at the same time there was feeble tension see fig. 45). The sudden penetration of blood in the arteries swells the fulness of the pulsations and causes dicrotism. This is the more marked in proportion to the rapidity of the loss. Fio. 45. Sphygmogram of a case of post-partura hemorrhage. (Faneourt Barnes.) If haemorrhage is very abundant, a contraction of vessels is produced which restores tension, and causes disappearance of the increase of fulness of pulse, more especially since the radial, like all the arteries, undergoes a diminution of calibre, which by itself would render the pulsations weaker. It is this kind of shrinking of the vessels which J. Hunter observed in animals bled to death, which led him to the discovery of the contractility of the arteries. There is an indescribable sense of oppression in the chest. The woman calls out for air, will have the windows open, insists upon sitting up, sometimes would even get out of bed; the respirations rise to 30, 36, or even to 40 in the minute, they are laborious; she tosses her arms about, says 'she is sinking through the bed;' is more or less delirious; her perception of external objects is often dul...