Extra-uterine pregnancy; its causes, species, pathological anatomy, clinical history, diagnosis, prognosis, and treatment.

  • Parry, John S. (John Stubbs), 1843-1876.
Date:
1876
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Licence: Public Domain Mark

Credit: Extra-uterine pregnancy; its causes, species, pathological anatomy, clinical history, diagnosis, prognosis, and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    easily, than normal pregnancy in its early stages. The one pursues an irregular, and the other a regular course. The severe symptoms of an erratic conception can scarcely fail to attract attention. If there have been no evidences of either miscarriage or rupture of the cyst, combined vaginal and abdominal exami- nation may reveal the presence of a tumor by the side of the uterus, a sign of the highest importance; but unfortunately there is generally so much tenderness of the parts at this stage of the pregnancy, that it is useless to attempt to de- rive any knowledge from a physical examination, unless the patient be ansesthetized. The administration of ether, the anaesthetic generally used in America, and the only one which should be employed, is not unattended with danger, since the vomiting which it so often causes may lead to rup- ture, the most fatal of all the terminations of misplaced con- ception. But, under the circumstances, the aid of anaesthesia may be invoked for diagnostic purposes. The dangers of the condition are so numerous and so terrible that no means should be left untried to discover the true condition of a woman suspected to be the victim of this unfortunate accident. This advice is given upon the principle that the greater of two evils is the one to be avoided. Every known precaution should, of course, be taken both before and after its adminis- tration, to prevent the unpleasant effects of ether. Much may be done by moral influences to prevent the patient from strug- gling ; while the proper use of food before, and the adminis- tration of bromide of potassium, and other remedies after it, may in a great measure control the vomiting. The discovery of a tumor by the side of the uterus, in which the sign of ballottement can be detected, removes all doubts. Dr. Thomas^ has recognized a three months' foetus by ballottement, and says that he has been able to demonstrate the presence of the child in this manner in three out of four cases which he has seen. In order to be able to recognize pregnancy by ballottement, it is necessary that the fcetus should have attained a certain size, and that the walls of the ' New York Med. Jouru., June, 1875.