1. family and parenting
2. motherhood
3. pregnancy

L-
"cC^a^i^
///^
ESSAYS
PRACTICAL
THE
ON
.^;^
c/^U^:^cc
OF
MANAGEMENT
LABOUR;
AND
PREGNANCY
ON
AND
INFLAMMATORY
THE
DISEASES
FEBRILE
and
OF
WOMEN.
LYING-IN
By JOHN
M.
CLARKE,
D,
/
,
OF
TEACHER
SECOND
/jNCEVS
HEREO^
gOA
MIHI
VIA
"C.
LONDON,
IN
MIDWIFERY
"C.
EDITION.
INSISTENDUM
j;ST,
UT
JEGRIS
Sydenham.
VENiAM.
LONBON:
PRINTED
FOR
J. JOHNSON,
ST.
1806.
PAUl's
CHURCH-YARD.
SUB-
Printed
by
E,H"msted,
GicatNew
Stwet,
Fetter
Lane,.
TO
PHYSICIAN
D.
OF
PRINCE
S.
R,
R
WALES.
SIR,
I
lowing
the
TAKE
Essays
sheltering
them
under
for
the
I
the
and
I
have
the
DE
Your
most
and
S
AR
12,
I
of
JOHN
1
793'.
R,
obliged,
obedient
-
oa-
an
be.
to
London,
^^
February
of
exertion
honour
so
one
obligations
my
successful
oi
professional
myself
avail
may
of
his
for
sake
the
patronage
acknowledging
kind
for
more
foU
the
addressing
family,
own
my
that
of
portunity
not
you,
conspicuous
than
talents,
of
liberty
to
pre-eminently
in
AND
KING
THE
TO
DEAR
you
M.
WARREN,
RICHARD
servant,
CLARKE.
them
to
PREFACE.
Some
public
a
years
ago,
short
account
which
and
proved
in
different
Many
women
higher
stations
in
my
and
in
the
struck
them
rassment
When
middle
at
I had
various
and
with
this
in the
the
the
a
authors
b
classes.
public
a
the
ing-in
Ly-
what
I
orjof
I
found
disease
who
of
appeared,
had
the
could
difference
of
"
in
which
state,
and
treatment
country.
opportunities
uterus,
remarkable
complaint;
i consulted
in
time
with
puerperal
men
wo-
it.
to
symptoms
them
of
some
considerable
of the
the
and
that
lis,
metropo-
lower
the
in
sacrifices
inflammation
during
be
the
comparing
upon
seen
persons
situation
Hospital,
remarking
to
fell
of the
parts
remote
mic,
Epide-
numbers
great
to
the
in
the
to
Lying-in
among
only
not
also
and
alarming.
appeamnce
fatal
confined
not
From
its
offer
to
very
a
prevailed,
but
was
induced
was
of
made
Women,
It
I
before
naeum
peritobut
not
between
emba-
great
new
bad
to
me.
written
upon
Vl
P
Puerperal Fever,
Upon
sened.
I found
the disease, and
recommended
left
of
a
the
description^
to
the
difference
in
as
of*
nature
the practice
it, that
of
cure
les*
not
I
was
uncertainty,and disappointed
with
information.
As
successive
when
and
arose,
cases
time
more
had
given greater opportunity for observation,
the
exercise
1
of reflexion
the
thought,
febrile diseases
That
too
I
and
too
things
which
as
u\y
-pAYt of
the
I
experience
The
the
of
spur
must
thought
which
I
making
accidental
the close
facts
if
occasion, because
present utility,
consist
it my
had
in
have
their
duty
whose
early
publish
to
for
acquired,
observations
circumstances,
than
That
extensive
of the
hastilythrown
were
practical advantage, of those,
of
describe
to
results
be of any
to
merit
publication.
the
of
difficulties al-
determined
collected,
were
their
ficient
suf-
a
obscurity already
and
doubts
I
then
observations
made
been
the
to
them.
the
more
satisfied that
not
add
increase
I found
together on
the
and
lying-in women*
numerous,
had
I
had
mig^htnot
great,
ready
of
judgment,
and
I became
more
discrimination
a
in
confusion
sentiment
for
perplexed
""
was
difficulty
my
great
so
C
A
much
so
diversityof
much
so
F
E
R
ties
opportuni-
might,
been
the
more
from
tracted
con-
mine.
epidemic gradually disappeared
of the
year
followingthat
towards
in which
it be-
gan.
#ii
PREFACE.
that
so
gan,
called
to
similar
a
to
few
very
and
procure
far
as
reason
been
comparatively but
believe
between
be
may
in
one
considered
ten
of
them
upon
To
the
improper
I have
pretend
these
The
cases
neither
that
the
times
labour
muit
which
forty^five,
are
of
have
unljnown, which
I
child-bed
at
the
rare
those
for
been
is
I shall
of
treating
of
found
and
count
ac-
some
in
women
that
apprehend
their
nancy
pregsome
origin to
believe,
to
in these
hardly
to
observing
ill spent,
nor
do
Essays
practicalpart
the
state
periods.
vanity
in
ages
that
plan,
owe
observations
in
about
ration
conside-
the
in
in my
management
treatment
Discoveries
new.
;n
of
died
who
advantage, I have
most
last
the
from
as
scale.
labour, because
diseases
there has
time
great importance.
comprehend
to
of the
proper
the
subject,I
occur
extensive
more
a
necessary
of
that
require any apology
do this with
and
able
child-bearing age,
which
of
matter
a
been
off in child-bed,
diseases
therefore
not
it
be
to
comes
the
still
the
as
cut
w^re
have
mortality among
small
a
of fifteen and
age
vate
pri-
that of all females
it appears,
the
upon
Yet
puerperal patients.
yearly bills
I
as
with
or
that in that
have
to
public
in
information
any
attended
cases,
either
symptoms,
practice;
only incidentallybeen
since
I have
be
and
if much
of
2
are
physic
expected.
recording|
rernai,n^
capable of investigation
;
b
I
and
tha,t
Vl^l
PREFACE.
that
ordinary
that
time
all his
of
opinion
in
all
has
which
in
clear
away
In
this
all
to
appears
and
infatuation,
who
have
exception
scattered
they
of
have
few
a
servile
might
be
there
I expect
to
difference
there
been
be
in
a
thors,
au-
inflam-
With
in different
the
passages,
writers, they
in
striving how
Contradictoiy symptoms,
with
different
to
prove
;
if I
complaints.
"
them
right,then
am
practice must
stead
in-
in childbed
women
strikingdisparitybetween
able
the
and
a
ceding
pre-
of the
detached
and
employed
attacked
is
been
respect for
the febrile
on
but
;
confused
greater number
cases
down
to
new
a
have
to
supposing it possiblethat
That
him
different
been
lying-in women.
reconcile
could
of
for
diseases
seems
a
the
of
and
up
or
treated
diseases
to
ages
many
propose
have
There
opinions,in
seem
his
in the others
that
me
treatment
other.
each
matory
before
treatingdiseases.
of
manner
symptoms
strange
and
errors,
improvement than
less
especiallyit
with
former
lieve
be-
department of medicine, however,
has been
in
so
researches, it remained
vain
iand successful
'
that after
false, or
should
written
been
than
more
a
who
himself,
in
is
contemptuous
a
predecessors,or
confidence
physic
Spent
either
entertain
must
man
be
the
a
quence,
conse-
"
'
principalobjectof
The
that
of
these
discriminatingthern
that
Essays
they
will
may
be
be
respectively
IX
PREFACE.
adapted
be
may
which
is found
There
which
I have
But
imaginary.
others,
they
of
capable
will
I have
of
merely
arise
to
of
such
in
the
of
of
critical
received
fair
not
elated
much
the
these
the
other.
I
its
than
the
praise
be
from
the one,
demand
be
considered
the reach
has
approbation
I
for
public
Edition
whose
a
new
as
some
its
ment
judg-
neither
am
from
only
or
without
nor
solicitous,
the
above
some
contemned,
fate
servations.
practical ob-
honourable,
of criticism
The
Essays may
is
turally
na-
theoretical
former
of
me
the
For
for
writes
praise,nor
If
to
little
am
with
tical
hypothe-
any
I consider
as
who
to
with
that
connected
subject.
consequence
man
to
many
matters
any
appeared
as
flatteringshare
proportion
is
to
less
censure.
any
whose
those
of
out
indifferent
be
can
my
assured
introduced
it is such
No
"
by
artl
simply
or
proportion
discussions
within
admitting
opinions, however,
same
I
tinctions
dis-
real, but
not
witnessed
of
have
I
reasoning,
the
practicallytrue.
opinion,
When
theory.
influenced
occurred
been
cautious
been
have
state.
that
are
judging,
found
be
drawn
and
observation,
own
actions
puerperal
suppose
they
as
treatment
perhaps, who,
some,
prejudices, may
former
by
be
may
the
in
exist
to
the
diseased
variety of
the
to
that
order
in
respectivelyknown,
too
obligations
o*^
Edition
proof
of
their
PREFACE.
S
their
endeavoured
have
I
contained
be
may
those
to
who
them
have
in
so
the
hope
to
that it may
not
have
been
of
the
arrange
instructive
practice
the
this share
to
tions
observa-
following sheets, that they
and
intelligible
beginning
are
me
altogetherunacceptable.
be
not
induces
utility,and
of
to
medicine
long engaged
my
;
who
and
if
in it will allow
merit, I shall
misemployed
those
think
that
timCo
CONTENTS*
X
CONTENTS,
Pag^
PREFACE
with
the
III.
with
and
of
pains,
Essay
IV.
and
V.
Essay
the
I.
febrile Diseases,
On
III.
Section
Section
of the
On
-
Affection
sometimes
Section
Epidemic
VII.
in Child-bed
On
-
the
-
Chronic
-
System
the.
the
Uterus,
of the
Placenta
-
of Child-bed
-
Pain
-
of the
85
and
-
Abdomen,
74.
-
nected
con-
-
Fever
of
men
Abdo-
of
Portions
Low
of the
Inflammation
of
^j
.
Peritoneum
-
Affection
Affection
the
^y
and
_
Cavity
of local
Cases
-
with
_
-
System arisingfrora
VI.
in the
Uterus
of the
-
the
3S
~
tory
inflamma-
the
-
of the
left behind
Section
"
other
of
_
inflammatory
On
mation
Inflam-
the
on
24
-
-
attacking Women
Inflammation
On
V.
After-
=
in Child-bed
with
the
Inflammation
On
IV.
Of
-----
investing Membrane
Section
after
Women
Breasts
the
On
in Child-bed
Ovaria
or
of
Suppuration
II.
and
Fever,
IS
-
-
Discharge
Milk
the
Puerperal State
Section
-
of
t
in Labour,
Intention.
same
Section
and
-
Lochial
the
Disease
of
of Women
Treatment
men,
Wo-
Pregnant
Prevention
View
sime
On
of
Management
General
Delivery,
the
to
General
with
Essay
View
a
II.
Essay
Management
General
I.
Essay
V
-
-
"
90
nected
con-
which
-
is
-
94
Abdomen
153
-----
ESSAY
ESSAY
GENERAL
THE
ON
ON
those
*F
off
who
the
upon
it
even
when
they usually
there
nagetnent
that
do
situation
and
is
of
more
of
enjoy
state,
when
they
complaints
at
in
that
a
time,
few
lays
pregnancy
B
disease
that
m
better
;
general
still
occur
which
are
though
al-
men,
wo-
thari
know
we
which
ing
durat
least
dangerous.
that
the
is
and
;
health,
instances
than
certain
men.
wo-
pregnancy
not
are
it
ing
respect-
pregnant
whole,
state
a
not
therefore
thing
any
are
and
;
of
probable
some
are
troublesome,
Nothing
as
seems
in
say
the
upon
few
very
pregnancy,
labour
to
of
consequence
management
although
looked
their
of
RUS.
UTE-
THE
that
of
act
general
Yet,
that
the
in
known
time
superfluous
appear
not
the
during
many
die
it is v/ell
during
AND
OF
women
T3
DISEASE:
OF
uterogestation,
VIEW
A
RETROVERSION
THE
OE
WITH
PREVENTION
THE
may
MANAGEMENT
WOMEN
PREGNANT
cut
L
the
mismaof
foundation
many
S
GENERAL
for which
the
which
diseases,
many
cause
of
attendant
pregnancy,
herself,
woman
is
attributable
wholly
was
delivery, and
after
occur
medical
the
0?
MANAGEMENT
the
to
duct
miscon-
either
from
false ideas
the
absurd
advice
or
when
blamed,
of
the
h"r
of
friends.
of
Many
time
such
;
of
relief
when
is
very
in
the
:
stomach
often
are
would
the
to
or
factum.
be
applications
to
found
the
nostrils
in full
habits,
will
often
has
much
sickness
and
vomiting
medicines
Such
made
by
taken
complaints
the
or
irritation
is
affected
only
diseased
ascarides
the
as
liver,
in
extremely
in
pregnant
the
the
depend
enlarging uterus
nerves,
a
found
effect
of
reason
the
large vein, especially
be
into
as
of
a
more
The
ineffectual,
as
in
cases
some
on
directlyto
be
to
from
and
any
made
shoulder
in
Bleeding
is
pable
ca-
ous,
efficaci-
are
the
stomach
the
not
are
depend
pregnancy
and
uterus,
by sympathy
they
in
:
as
itself.
stomach
in
vomiting
means,
symptoms
the
obvious
and
arrhoea,
di-
admit
these
degree, they
same
same
of
derangement
the
by
the
in
vomiting,
however,
sickness
violent
are
generallyyield
and
sickness
When
depend
pregnancy
these
Sometimes,
palliation.
pregnancy
the
are
"c.
of
of
complaints
simply, and
irritation
upon
to
the
others
ful,
use-
appeasing
the
than
women,
stomach.
upon
upon
parts
the
the
pressure
sorbents,
veins, ab-
Uable
to
it,
are
PREGNANT
frequently found
most
are
fourteenth
of
the end
and
cramp,
one
diseases
the
will
treatment,
one
lower
depending
labour
I
inabilityof
motion
the
os
to
a
lower
in the
fered
delivery, suf-
soft parts,
spine and
rous.
dange-
called
was
before
of the
last, and
cious
palliatedby judi-
they rarely become
however,
;
4jtPaese
the
in
far
so
time
parts
by quickening
relieved
be
cose
vari-
paraly^^^^y
total
that
mortification
the
and
also
extremities.
lower
some
part of the
the
be
case,
extremities, for
a
in
time
from
patient,who
piles,as
are
period, by
mean
In
the
of
sion
conclu-
the
to
partial, or
commonly
former
in the
may
of
both
or
thirtieth
oedema,
end
the
eighteenth week,
Such
sometimes
3
from
the
of the
pregnancy.
veins, and
at
of
that
to
again from
of
WOMEN.
covering the
of which
sacrum,
she died.
The
only
Retroversion
local
of
disease, which
dangerous
become
likely to
This
is
it, that
very
much
of
the
in
occasional
The
we
teacher
ever
of
cause
of
the
from
;
be
since
a
cessary
ne-
far
so
doubt
the
toms
cus-
in all instances
Dr.
uterus
was
Hunter,
midwifery in Paris,
B
not
society, I
occur
to
men.
wo-
it.
of
learn
and
all
at
pregnant
of
state
societyseem
retroversion
as
goire,a
natural
a
is
uterogestation;
upon
if it would
civilized
to
acquired disease,
an
attendant
from
of, that
I know
the
is
Uterus
the
2
scribed,
first de-
by
Gre-
in his lectures
:
4
GENERAL
tures
J
would
but
it is
have
MANAGEMENT
OF
that
probable
the
entirelylost,
been
if Dr.
of
hi^nquiries into
the
London
the
Medical
disease
The
account
found
be
may
Observations
it
had.
Hunter
investigatedthe subjectfarther.
not
of
knowledge
and
in
Inqui'
ries.
The
retroversion
displacement
that
it lies
the
turned
the
lower
felt close
Such
a
before
to
fixed
of
time
though
case,
quickening
the
it could
of
the
the
In
thin
pubes,
The
part will
;
uterus
be
symphysis pubis^
hardly
uterus
and
because
produce
in fatter
in
a
strong
ter
af-
the
and
first
tion;,
situa-
after the
the
bladder
women
occurs
cannot
will be in the
full
found
indistinctly
subjects,if
the
easilydistinguished
; andmake
will
per
pelvis, and
the
confined,
remain
not
of the abdomen.
that
of
might change- its
uterus
quickening
above
w^ill be
of the third- month,
the end
the
tumour
of the
situation
uteri
os
examination
part of the
the upper
wards
to-
Upon
uteri
os
vis,
pel-
the
posterior surface
the
posteriorpart
the
the
a
manner
a
of
of
downwards
with
against the
of
lip
such
cavity
and
large rounded
a
occupying
on
the
symphysis pubis.
vaginam,
laid
in
inclined
coccygis,
OS
consists
uterus
uterus
its fundus
upwards
of the
time
the
transverselyin
with
or
the
of
the
of
cavity
hand
be
will
be
pressure
inclination
to
water.
effect of this
change
in the relative
situa-
tion
6
GENERAL
The
merit
as
without
;
for
better
mankind
and
when
whereas
thought
of the
and
have
suffered
been
drawn
a
the
suppression
that
in
tice
prac-
have
been
in the
urine
uterus
was
of
urine
was
and
the
neither
the retroversion
the
to
of w^hich
if the
rus,
ute-
replaceit
to
mischief
considerable
:
the
not
of
made
inconvenience
off, and
dered
consi-
been
situation
were
bladder,
been
the
consequence,
doing
any
ought
suppression of
known
attempts
the
to
it
never
have
was
alteration
risk of
the
uterus
as
violent
most
with
merely
the
be
had
disease
would
it
to
perhaps
it then
and
displaced,
cause
if the
treated
and
Denman,
it would
of
general cause
great improvement
a
which,
because
known,
Dr.
to
considered
be
OF
ascertainingthe
of
is due
this disease
to
MANAGEMENT
would
had
water
of the uterus
discovered.
never
The
of
pressure
of the
the
symphysis pubis
catheter
introducing a
It will
cathetei
and
sometimes
,
the
to
afford
uteri
and
passage
to
OS
a
It has been
of the
and
the
bladder
that
above
the
permitted to observe,
difficult.
rather
by employing
a
a
symphysis pubis,
the
instrument.
been
of
difficulty
some
necessary
pubis.
1
must
that it is rather
cases
to
small
tween
fingerbe-
the
in
of
operation
by passing up
has been
it has
the
sometimes
said, that the
catheter
inside
against the
renders
facilitated
much
be
uteri
os
so
as
tion
introduc-
rable,
insupepuncture
however
be
singularthat
such
WOMEN,.
TREGNANT
such
hazard
to
in all cases,
the
opinion, that
an
by
with
the
might
be
not
right to
the
evacuate
the
of the
would
both
because
the
to
of which
that
was
organ
disease
and
than
so
it
to
as
nish
dimi-
this
jections
ob-
the
the other
to
;
operation
an
it offers
dangerous
foreseen,
and
danger
any
gested
sug-
c^ses
because
the
be
in
never
of
use
means
to
such
;
cannot
such
this
also
uterus
ofF,
been
uterus
But
that
necessary,
great violence
?
believe
I
be
never
can
the
still greater
be
also
in
puncture
uterus
the
to
It has
liquor amnii, and by
bulk
small
a
drawn
be
may
Whether
question,
a
with
ture
ven-
perfectlyacquainted
is
of the disease.
nature
as
who
and
instrument,
I may
either
accustomed
person
a
ledge,
know-
own
my
I think
and
;
catheter, the urine
flexible
a
in
occurred
never
in London
even
or
or
haus
case
a
7
sequences
con-
when
from
the
itself.
,
It has
been
divided
is sometimes
complaint
from
the
;
the
catheter
pressure
pubis, and
not
was
drawn
higher into
the
of the bladder
to
an
into
this is
but
not
having
of the
off till the
in
catheter
was
arose
4
in
arisen
first iri--
the
of the
the
physis
symwater
carried
up
of the division
cavities, which
impossibility
; because,
B
the
against
the whole
as
has
this
perfectlyclear
be
to
the idea
two
in
been
uteri
os
thence,
into
chambers
two
mistake, which
a
bladder,
that tb^ebladder
some,
pushed high enough
stance
from
supposed by
first
is next
place,
as
GENEP.AL
5
bladder
the
as
its dilated
the
by
at
of it
to
have
any
lower
to
lower
in
time,
the
ovum
within
the
be
cured.
within
any
yery
and
it
:
in
again
upper
should
of
more,
that
the
about
it
it is
in which
the
In
inflammation
bladder
it has
and
the
has
the
the
but
be
to
has
disease
will
has
of it has
burst, and
are
the
been
urine
fallen
suffered
on
feared, have
sustained
length,
into
uterus
cases
size
uterus
practitionerneed
;
,
mean
in
at
which
instance
no
knowledge,
so
the
remove
at
away
In
pelvis, will
the
be
considerable
increase
to
a
urine
never
taken
be
of
the
any
should
abdomen,
the
solicitous
in others
not
as
the
evacuate
continuing
In
injury,
some,
cond
se-
strong
so
removal
the
twenty-four hours.
of
my
many
to
assistance,
any
cavity
as
in
the
bladder,
for
only
once
cavity
the
in
descending from
therefore
and
twice
without
so
that
suppose
the
uterus
collect
to
quantity,
least
the
of
suffered
of
sufficient
bladder
the
hardly
urine
be
not
retroversion
from
contract
and,
:
part
chamber.
will
It
the
middle
to
power
it
introduced
is
the
to
into
brought
urine
bla.dder
can
we
of
allow
the
the
urine
distinctly from
it
contraction
partial
to
of
its contracted
bladder,
it in its
in
part
from
that
as
urine
OF
the
of the
part
place,
a
and
;
never
retain
changed
only by
state
lower
can
the
is
ureters
the
MANAGEMENT
be
not
record,
occurred,
great mischief.
brought
has
been
on
;
dis-
charg
PREGNANT
into
charged
patient has
The
the
that
in
the
woman
period
of pregnancy,
any
danger
;
be
If
the
pain
has
nor
the
kneel
the
and
bladder
the
retroversion
reason
to
at
with
than
may
employed
it
is
to
doubt,
by
a
all
the
be
the
the
cases
pressure
of
the
in
pressure
vagina.
"
not
the
That
cause
ployed.
em-
of
of
it is generally
is
there
have
be
fulness
predisposing
too,
cause
her
mend
strongly recom-
that
uterus.
let
to
placed
the
should
above
is
fundus
gentle
I
no
with
rest
very
force
be
gentle
best
means
success,
the
should
the
fingers in
two
3ut
when
abdomen,
and
this
from
uneasy
sometimes
always
occasional
the
bed,
may
observed
of
be
there
from
additional
the
if
By
fail of
been,
the
less
of wdiich
removed
it with
that
which,
;
complaint
of
a
floor.
should
It has
on'
then
upon
this
the
situation
natural
made
should
tried,
gravitation is
its
much
patient
tenderness
patient
on
gered,
endan-
rarelyattended
with
emptied,
be
uterus,
If
been
may
elbows
pressure
be
may
miscarry
means
of
any
methods
of
the
continuance
bladder
the
pecting
res-
uterus.
however
the
from
violent
by
tjie
arise
can
foetus
is
certainly
occasioned
replace
which
may
this
and
destroyed.
way
life of the
it, the
and
abdomen,
is, that,
uterus
upon
Q
the
consequence
the
made
of
cavity
been
worst
WOMEN.
come
now
to
no
my
knowledge
10
GENERAL
knowledge
MANAGEMENT
where
external
belly (thebladder
at
time
immediate
time
a
upwards,
urine.
has
Such
"
being
yet I
with
that alteration
instance
every
the
bladder
the occasional
monly
Besides
this
the
attended
excited, and
part,
should
strong,
with
symptoms
of
mention
of
regulated by
the constitution
still
and
hot
violence
of the
by
requireto
urine
has
be
tinued
con-
will be
of the
pain
be
ternal
ex-
skin, thirst,and
may
of
that
near
frequent
be
It is
precise quantity ;
the
com,-
which
fever
much
advantage.
the
of
If, therefore, the
should
fever, blood
considei'able
fulness
symptoms,
bladder.
pulse
dry
therefore,
;
inflammation
complain
a
which
occasioned
suppressionof
the
if the
or
produce
the
time, considerable
of
:
lence
vio-
uterus
urine
urine
other
sometimes
surface
patient
are
If the
some
happen
predisposing,and
suppressionof
to.
for
of the
equally dangerous,
not
of
cause.
disease, there
though
with
least the
at
ed
turn-
was
ever
consider
must
we
and
external
no
of
;
ly
comparative-
can
suppression
a
woman
suppression
are
that
of the situation
of
craise
the
sometimes
bladder
ertpty
an
distended
a
uteri
os
a
do
they
tlic
to
downwards
however,
fully persuaded
am
is the
the
in
to
uteri
occasioned
cases,
applied
pain
when
nevertheless
rare,
to
force
by pressing the fundus
backwards,
in
the
at
state)has given
and
OF
taken
not
and
other
away
necessary
that
must
the symptoms
be
and
woman.
Costivene?s
PREGNANT
disease, and
fundus
the
in
depends
If
injected.
to
replace
the
be
the
uterus,
of
flexure
the
discharged, prove
which
evacuate
the
moid
sig-
the
not
of the
return
by
pressure
of
fundus
the
upon
stances
in-
will, if
the
situation
make
will
they
all
and
which
to
made
in
to
rectum,
obstacle
an
may,
are
up,
colon,
its natural
into
Uterus
attempts
the
of
quently
glystersfre-
giystershould
in
contained
This
by
thrown
upon
pressure
rectum.
any
a
previously
faeces
the
upon
relieved
be
instances,
attendant
an
against the
uteri
most
Il
also is sometimes
Costlveness
this
WOMEN.
the
uterus.
With
regard
Women
the
previous
pregnant
will
of the
The
verges
the
natural
towards
been
To
in
which
which
this
the
cause
should
be
texture
takes
to
of
place in
coagulating lymph
and
be
the
such
is either
In
those
to
thereby
the
health
considered.
pregnant
diseases
is
and
upon
be
may
upon
disposition of
denominated
labour
is recommended
and
labour,
plethora,
bered,
remem-
patient's health.
the
afterwards,
woman
be
much
very
the effects which
upon
to
future
the
depend
of
state
women,
produced
that
of
of
Management
ought always
thing, therefore,
every
have
it
General
progress
its consequences
the
the
Child,
with
that
to
women
diseases
which
of increased
tion.
ac-
attributed
the
blood,
similar
diseases,
in
smaller
where
ration
alteto
the
quantity
than
in
than
of
power
perfect health,
coagulating so
fallen
having
same
time,
and
the
This
which
the
the
cavity of
the
bulk
the
of
the
aggravated by improper
exercise
it
drank,
will
to
sufficient, in
be
the
upon
inflammation
of
inflammation
similar
To
constitution
of the
uterus,
breasts, and
of
labour
hoemor-
placenta,
peritonasum,
other
of
diseases
during pregnancy
guard againstthis, women
table, and
of food
dently
imprulus
stimu-
the
and
lent
vio-
predisposed,
so
of
or
up,
kind.
should
nor
exertions
detachment
the
ing
enlarg-
the
produce fever, puerperal convulsions,
rhages
a
a
that
apparent
the
from
arisingmerely
kept
be
upon
heating food, by
or
be
must
is in
plethoric
liquors freelyand
strong
or
the
by
action
increased
monic
pul-
make
If this
gravid uterus.
dispositionand
that
at
towards
abdomen
occasioned
thorax,
head-ach
encroachment
the
by
of
contents
the
To
last, perhaps,
increased
measure
globules
the
disposition
strong
red
frequent
so
of
pregnancy
cake.
referred
are
complaints.
5ome
of the
be
which
giddiness
in
bufF, the
a
its
consequence
women
bottom
to
are
cause
and
the
to
lias lost
or
in
;
from
with
generally covered
is
soon
drawn
blood
the
which
of
state
a
Ol
MANAGEMENT
GENERAL
12
as
most
should
neither
afterwards.
carefully avoid
confine
stimulate
Fruits
all
their diet
during
of the
excess
to
such
their
kinds
digestion
therefore, vegetables,
and
General
14
of the
the
in
use
well
need
methods
of
be
not
to
a
pregnancy,
health, and
the
usually prescribed
such
as
peated.
re-
ing,
topical bleed-
demulcents
internally,are
every
medical
so
that
she
with
the
violence
treatment
be
and
conducted
will
fall into
exertions
it, without
the
progress
of
of disease
being produced
they
place.
to
these
through
constitution
of the
that
man,
in this
attention
constant
will be
woman
the
a
should
externally, and
enlarged upon
By paying
to
stimulants
of relaxants
known
sufficient
not
operation
complaints,
application of
the
so
the
these
or
bleeding is
one
symptoms,
other
The
the
If
lungs.
remove
management
labour
the
in
prepared
points,
state
of
perfect
to
tain
sus-
employed during
most
remote
ger
dan-
afterwards.
ESSAY
PREGNANT
:!l^
WOMEN,
ESSAY
"General
management
VENTION
of
the
In
the
the
the
and
the
soft
which
and
so
in
Osborn,
in
nothing
the
from
and
want
just as
Much
his
Essays
and
of
the
;
ac=
der
or-
;
by
the
of
the
the
on
and
depend
been
so
the
erect
friend,
wifery
Mid-
Labours,
that
the
be
to
which
subject.
aflFected
they
that
know
disturb
will
Dr.
of
upon
in
titude
at-
critically
Practice
it is well
hope
upon
the
liable
cautions
pre-
counteract
from
Difficult
will
wise
to
valued
mind,
confidence
and
has
my
is also
women
animals
of
i
passage
those
to
added
be
to
confidence
will
by
Natural
in
the
taken
This
described
operation
other
has
body.
remains
Labour
occasioned
necessarilyresult
the
ably
of the
them.
nature
which
of
ling
expel-
muscles,
to
parts,
^or
consists
abdominal
chieflyreferred
be
the evils
TRE-
subject the difficultyof parturition
human
may
THE
nature
resistance
through
head
by
placenta,
and
uterus
overcome
pelvis,
TO
m
DISEASE*
and
the child
women
VIEW
employed
process
child's
A
OF
The
to
of
WITH
LABOUR,
tion
II,
and
by
differ
fear
retard,
facilitate,labour.
skill of the
practitio-
ner
l6
GENERAL
OF
regulatingthe passions
in
ner
MANAGEMENT
so
that
with
the
patient,
The
their
regular
exercise
of
doing
the
which
influence
voluntary
much
mischief
of his
terfere
in-
not
may
parturition.
is also
powers
in
pable
ca-
operation
an
alone
were
powers
tended,
in-
accomplish.
to
than
common
more
of
of the
fullyequal
are
mind
the
progress
involuntary
and
is
undue
of
hear
to
it
thing"
Norecom-
o
that
mended
themselves
called)assist
the
the
be
(as it
or
of
early part
of
being
bour,
la-
natural
a
the
taught by
is
skilful
to
ignorant.
different
which
in other
is found
of the
the
from
species the
newly
into
which
arjy
accident
the
indeed
animals.
attached
have
of her
the
bitth
the
placentaj if
part
of
first
nature
the
of
the
it should
fatal
to
must
the
that
the
ternal
ma-
the
rus
utecrescence
ex-
an
human
placenta
not
open,
be
ensue
every
child, upon
had
to
in
ing
be-
consistingof cells,
uterus
hsemorrhage
been
in
but
:
substance,
of
from
being,itself
formed
any
tween
be-
consists
them
In
young,
uterus
vessels
this
placenta
portion
uterus,
must
the
miaternal
the
and
;.
it continues
after the birth
from
of
structure
portion of
a
noticed
usually
been
not
difFerence
comparative parturition, which
and
human
has
considerable
another
is
There
a
in
to
art
an
were
process,
down
bear
parturition,instead
if
as
should
women
the
woman
if
by
separated
;
which
with
separationof
wisely provided
such.
IN
WOMEN
such
muscular
a
the
prevent
The
"
one
of
other
or
circumstances,
direct
will
of
part
which
the
is
Real
;
prevent
of
often
be, and
and
object
evils.
remedy
are
very
the
prevented by
labours,
produced
of
both
as
by ignorancii
mismanafjement.
The
first
the
to
prevent
to
be
first
labour,
and
All
not
waste,
takingcare
be
to
have
of
that
the
and
powers,
are
likely
her
fever
from
afterwards.
finishingthe
of artificial
use
means
otherwise
when
they
required.
strength
the
gulate
re-
of them.
and
necessary,
been
to
guarded against are.fa-
labour,
render
may
be
which
violence
incapacitate
may
deliveringher
would
the
the
tigue during
The
inconveniences
things
two
woman's
the
upon
should
above,
of the
exertion
those
accoucheur,
an
down
produced by
The
of
object
principles laid
for
great
a
labour
natural
are,
the
to
in
be
often
prudent management
may
than
dangers
may
.these
to
oner
judicious practiti-
every
more
or
both
and
attention
practice of midwifery,
to
oned
menti-
have
I
attention, constitutes
his
difficulties
rare
irregularityin
which
of and
care
v/hich
to
evils, attendant
an
upon
points
the
therefore, the
;
would,
as
effectually
cases,
the
of
depend
labour,
uterus
blood.
number
greater
upon
generality of
of
loss
IJ
of the
structure
the
in
does,
and
LABOUR.
woman
C
is
to
do
be
not
avoided,
employ
hy
her
voluntary
l8
MANAGEMENT
GENERAL
if the
which,
itself sufficient
labour,
All
time
should
be
reason
either
be
placenta ;
by
the
the
patient
will
the
bour-pains,
la-
of the
frequency
uteri,
os
or
account
sam.e
the
system,
and
if the
the
immediately
to
have
frame
a
The
tendency
very
much.
to
of
be
there
the
from
it, the
no
powers
restrained, and
be
die.
This
is perhaps
of the
sudden
death
delivery.
a
That
or
of the
violence
disturb
through
woman
guard against fever
delivery.
have
child,
part
objectin conducting
next
after
after
uterus
should
will
can
cause
the
supervene,
any
probably
very
the
save
separation of
there
of blood
of
of the
should
of
to
powers
delivery
frequent
labour, is
whole
the
patience exercised.
careful
flooding
a
loss
most
women
alone
involuntary
complete
to
being
detachment
which
her
of
possesses
the
by
on
being exhausted,
The
uterus
unfiivourable
an
if
or
casual
the
pf
in
exhausted
uterus
will
exertions
for
particularly,is, that
the
cious
ineffica-
as
by stimulatingthe
geiieralstrengthof
will
exit
discouraged.
Ariother
been
such
the
stimulants,
internal
well
as
and
allowed
either
by
the
muscles,
increase
to
attempts
for
aided
powers,
being
prepared
the
abdominal
of the
action
labour,
then
are,
because
unnecessary,
the
hurtful,
be
they
of
course
not
are
must
if
and
:
be
parts
child,
of the
the
in
v'oluntary exertions
Of
and
this
tion
inflammaexertions
stimulate
the
disposition
may
not
WOMEN
be
mild
very
barley
solid
food
this
of
kind.
any
will
labour
hardly
will
be
liable
For
this
I
take
the
in
of
of
Nothing
is
going
for'them
do
harm
will
than
and
which
the
when
this
if
arterial
mere
the
although
so
likelyto
the
constitution
will
fever
bring
labour
alone
beyond
what
C
any
If there
might
not
it could
2
thing, they
of
degree
subside
were
any
system,
thing
no-
activity;
stimulate
bear
the
produce
always
it into
bour
la-
likelyto
that
her
nor
occasion
no
will
not
in
a
action
of labour
is delivered.
woman
previous disposition to
is
do
beyond
system
action
increased
If
more
the
increase
exertions
be
much
they
a
spirits.
or
principle,
can
are
lower
labour
tendency.
If
good.
tigue,
fa-
stimulating by
in
there
ill,they
certainly
most
heart
and
and
;
it
lent
preva-
and
spices, wine,
its
well,
on
very
during
false
in
prevent
middle
rendered
more
destructive
more
the
with
be
can
to
as
is still
taking
substances
being impregnated
digested,
liberty of objecting very
practice, which
life,
of
by
afterwards.
well
as
to
during
eaten
not
harm
the
persons
among
variety
much
gruel,
digested, except
if
gestion.
di-
easy
preferred
be
food
and
:
then,
must
stations
do
to
reason
stronglyto
be
stomachs
strong
very
very
Ibould
broths,
to
Solid
ever
labour
of
weak
much
are
the
and
account
water,
IQ
during
in it's nature,
On
or
LABOUR.
increased, herfood
be
not
IN
;
and
the
(or, in
other
;
off after
go
the
be
may
vascular
the
offered
violence
parturitionwill
in
fever,
of
foundation
frequent examinations,
and
"
os
uteri, either
by attempts
at
themselves
in
obstacle.
But
the
OS
uteri
the
of
if that
effect be
no
tnost
said
his
other
to
and
time
own
safety,why
will
honest)
should
overcome
the natural
the
time
same
constitution
a
or
the
do
will
his
than
it.. Time
parts of
that,
must
I need
the
os
injury
the
al-
consider-
patient's
and
ence
pati-
which
difficulties
no
and
attempts
who
of
rigidity
will
;
judicious(I had
man,
avoid
any
arise from
at
to
of less consequence
he
it
to
means
the part,
inflame
reasons
a
the
ploy
em-
that the
such
enough by
produced,
not
that
consider
it is remembered
when
inevitablystimulate
offer
they
passing through
head
allow
what
the
v/omen,
of the soft parts,
removing
dilated
be
cannot
by
difficulty
except
contraction
arises from
too
dilate
to
present
having
idea of any
by
clining
gradually de-
are
who,
no
the
inflammation;
local
or
cerned
con-
lay
chieflyby
ignorant practitioners,
as
fever
a
parts
of
only pursued
are
the
most
which
crease
in-
to
sometimes
practices,however,
These
it.
means,
system,
to
also
or
stimulating the
as
dually
gra-
consequence.
Accidental
such
of
action
the
if such
still farther
tend
as
might
uterus
delivery),yet
employed
been
have
of the
actions
the
arisingfrom
circulation
increased
the
although
words,
other
OV
MANAGEMENT
GENERAL
20
uteri
either
may
;
to
and
the
woman.
Violence
22
MANAGEMENT'
GENERAL
come
it will
that
half
in
away
OF
hour.
an
rarely,
happens
It
after, the
expelled immediately
be
child.
not
my
intention
into
the
management
is
It
length
in
of
only cursorily to deprecate
it
artificial
by
hand
into
the
Osborn
Dr.
be taken
of
that, without
delivery
in
in
than
more
the
patient, seen
considered
the
the
have
of
of
the
the
deliveryof
even
by
referred
the
both
it is
expelled,
had
have
never,
and
weak
which
the
casion,
oc-
introduce
to
years,
upon
from
hastening the
scarcely ever
very
tention
re-
cases,
merit
any
not
hem.orrhage,
and
of
cessary,
rarely ne-
generality of
and
a
alarming,
placenta,
but
of
already
myself
to
uterus,
any
as
is
when
twenty
instance
one
in
child), I
into
hand
my
Avork
(except that
of the
the
at
extraction
hasty
purpose
hemorrhage
assuming
the circumstance
enter
placenta,
certainlyprevent
placenta
chance
the
to
strongly recommended
valuable
so
the
the
retard
to
place
introduction
this
been
his
in
of
and
has
it will
and
to,
for
uterus
This
child.
the
The
means.
if care
this
cept
ex-
delicate
could
be
separation
the
of
patient
in
that
the
placenta immediately
case
recovered.
,
The
after
hasty delivery of
the
except
endanger
of
birth
the
in
the
cases
life of
particularlyafter
child
of
the
tedious
can
be
never
hemorrhage,
woman
and
in
and
many
sary,
neces-
must
cases,
lingering labours,
where
the
where
is
uterus
indisposedto
though formerly
late
of
been
prudent
will
come
or
one,
at
of
the
a
no
it.
placenta
hour, by
an
uterus;
or
gentle assistance
very
vagina,
the
the
has
that
so
pursuing
half
of
contractions
more
tice,
prac-
England,
cases
of itself within
away
it from
remove
of
thinks
greater number
only requires
most
of
this time
at
the
In
in
common
This
act.
properly discarded,
very
man
2^
LABOUR.
IN
WOMEN
has
which
no
to
power
expelling it.
"The
the
after
to
be
the
birth
revived
and
and
example
"therefore
from
of
practice
the
hand
into
the
of
at
hastily delivering
the
child, has
different
ignorant
have
times
persons
been
but
fortunatelylittle
of
C
their
4
mischief
troducing
in-
immediately
attempted
by bold,
;
by,
their
turous,
adven-
advice:
cautiouslyfollowed,
been
propagation
titerus
it
has
and
arisen
opinions.
ESSAY
24
ESSAY
TREATMENT
III.
WOMEN
OF
WITH
THE
VENTION
PRE-
OR
DISEASE,
AND
VERY,
DELI-
TO
VIEW
A
OF
PAINS
AFTER
AFTER-
LOCHIAL
THE
DIS"
CHARGE.
Of
all
who
women
far
child-bearing,by
ofFby
diseases
after
although
a
the
during
of
diseases,
so
than
attended
at
least, and
the
the
the
and
to,
after
immediate
itself,and
the
we
the
this
the
have
woman
is
tients
pa-
tutions
consti-
nothing
more
dant
necessarily atten-
it.
ver,
If, howe-
preceding Essays
two
will
be
nothing
brought
of
consequences
circumstances
by
hence
their
that
disposition
shall
after
pregnancy
have
exertions
in
action
appetite;
disease,
to
offered
rules
be
against
of
of
dation
foun-
the
into
time
ed
destroy-
are
yet
come
good
labour.
of
act
parturition to produce
upon
the
which
plethoric,
required
the
cut
are
few, with
very
labour,
laid in the
disposed
number
proportion
of
indulgence
become
is
small
of
consequence
greater
delivery,
time
delivery,is often
improper
the
in
dying during
management,
But
die
which
to
checked
to
guard
bed,
the
always
but
labour
attend
up
OB
WOMEN
puerperal
the
imon
DELIVERY.
AFTER
2^
is
It
state.
impossible
with
believe, (because it is inconsistent
be
should
women
of
natural
a
those
of labour
before,
during,
have
been
With
to
this
in
is
partly
frequentlyto
of
indulgences
with
the
her
obstinacy of
need
It
quiet
appetite, which
of
contribute
which
be
observed
that
appease
is occasioned
by
the
and
of
what
therefore
that
be
must
to
friends,
all
avoided.
without
but
horizontal
instances
should
in
cheur
accou-
more
using
well
the
or
some
tible
incompa-
are
here
which
after
irritation
violent
meant,
folly and
not
be
posture.
the
woman
how
much
labour
must
of the
system
efforts
of
bour,
lait
great consequence
of
patient
being newly
she
an
admission
The
things
very,
deli-
much
the
to
or
immediately
rest
mer
for-
nurses.
hardly
and
the
to
herself, either
situation,
bad
either
after
but
perhaps,
ill-judgedadvice
but
conse-
a
two
treatment
imputed
be
to
woman
the
tribute
at-
considered.
instances
som.e
is
The
labour.
formance
per-
must
mismanagement
improper
to
the
we
disease
which
after
already
respect
therefore
some
or
from
disease
to
act,
in
cases
.quence
bed
liable
necessarilybe
must
that
they
that
constructed,
ill
so
dom
wis-
works),
other
all his
in
Creator
the
of
the
to
be
company
should
be
dressed, and
allowed
I have
has
to
laid
in
all
above
be
known
died
fully
care-
in
any
some
imimedi-
ately
46
GENERAL
after
ately
erect
an
OF
deliverv, from
of
posture
the
exemplifiedin
which
arm,
MANAGEMENT
This
body.
instance, of
fainting,if they be upright,
whilst
lie down.
they
blood
some
althoudi
very
when
in
are
too
here,
Every
w^iil
understood
well
attitude
erect
an
the
carrj/ing on
and
all persons
all without
performed
lose
must
away
and
;
the
sustain
yet, from
loss
causes
requireexplanation
to
is very
unfavourable
to
such
life under
of
functions
the
at
woman
supine posture,
a
viell
very
bear
placenta comes
the
constitution
the
well
which
is
better, if the operation be
sustain
can
bear
to
bleeding from
cannot
persons
many
unable
being
circumstances.
The
is
guard
to
stitutions
of
better,
of
believe,
I
of the milk
some
necessary
gruel and
may
be
that
the
too
it will
and
barley
for the strong
have
by
water,
and
a
regimen
the
can
efl^ectof
this
be
to
of
is
all
plethoric.
be
must
there
whom
substantial
however
be
ferent
dif-
the secretion
because
is
con-
a
food
even
more
bour,
la-
general,it
women,
description,it
latter
low
delicate
support
than
of
arisingfrom
But
so
necessary
animal
limitations,
weak
to
avoid
to
the
as
In
subsided.
some
very
be
women.
stimulus
has
v/ith
done
will
treatment
But
extremely,
vary
different
in
till the
kinds,
acjainst fever.
women
mode
observed
after
object in treatingwomen
great
proper
arp
it is
food
they
patients
In
hardly possible
pursued,
diminishing
because
the
milk
fevc|'
AFTER
^^"OMEN
all cases,
in
fever
Breathing
a
the
of
and
the.attacks
to
DELIVERY.
air
chamber
is
in
them
rendering
of fever
either
pure
27
less
inflammation.
or
fore
there-
necessary,
very
which
tire
able
li-
Datient
is
con-
J.
fined
free
of
if
should,
ventilation
heat
"all
and
possible,
should
should
cold
impurities
contaminate
might
after
Women
-"bour, have
to
^necessity
of
Great
:with
of
and
and
"means,
clothes
curtains
round
of
it, and
is
not
^uch
happen,
or
if
it
sweating
patients,
than
;
the
a
fever
should
will
and
be,
smallest
will
not,
by
bed,
keeping
will
accident
;
passive
more
the
nature
management
should
and
be
can
a
tlie violent
large
the
necessarily very
quanthe
fire in
the
consequence
if
by
avoidable
un-
any
to
exposure
almost
such
by drawing
the
that
mental
detri-
by
on
large
a
plied
ever
how-
gentle
encouraged
on
with
and
Now,
perspiration brought
heaped
This
such
nothing
of
the
frequently
a
and
upon
perspiration,
been
la-
sleep
to
laid
been
natural
recovery
farther
;tityof
joom.
be,
active
fatigue of
the
has
up
and
may
the
to
room.
heating liquors.
advantageous
perspiration
the
disposition
a
and
wliicli
removed
from
have
they
draughts
of
stress
keeping
intention
air
delivery,
naturally
perspire.
this
the
a
extremes
equally avoided,
be
constantly
be
airy;
the
allowed,
be
and
spacious
be
cold
certainly
continuance
much
sue
en-
of
weaken,
and
20
GENERAL
and
render
her
child.
But
and
it would
the
natural
the
especially as
it is well
who
after
if
delivery
will
and
certainly
which
hours,
the
views
should
be
Of
late
of
I
saline
have
less from
to
be
used,
of
rience
expe-
who
have
milk
the
in
be
by
fever,
powerful
more
has
antimony,
considered
and
it
either
or
it will
differentlymanaged.
remedies
that
if there
and
;
six
with
degree
patients
been
;
some
every
warranted
am
are
exhibit
to
fever,
exhibition
mixture
maintained
the
usual, and
been
nature
those
that
of
use
ease,
dis-
medicines
some
preparations of
as
the
ought
in
comply
corrected.
the
women
from
mixture,
saline
dispositionto
years
relaxants,
as
the
any
v/ho
tends
generally at-
of
no
v/rong,
intentions
those
than
it has
but
treated, suffer
thus
it
gentle
a
parturition,
perfectlyfree
and
saying,
in
been
as
will
measure
some
that
perhaps
be
cannot
slightrelaxant,
after
is
attempt
governed implicitly by
be
absolutely required ;
it
to
treatment
are
suggested above,
rules
there
best.
they
j^
neces,^
means,
unwise
days
medical
the
seem
dispositionto
known
recover
Respectinp-
not
such
be
first few
perspiration
those
it does
sweating by
up
counteract
that
time
same
keep
incapable of suckling^
patientalmost
occasion,
no
to
the
at
to
sary
the
OF
R/fANAGEMENT
none.
has
such
ple
sim-
so
dently
confi-
been
active
But
perseded
su-
dies
reme-
it
is
a
questio3i
30
GENERAL
MANAGEMENT
be
prevented altogether.
so
violent
the
deprive
opiate
an
leave
during
the
so
them
day,
doses
that
the
pain
Another
the
This
or
is
pressed
out
placenta,
Much
comes
conceived
be
to
view
a
to
we
vary
of
to
many
any
rule.
much,
The
in
from
flows
the
blood
part of the
of
to
it
uterus.
ascertain
the
which
discharge
regulate it, especially
has
diseases
redundancy,
consider
very
of the
lochial
is,the difference
evacuation
to
the
has
detachment
taken
been
laid in the
be
when
But
found
cavity
foundation
the
as
the
the
of
cellular
the
upon
with
away,
of it.
extremities
quantity of
average
such
women
either
the
have
pains
in
discharge.
lochial
supplied the
directlyinto
open
effects
attention
of
treatment
which
which
and
their
the
blood
of
had
the
is the
state,
of the
which
sleep, and
sensibilitya littlcj
which
to
in
consists
vessels
of
DISCHARGE.
directed
puerperal
the
dose
a
procure
the
is
tolerable.
be
may
subject
much
such
produce
diminish
LOCHIAL
been
will
this
only give anodynes
or
to
as
they efFectually
give
to
to
sometimes
When
rest.
night, as
at
either
sm^all
of
advisable
be
they are
But
degree, that
woman
it will
case,
their
in
OF
what
of the
and
the
been
paucity
or
nature
of
quantity will
not
quantity of
to
the
be
ducible
re-
lochial
discharge,
WOME^J
well
discbarge, as
be
much
of
the
will
be
of
more
the
in
to
more
ql
of
after-pains,
may
prudent
be
must
management
lochial
of
on
surface
to
there
will
there
contracted,
discharge.
this
depend
that
obvious,
contracted,
it is' less
the
the
of
extent
is
quantity
also
found
it
where
and
less,
for
uterus
attack
the
by
placenta :
the
DELIVERY.
the
as
lessened
where
be
AFTER
ence
differ-
A
discharge, will
the
difference
which
the
be
the
in
placenta
is
attached.
The
evacuation
will
afterwards
and
and
the
will
has
of diet
of the
very
but
and
who
have
the
from
and
have
noxious,
to
after
the
little
any
been
causes
the
of
it
by
disease, and
accordingly
found
charge
dis-
heart.
charge
dis-
lochial
disease
the
all such
rather
blood
quickness
various
commonly
the
In
irregularity
attributed
have
pervious,
im-
serous
the
considered
are
simply
of
appearance
of the
promote
the
greenish
a
suppression of it, haye
alterations
the
have
last is
at
force
the
and
or
anxious
such
tracted,
con-
length becoming
at
even
begun,
diminution
not
and
serum,
changes
circulation
as
more
it is of
exercise, Vv'-hich increases
or
Those
the
then
v/ater:
sometimes
return
becomes
discharge stops altogether.
of these
course
blood,
common
smaller, it will
vessels
the
till
watery,
bloody
first
at
uterus
vessels
resembles
and
colour
the
as
the
of
appearance
be
to
been
means,
effects,
measures
detrimental
than
3
2
GENERAL
than
of
lochia, and
the
remedies
the
If there
useful.
the
will
like
rarely
great strength of
too
a
upon
great weakness.
of the
force
In
and
the
relieve
the redundant
the
The
and
lochia
former
the
this has
disease.
of the
fcEtor
maternal
portions
or
come
away
been
formed
arteries
acted
of
very
been
;
of
foetor
to
to
as
a
of
of
the
decidua,
or
the
coagula
in
the
strongly
rest
will
and
then
it will
upon
the
be
the
and
of the
time
coming
of
is
there
portion
behind,
which
blood
of
proof
putrefy and
which
of
foetid,
depends
left
the
if
(especially
at
a
small
placenta
of
be
to
where
very
extremities
uterus,
all the
by
in the latter
often
circumstances,
placenta) putrefying
a
and
the lochia
part
the
or
arteries
system,
supposed
disease, such
certainlyno
either
lessening
and
observed
sometimes
accidental
is
is removed.
cause
often
But
upon
of the
state
are
lochia
astringent remedies,
other
the
plaints
com-
circulation,
discharge dependent
when
cease,
of her
olic
by bark, bitters, vitri-
system
morbid
no
diseased,
depends
bleeding,purging, and abstinence;
acid,
be
of the
of the heart
action
strengthening the
health,
relief
but
affection,
upon
the
the
she
redundancy
the
primary
a
if
in
it.
reproduce
manner
be
and
evacuation
no
or
woman
appropriated to
means
In
little
be
required,
are
OF
MANAGEMENT
veins
it have
had
and
not
expelling the
away,
give
discharges.
It
AFTER
WOMEN
from
after
delivery.
Great
of
giving
its
by
the
in
of considerable
doubts
of this
possible that
than
the
then
it
one,
not
lochia
the
a
the
in
the
the
days
ihe
be
before
passage
be
larly
particuauthor
late
broad
should
of
will
on
expected
been
child's
true,
arise
may
danger
an
the
which
of
serves
de-
of
dentia
proci-
weight
of
delivery, will
after
selves,
restoringthem-
likely to
more
horizontal,
vagina
so
than
Besides,
body.
dilated,
head
the
for
;
from
of
that
more
this be
If
much
be
hardly
unimportant,
the
is
posture
a
it is
retained
be
or
is in
had
considered,
early rising,
ligaments
woman
of
vagina,
early days
they
is
it
the
to
as
inconveniences
some
perpendicular
cannot
when
being brought
which
when
a
entertained
inconsiderable
uterus,
do
by
discharge.
practice
uteri
prevent
been
has
of the
attention, which
the
it should
upon
practice,
that
seems
the
tention
in-
the lochia,
to
uterus
be
may
menstruous
from
priety
pro-
the
early with
This
direction
the
from
the
on
up
celebrity.
some
propriety
sit
to
some
discharge
mischief.
of
by
very
strongly insisted
and
that
free
a
retention
productive
But
laid
been
be
should
women
allowed
be
sittingup
women
of
lest
has
stress
and
bed,
their
rise
when
the time
concerning
said here
should
something
that
expected
be
It may
33
DELIVERY.
which
as
to
through it,
a
in
it
few
permit
can
be
in
contracted
SO
of the
weight
these
For
end
of
bed
made
she
all
if she be
and
should
be
A
sofa,
this
she
When
that
do
much
would
begins to
from
long
than
certain, that
not
be
best
which
mentioned
for
means
at
bed,
weaken
should
not
fatigue,else
good.
an
that
will
and
to
delicate
or
of the
she
as
the
ject,
subsition
poit is
kept absolutely in
be
up,
have
to
meant
outside
sit
harm
more
delivery,by
above
the
position so
in
she
the
horizontal
it is not
advantageous,
quite as
far
that
rise before
even
an
it
other,
no
weakly
a
observe
even
or
were
day,
fourth
or
necessary
bed.
the
sustain
to
as
should
woman
no
longer. By
at
so
if there
reasons,
;
time
uterus.
third
the
short
a
right that
seems
"C.
MANAGEMENT,
GENERAL
34
least
all the
a
less.
remain
it will
Indeed,
horizontal
may
it
is
posture
fortnightafter
inconveniences
will be avoided.
ESSAY
35
ON
THE
MILK
AND
be
can
intended
With
is made
which
the
that
it will
atundance.
rapidly,
breasts
the
about
become
of
in
third
delivery.
occasion
such
tity,
quanin
nipples
goes
fourth
or
cretion
se-
most
on
until
day,
distended
enormously
great
the
however,
delivery, and
after
de-
during
will
labour
commonly,
More
begins
time
of the
out
run
great
considerably
sometimes
before
milk
a
suckle
breasts
become
thence
circulation
of
secretion
the
to
enlarged, especially near
increased
this
to
that
than
should
women
view
a
of blood
pregnancy,
the
IN"
OF
self-evident
more
that^every
child.
own
termination
a
THE
BREASTS.
nature
This
ON
SUPPURATION
AND
Nothing
her
IV.
Y
FEVER,
FLAMMATION
THE
A
S S
E
and
very
painful.
The
a
degree
great
begins
of
irritation
often
by
a
with
severe
of
this
fever
a
sometimes
in
violent
hot
the
D2
system,
rigor,
fit, and
produces
a
and
which
is
lowed
fol-
profuse degree
of
3'0
ON
of
sweating.
"Any other
than
When
FEV^R,
it
is
twenty-four hours.
has
the
It
milk
taken
done
prevent
duration-,
considered,
witb
more
rnstances
rare
tfee continuance
and
or
in
kept
other
cure
this
of
kind
small
so
other
by
up
arising, and
to
simply
once
excited,
tend
or
right to
it
suppress
portance.
im-
require
causes
it is
disorders,
so
would
when
as
cessary
ne-
disease
a
itself of
assistance,yet,
be
littleis
notwithstandingthat,
fever
a
little medical
from
some
then, that very
to
But
excite
In
place during
conceived
be
slx)rt in iSs
may
combined
not
feverl
be
may
to
k
MILK
disease, it scarcely everxontinues
delirium
"f
THE
to
it
prevent
directlyupon
its
attack.
Evacuation
effect than
by purging
in the
It has
three
especiallyin
The
and
the
Nothing
have
the
by
is
more
are
fever, than
been
this
ployed
em-
cure.
give a
to
some
years
after
delivery, so
derived
means
cretion
is less apt
liable
those
in
to
any
whom
Even
to
that
certain, than
omitted.
been
evacuations,
breasts, these
less
more
and
as
this
patients.
constitution
in- this way
milk
is
day
four
or
robust
blood
from
for
third
the
have
prevention or
customary
on
procure
which
means
of
way
been
purgative
to
other
any
produce
to
seems
to
the
less,
becomes
be
testines
in-
stimulated.
patients treated
severe
such
after
the
of
attack
evacuations
fever
has
begun,
38
SzC,
INFLAMMATION,
the
part
whether
or
;
cold
the
that
which
produces
breast, brought
in
on
much
of
not
cold
is
of
the
creased
inthe-
it
is
inquire.
It
another,
here
to
state, that
to
purpose,
in
inflammation
of
cause
the
sometimes
someiimes
a
but
case,
of
whether
a
disposition,
consequence
present
frequently
is the
inflammation
consequence
is sufhcient, for the
makes
breasts
feverish
an
or
and
place
the
these
a
by
circulation,
takes
of
none
is terminated
one
of
inflammation
of which
the breasts.
The
is
first
generallythat
the
breast,
few
hours
the
gland,
of
takes
the
this
is
and
small
absolute
quantity
of
oedema
often
of
at
finger,especially
After
days,
a
red
skin
that
more
and
according to
with
matter
surrounding parts,
and
this
the
the lower
has
prominent
been
than
the
is
extent^
of
rest
it
;
part.
some
affected
redness
fiDrmed,
impression
remained
has
Soon
disease.
the
yield to
covering the part
colour;
diffused
to
the
or
but
inflammation
the
the
found
be
and
inflammation,
of
the
hard
part,-
a
par-r
depend entirelyon
not
it will
the
of
a
of
breast
becoming
swellingeither
In
more
occupy
whole
the
part of
some
touch.
the
to
as
breast, does
in
lump
painful to
sometimes
patient feels,
the
inflammation,
of the
partly on
a
enlarges so
The
%vhole
of
which
the
tender.
which
symptom
one
the
assumes
more
the
will
or
less
part
be
fected
af-
found
part becomes
skin there becomeii
BREASTS.
THE
OF
g9
internal
absorption,
particularlytender
than
any
length it
one
breaks
which
through
is
from
thinner
comes
by
the
at
either
fluid,
mixed
or
pure,
flows
then
orifice
be
of
formation
diminished
much
or
the
of
out
mation
inflamis at
pus
an
Milk
purulent
or
serous
a
dent,
depen-
quantity.
in
with
abscess
the
being emptied,
whole
subsides, the
end,
the
At
openings,
in
contained
matter
more
place.
small
more
or
gradually discharged, if
till, the
other
and
orifice, which
the
at
length closes.
Sometimes,
themselves,
in
break
the
not
disease
into
so
one,
other
lowest
part,
the
ipainder,
During
the
and
the
becomes
become
then
and
the
by
the
edges,
abscess
ing.
heal-
in
being
not
it's pressure,
another
which
at
duces
pro-
orifice
takes
discharges the
re-
closqs.
of
progress
extensive,
full
hard, full, and
this
the
with
afFected
especially in
their
longer
orifice
^nd
part,
of
is
formed,
are
cavity of
matter,
below,
lowest
breast, if it be
more
the
that
rested
inte-
becomes
orifices
to
tion.
termina-
a
skin
ulceration
occasions,
ulceration
at
of
several
exposed,
more
On
place
;
left
abscesses,
favourable
so
afterwards, by
becomes
the
have
larger quantity
A
which
such
however,
of
constitution
febrile
habits.
strong;
JD 4
disease
The
the
the
times
some-
symptoms,
pulse
tongue
will
will
be
40
"C.
INFLAMMATION,
be
white;
pain
in
there
the
will
be
head, and
whole
breast
almost
intolerable, and
the
is
restlessness.
inflamed,
so
the
frequent, and
pus,
ings ensue,
or
till it is
artificial
an
This
be
milk,
other
induce
might
diseases, such
legs, inflammation
;
we
misled
tiren,
of
stopping
tei^itionshave
tbe
the
at
a
back
find
the
give ease
had
the
even
that
have
nia
ma-
practical
afraid
been
their
All
suppurative
the pus,
into
and
process,
formed,
when
to
during
the
advised
the
and
to
use
lient
emol-
poulticesto
inflammatory
patient,and
to
state,
hasten
the
matter.
having
"
swelled
largeopening.
inflamed,
From
gerous
dan-
and
usually directed
been
to
ful
hurttution,
consti-
the
and
outset.
very
therefore
of
dered
consior
into
uterus,
anodyne fomentations,
of
ral,
natu-
a
many
violent
more
and
formation
shiver-
redundant
been
accordin;gly
to
the formation
by
has
the part
have
been
opinions,
free evacuation
by making
both
such
forwarding
giving a
It
it
deprive
to
as
violent
surprised to
by
sometimes
puerperal fever,
as
of the
not
are
is
opening.
if carried
which,
the
When
discharged either by
deposition of
a
After
sometimes
complaint having
to
pain
violent,
patient entirelyof sleep.
of
thirst, sometimes
great
had
effects
abundant
frequent opportunities of
of
this
reason
mode
for
of
serving
ob-
treatment,
being
I
dissatisfied
with
THE
BREASTS.
seems
to
OF
with
it, and
why
this
allowed
to
will
resolution
by
cure
should
If she
the
febrile
symptoms
evacuation
also
the
of
the
T,he
in the
a
bleed
wine
time
some
two
procure
on
it
and
the
the
It has
the
first
strong
minish
dition
ac-
tions,
inten-
or
taken
leeches,
have
fastened
have
be
necessarilydraws
so
as
it's
to
useful,
intestines,
the
off^ the
off".
tage
advan-
farther
to
on
dropped
stools, besides
closed
in-
allowed
day,
every
determination
away
four
may
they
purging
circulation
circulation
breasts.
been
to
and
a
to
same
be
general principle, is
produces
order
the
which
;
after
three
or
therefore
from
by
necessary,
the
therefore
three
part
in
the
diminish
to
be
purely antiphlogistic.
glass, till they
Evacuation,
as
is
and
derable,
consi-
be
and
further
should
inflamed
for
blood,
be
application of
most
to
Blood
part.
in
the
should
first.
will
arm
To
object
next
the
by
of
vessels.
food
her
the
convenience
in-
if the
woman,
at
by purging,
quantity
future
inflammation
or
if it
constitution,
strong
a
bleeding from
and
the
attempted
of
be
other,
any
and
present
to
reason
suppuration,
to
spared
be
good
no
than
on
Much
be
be
more
run
prevented.
be
can
inflammation,
be
should
there
^I
1
mentioned
the
will
use
here
place, by
of
above
that
fomentations
state
their
what
warmth
there
and
they
they
jections
ob-
are
ces,
poultiIn
are.
derive
lai^e
a
"C.
INFLAMMATION',
42
large quantity
if
that
it
when
v/hich,
be
made
artificially
of
such
is
of
lead
inflamed,
of the
whole
The
difficult
very
should
therefore,
Instead,
think,
I
arise from
it
though
large
a
found
be
the
of
use
cold
should
to
the
the
be
breast.
of this
mode
of
trearnent
are
:
The
1.
formed,
generally in
it.
the
degree,
a
be
constantlyapplied
even
advantages
several
such
in the
large opening
a
into
*
weaken
always
utilitywill
more
solutions
part
is
applications,it will,
much
that
they
to
parts
happens,
healing, especiallyif
of
and
inevitably
abscess
the
quantity,
parts,
power,
should
matter
the
to
the
strengthof
and
tone
blood
relaxant
their
by
next,
of
cold
repels
which
is farther
lityof
the
the
assisted
lead, and
from
blood
by
hence
the
part,
the
astringent qua^
the
inflammatioji
is
lessened.
If
2.
the
less affection
if
or
will
*
acetum
A
solution
very
of
good
way
and
of
a
either
drachm
; to
five
which
be
pain,
diminished,
and
there
will
constitution.
be
in
be
of
duration
the
distillatum
spiritof wine,
the
it will
formed,
shorten
of
will
Matter
3.
less
suffer
will
woman
be
should
inflammation
the
of
cerussa
may
ounces
of
be
formed
not
less
the
quantity, which
disease.
in two
acetata,
added
all,
at
an
ounce
distilled water,
ounces
of
rectified
will be found
applyingit.
4.
of
The
a
OF
The
4,
should
abscess
with
up
should
employ
the
six
with
Let
be
it
often
aturine
be
pain
not
be
likelyto
it
may
be
under
tent,
to
to
prevent
make
the
with
be
skin
it from
as
breast
of the
skin
too
small,
largeas
do
termission,
inif the
not
seem
disease,
it may
small
a
sily
ea-
of
piece
cavity,
the barrel
and
be
fastened
the
the
;
spontaneously ;
slipping into
the orifice
the
in the
bit of thread
a
extent
points, when,
the
too
without
continued,
enlarged, by introducing
spunge
the
that the fluctuation
break
to
flammation
in-
lessened.
that
largelyinvolved
allowed
line
sa-
pease
ap-
called
be
much
very
great, and
very
a
early,and
should
abscess
opening should
if the
be
be
may
very
in
altogethersuppressed.
be
and
till the
right
punctuality,the
and
felt
distinctly
lotion
be
oftener,to
or
supposed, however,
be
can
it will
complete resolution,
a
suppurate,
matter
an
filled
sooner
undertaken
been
suppuration will
should
if
it.
assistance
produce
of the
be
pain,
hours,
strictness
if medical
But
s
of
has
plan
will
to
that
so
quantityof opium
sufficient
a
violence
this
pursued
late
it will
much
be
draught, every
If
weakened,
not
formed,
be
43
healthygranulations.
If there
to
is
breast
BREASTS.
THE
of
a
to
it,
so
as
small
quill
.
But
should
if the pus
seem
be very
that
probable
very
largely,or
then
it is better
if the
to
near
the
skin
pain should
make
a
small
surface, and
the
will
be
it
give way
insufferable,
artificial opening
of
44
of the size
to
mentioned
above., with
The
whole
because
the
long
should
the
than
half
then
the
orifice
and
out,
till the
a
fourth
within
the
After
lastly,to
the
from
the
the
a
milky
re-assumed
orifice
attempted
to
will
be
of
close,
an
will
lation,
granutain
con-
has
charged,
dis-
been
by squeezing
of
the
a
which
in
day"
a
discharge
serpus,
and
proves
that
healthy action, and
even
though
it
might
kept open*.
I
*
Since
the
peated
re-
originally
was
least twice
appearance,
or
be
be
abscess
whole
nature
and
isevacuated^
kept empty
at
more
length not
which
the
tains
con-
out
should
the
at
it
that
it should
whole
a
up
lint,
independently
out
will
ounce,
when
being purulent, to
parts have
then
be
time,
some
changes,
filled with
an
sides of
once
thoroughly
matter
be
part of the pus
it should
the
most
cavity would
When
it.
the
days,till the
themselves,
contract
let
discharged.This
this treatment,
take
supposing
rightto
day,
ne:s:t
more
for several
By
at
day,
one
that the abscess
not
should
till the
in
large, and
be
surgeon
or
ounce,
tent
spunge
taken
an
give
sloughing
and
difficulty,
it is
eight ounces,
will
the
emptied
th-e contrary,
to
appear
be
not
great
On
time.
which
prevent
cavity will
alv/ays fill with
lancet, and
a
skin.
should
then
and
pain,
largeportion of
a
be
the matter,
of
discharge a part
great relief from
of
"C.
INFLAMMATI02"%
of ^he first Edition
publication
of these
was
Essays,
this
^S
sometimes
formed
wards.
trouble
patient, or
heals
very
Whatever
for
of
and
is
This
which,
on
liniments,
followed
of
whole,
because
by
any
salivation, which
from
will
in
monly
com-
tion
suppura-
often
remain
the
been
is
assisted
one
three
or
it is
by
seat
times
in
preferable to
more
sometimes
a
very
the
but
use
part of camphor,
cleanly, and
in delicate
day
a
mercurial
is
not
such
as
habits
curs
oc-
unpleasant symptom,
employing
of mercurial
had
much
be
oil, twice
the
it
as
the
to
generallyyieldsto time,
liniment, consistingof
four
pursued
hardness
a
disappearance will
a
down^-
pain
surgeon,
in the part which
of the disease.
breast,
soon.
breasts,
time
some
the
to
the
of the matter
gives much
treatment
the
of
bottom
seldom
this
But
of
the
at
of the pressure
in consequence
its
"G.
INTLAMMATION,
inconsiderable
tity
quan-
ointment.
FSSAY
;
47
V.
ESSAY
ATTACKING
DISEASES
FEBRILE
STATE,
L
SECTION
writings of physicians, whether
the
In
which
to
liable, and
of
often
and
The
that
negligence is,
practiceof midwifery,
of
lying-in
the
women,
lead
them
the
Among
made
nature
of
whose
make,
or
record
ancients,
from
rooted
and
to
the
hands
inveterate
innovation,
as
at
of
of
are
of
this
tients
pa-
rent
appathe
countries
subsequent
to
did
"education
not
observations.
any
attempts
were
department
ignorant
prejudices
ment
treat-
committed
been
this
however
state
they
numbers
Athens,
rescue
the
proving fatal,
most
has
few"
on
that
soon
the
and
cient
an-
very
puerperal
reason
in
women
occasionally to
physic
yield
to
the
nature,
time.
in
observations
carrying off great
short
a
find
we
it is remarkable
serious
sometimes
in
in
women
yet
very
a
times,
chieflydetached)
those
diseases
are
modern
more
or
(and
MEN
WO-
PUERPERAL
THE
IN
AND
INFLAMMATORY
OTHER
THE
ON
women
do
useful
not
it
;
of
but
readily
is
likely
to
40
to
cHnation
be
ot
trouble
than
devoted
their
attention
to
of
time
that
has
has
been
under
painful
human
to
and
or
holding
bodies
some
been
of
relieve
surgeons,
a
peril of childbirth,"
a
fistula
circumstances
in
ano
of
a
delicacy of
"
to
the
men,
wo-
by prejudices,
of
branches
now
sic.
phy-
well
very
have
practice
in
labour,
situations
held
derstood,
un-
been
as
save
were
suffering
tion
disqualifica-
higher
if it
than
a
offices
less
the
greater
the
lesser
her
haemorrhage
of
the
of
one
of
as
the
from
woman
of
parturition, however,
of
some
flect
re-
we
perspicuous.
trying
has
that
than
been,
the
for
in
and
nature,
from
and
space
progress
is
rules
women
a
the
other
of
plain
more
attend
To
most
the
wifery.
mid-
artfullypropagated by
and
circumstances,
and
have
surprising
more
opposed
management
most
rendered
by
the
practitionersin
short
especiallywhen
other
the
on
The
seems
obstructed
tle
lit-
practice of
how
hand
one
suggested by interest,
many
it
done,
the
on
and
the
pectable
res-
now
of science
already have
been
not
that
art
should
much
so
more
elapsed,
than
habits,
It is
men
it is considered
has
in-
an
rather
error,
antiquity.
since
When
shown
former
changing
century
a
FEBRILE
often
voluntary
for their
only
more
have
in
remain
to
the
at
mankind
and
prove,
Al^D
INFLAMMATORY
THE
ON
tant
impor*'
of
life under
the
in
most
pain
piles,
the
vio-
lent
lent
WOMEN
OF
DISEASES
the
from
nature
Celsus
Some
have
of
acted
the
the
upon
and
distresses
of
of the
the
of
not
to
gripes
in
to
would
of
want
the
in
women
of the
to
a
diseases
few
lament
to
that
their
Parturition,, in
its
importance
the
the
of
state,
ledge
knowfined
con-
being
the
most
al-
diseases
is
sex
of
of
nity
huma-
puerperal
individuals, instead
the
widely
to
the
upon
and
neath
be-
not
medical
deplore
to
now
peculiar
as
as
it
successors,
information
times
laudable
same
pregnant,
crates
Hippo-
of
distresses
the
their
evident
too
they thought
have
themiJelves
women
it should
that
is
sex
agony
modern
in
succour
to
not
said
fit
a
the
to
women
Harvey
If the
descended
total
nor
character
child-
of
softer
the
immortality
because
pains
relief than
of
never
cine
Medi-
the
pain
absurdity
of
parturientstate.
students
Is the
The
danger,
no
had
of
The
ancient, and
their
the
relieve
detection.
escape
in
was
to
deserving
alleviated.
wifery.
mid-
ous
principles, injuri-
proposes
he has
;
physicians
society.
subjected
child-bearing,but
be
of
Unfortunately for
has
Almighty
nose
practised
of
humanity.
?
the
interests
the
less
bearing less, or
tively
compara-
from
bodies
false
same
which
art
an
the
surgery
learned
most
certainly to
is
of
father
the
than
bleeding
a
49
CHILD-BED.
uterus,
of
triflingevil
yet
IN
fused
dif-
subje^ct
demands.
most
natural
state,
proba-
rO
INFLAMMATION
THE
ON
biy
is
and
unnatural
exposed
not
such
have
the
men
subjectedwo-
and
diseases
importance that,
which
industi-yagainst
delicacyto
yet luxury,
;
life,have
opposition
women
FEBRILE
danger
labour,
such
all the
of
of
modes
it of
to
with
much
to
difficulties in
to
AND
has
the
exerted
wifery,
mid-
of
practice
false ideas
consideration
weighty
more
standing
notwith-
been
length sacrificed
at
quent
conse-
of
self-preservation.
the
Still, however,
knowledge
following parturitionremains
for
indeed,
of
want
of
written
and
this
the
upon
and
country
much
the
to
of
for
France
in
late
subject by
reputation
them,
to
attained
Much
science.
any
obscurity, we
and
infancy
has
been
first abilities
knowledge
if
still there
impute
must
difficultyof making
cause
be-
but
the
of
men
not,
:
the
years
medical
;
diseases
confined
very
attention
seldom
perfectionis
of the
it
subject
any
in
mains
re-
partly
clear
at
once.
Another
in
the
knowledge
otherwise
which
have
been
is, that
every
delivery has
This
has
the
by
same
oi
created
different
these
called
their
;
and
they have
so
nature
to
ter
af-
women
Puerperal
great confusion,
authors, supposed
diseases
Linderstoood,)
better
attacking
disease
been
advancement
diseases, (which would
perhaps
opposite in
most
that
impeded
has
cause
that
Fever.
toms
symp-
have
been,
characterize
recortimended
the
modes
of
of
treatment
their
nion
of
The
description
the
disease.
name
of
Puerperal
of
misled
by
they
only
a
have
may
one
that
disease
under
any
and
disease,
have
writers
and
practice,
of
fantasies
theory,
descriptionshave
dissimilar
been
led
cord
with
and
their
have
whether
a
review
of
very
of
from
cases,
the
what
and
that
But
which
ever
how-
they
did
as
leave
may
their
have
not
ac^
anomalies
to
not
;
inquire
be
tacked
at-
complaints.
has
E
whims
nature,
disease,
child-bed
different
tion
reputa-
concluded
themselves
in
of the
engaged
the
to
in,
treatments
men
;
appear.
all
idea
woman
be
may
given
not
with
A
they
of
that many
physic
the
of, the
acknowledged
drawn
been
conceive
to
m.ode
it must
is
mistaken
been
addicted
not
selves
them-
ing-in
attacking ly-
the
of
men,
described
appearance
of
profession
a
with,
as
it is considered
men
become
respectively
the
in
erred
been
the
in
in
have
yet, when
And
either
have
tacking
at-
have
form,
mis-stated
have
must
or
other
hiust
women,
who
authors
been
disease
persuaded
frequently met
most
and
;
thus
disease, which
of
form
the
opi=
Practical
bias, have
false
this
that
has
inconvenience.
much
source
their
febrile
eva:y
other,
having
Fever
child-bed,
in
each
and
of symptoms,
given indiscriminately to
women
51
CHILD-BED.
IN
contradictory to
less
no
than
WOMEN
OF
DISEASES
been
2
said
by
different
authors
52
ON
INFLAMMATORY
THE
authors
will
AND
us
satisfy
soon
FEBRILE
of the tmth
these
of
observations*.
Some
writers
consider
the
the
inflammatory kind,
the
abdomen
is
Others
tion
of
abdomen,
which
the
and
that,
the
blood
the
of
accounted
vessels
time
the
at
in
rush
state
part,
and, from
cause
a
local
of
extraction
lochial
erence
of
opinion
I shall confine
the
in
subject
of
what
child-bed, will
in their works,
;
England
after
as
a
whose
branch
from
time
find
by
violent
and
of the
has
chieflyto
the
many
the time
rude,
hasty
what
of
have
said
sensible
been
have
written
is desirous
who
the
on
diseases
observations
Hippocratesto
midwiferybegan
dif-
they
has
to
be
the
disease
much
been
by
milk, "c.
reader,
inquisitive
The
for
"
part which
old writers
the
labour
considered
there
remarks
later times.
knowing
in
women
my
particular
by suppressionsof
the
to
there
accounted
of
hy
"
have
as
circulate
The
translations
inflammation,
delivery,a.
inflammation.
so
"
who
posing
sup-
may
placenta
those
by
slightobstruction,
time
uteri
os
"
local
of
the
it
some
farther
the
discharge by
a
on
been
in
of the
Among
*
very
has
management
treatment
as
a
arc
,of pressure
of
upon
plethora,and
inflammation
bad
may
for
removal
sudden
of the
cavity
appearances
fliiids than
natural
of
inflamma'
an
the
febrile
have
from
as
greater proportion of
a
fever
a
the affection of
disease
contents
symptomatic,
from
the
of the
of
which
as
symptomatic.
consider
some
of
disease
that
tered
scat-
of
denham
Sy-
cultivated ii"
of medicine.
conceived
OF
54
pregnancy
such
;
togetherwith
which,
parts of
putrid
up
the
into
which
This
appetite, in
bile is
collected, becomes
Small
and
crowded
air, and
is
the
as
the
followed
of
ideas
such
the
recommended
been
of
causes
extraordinary
emetics
given to promote
pain
and
cure
causes
the
;
same
and
genus
those
usually
with
of the
abdomen.
various
by
of
way
fcetor
means
prevention,
avoid
the
casional
oc-
sweating,and
this
on
are
principle,are
advised
to
of
the evacuation
to
all
be
ly
frequent-
putrid saliva,
exist in the
mach
sto-
duodenum.
rest
the
charges
dis-
putrefactionof
disease
putrid juizessupposed
prevent
lochial
putrefaction.
evacuations
discouraged,but
fined
con-
horizontal
an
are
Bleeding, blistering,purging,
The
in
predisponent, and
the
counteract
of
is absorbed.
liquors, a
of
be
to
which
of
and
strong
lochia, swelling and
With
and
to
malignant fevers, together
in
have
be
described
symptoms
of the
is said
jail fever.
hospital or
found
taken
be
the immediate
as
thin
to
lying
itself is said
disease
The
to
considered
are
rus,
ute-
supposed
occasionthe
to
the
intestines, the
putrid,
much
supposed
of
consequence
rooms,
too
weight
(which, by detaining the
posture,
them)
the
are
blood.
of
loss
hy
the
in
faeces
the
detain
ings,
petticoatbind-
and
tightstays
as
FEBRILE
AND
INFLAMMATORY
THE
a
of the
wai,tc
symptoms
treatment
qf
of
consists
strength,
and
of
means
to
resist,or
to
putrescency.
Besides
Besides
these
the
but
disease
good opinion
practice, by
different
and
supposing
kinds
febrile
have
I
had
of
in
shall,
I
that
opportunity
of
with
thors
au-
justice
sentiment
they
and
described
have
the
take
sequel,
from
has
of
name
same
of
notice
;
the
complaints
inflammatory
the
sidered
con-
I shall endeavour
under
disease
the
and
and
;
diversities
these
reconcile
to
have
some
accounts
public
the
accuracy
a
55
putrefaction.
to
different
these
taken
entertained
CHILD-BED.
tory,
being originallyinflamma-
as
verging
of whose
IN
general opinions,
soon
I have
WOMEN
OF
DISEASES
rious
va-
which
seeingin puerperal
women.
It
to
appears
such
concile
absolutely impossible
me
diversities
practicalinformation,
than
term
that
avoid
which
ing
the
give
collect
I
the
found
system,
and
to
facts, and
it, without
and
the appearances
by
any
good
principle
applying
similar
in the
women
name
any
a
describing
1787
years
of
men
re--
the
same
complaints.
in
attacked
in
other
any
of their
fallinginto
engaged
was
opinion
upon
stated
different
to
To
to
above
of
to
without
with
of
the
the
the
epidemic
puerperal
disease, but
describe
bias
any
the
to
which
preceding
state, dur^
not
simply
complaint,
to
as
particular
any
endeavouringthose
I
fever,
determined
I
1788,
when
error,
to
had
writers
reconcile
been
on
tioned
men-
peral
puer-
diseases,
E
4
This
5^
ON
This
appeared
the
at
that
disease,
the
which
have
with
met
advantage,
the
although
attention
and
difficultyof
of
clearer
of
have
been.
contribute
object,
it
have
any
be
the
left
degree,
state
will
will have
found
of
be
a
than
it
the
the
a
the
taken,
under-
subject
to
seems
a
gree,
de-
of this desirable
practical part
have
set
of
the
light, and
better
smallest
the
fully satisfied,
the
ter,
mat-
shall
to
manner,
misfortunes
child-bearing is liable,
sufficient
in
therto
hi-
m^e
shall, in any
I
alleviate
of
aware
have
I
place
I
whole.
the
well
am
to
to
of
be
considerable
attainment
in
in
of
which
If I shall
and
sufferings,
the
I
Whethei?
decide.
contributed,
the
which
to
must
profession to
in
task
view,
upon
might
it
and
;
medical
my
bestowed
it,
endeavouring
point
to
the
vations
obser-
information
result
the
upon
and
;
practitioners, if
have
I
way
reputation
that
some
in order
arrange
time
to
peral
puer-
own
cases
with
usefsal
thought
least
at
of
much
I
subject,
authors
conversation
in
lastly,having
Yet,
in
in my
the
time
of
cases
fallen
with
these
recorded
should
and,
much
different
upon
having compared
the
nicating
commu-
made,
bestowed
time, having
reflexion
friends
had
I
as
of
way
time, of^avoiding controversy.
same
Since
and
-
.
best
the
be
to
observations
such
"C.
INFLAMMATORY,
THE
and
my
my
sen
lesto
pectations
ex-
trouble
reward,
SECTION
b7
SECTION
ON
II.
UTERUS
THE
OF
INFLAMMATION
AND
-OVARIA.
has
It
these
a
and
employed
the
which
child.
In
is
labour
is
and
soft
size
of
of
the
of
early part
that
protruded
labour
into
lower
the
powers
child
the
child, and
the
head
Considering
appear
in
and
all
this situation
it
too,
segment
of
cavity
the
sides
these
evidently, that
of the
is
squeezed
causes
not
of
the
head
tween
be-
pelvis.
circumstances,
many
quor
li-
of the
body
pelvis along with, (because covering,) the
of the
are
by pressing
when
the
the
pelvis,
abdominal
first
afterwards,
and
child's
the
the
themselves
it.
The
of
and
posed
com-
of the
the
of
parts.
passage
of
overcome
smallness
the
occurs,
course
to
discharged, upon
the
the
overcome,
the
the
exert
is
unfrequently
uterus
from
uterus
membranes,
amnii
the
the
of
actions
muscles,
on
effect
to
of
destined
are
rigidity of
the
be
comparative
the
in
process
to
arises
resistance
head,
the
resistance
v/hich
exertions
The
the
that
Essays,
of
observed
already
been
of
it
will
violence,
or
58
the uteru.^, and
injuryto
or
also
it, as
its
and
OF
THE
the
peritoneum
INFLAMMATION
ON
lower
the
to
peritoneum,
will
UTERUS
part of
be
ing
cover-
bladder
the
applied in
natural
a
labour.
continued
Loner
the
upon
without
made
can
and
the
the soft parts,
these,
the
improper
the
vectis, by
be
add
farther
will
Besides
can
child,
inconvenience,
upon
head,
of the
body
of the
actions
it is
of
use
those
Hence
chance
of the
of
injury.
some
cases
especiallyof
it
it, because
employ
who
pressure
impaction
instruments,
still
done
may
have
micrht
arise
inflammation
would
produce
secretlyused,
violence*.
violent
feared, that in
be
to
the
to
hardly happen
the
by
exerted
uterus
more
of
o
of these
any
parts, which
the
accordingto
the
and
But
all
though
these
effect is
applied, the
the
topical dischargeof
of the
of
would
a
Another
generally preventedby
the
lochia, which
placenta,answers
very
those
the
fore,
there-
of the separation
secondarypurpose
otherwise
evils, which
arise.
likelyto
the
co-operatingto
cause
inflammation
consequence
necessary
preventing
be
of
causes
are
though
inflamed^
inflammation.
of the
extent
of the parts
nature
toms
symp-
end
same
is
*
time
The
of
improprietyof using
the
required,has
in his
accoucheur, and
been
Essayson
labours.
with
great
merely to
instmments
therefore
in
cases
where
by
reprobated
justice
the Practice of
Midwiferyin
Dr.
save
none
the
are
Osborn,
natural and difficult
OVARIA
AND
lochial
the
the
the
from
effectuallydefeats
that
which
uterus
is
takes
so
from
which
of
the
has
a
the
recited
of
out
of the
during
blood
above;
cold,
to
bed
after
to
part.
This,
that
of
times
any
the
it
in
the
for
as,
Fallopian tubeg.
the
health
become
lochia
will
disease
natural
from
to
example,
to
brought
that
on,
quence
conse-
in
some-
with
the
neigh-
the
ovaria
part
an
once
when
in
of
the
suppression
and
to
having
of the
a
in
communicated
it, and
functions
other
any
though
Inflammation
disturbed;
be
to
uncombined
disease, yet is often
coverino-
flow
the
inflammation
which
and
rection
di-
obtains
induces
an
uterus,
lating
circu-
That
predisposition
distinct
parts,
the
which
preference
produces
of the
begun,
the
and
peritonaeum
bouring
and
viscus
appears
other
uterus,
by
as
Sydenham.
parts.
naturally
labour,
substance
the
to
delivery,
throw
to
internal
to
pregnancy,
of them
the
the
upon
the
to
sometimes
uterus
general tendency
fluids
uterus
tion
determina-
practice deservedly reprobated by
This
the
tity.
quan-
precautions of
wise
exposure
taking patients early
a
in
necessary
causes
added,
be
may
when
there.
inflammation
place
time
diminish
to
But, notwithstanding these
nature,
the
blood
of the
of inflammation
support
^g
about
begin
revulsion
breasts
to
milk
evacuations
This
to
of the
accession
is the
CHILD-BED.
IN
increase
cause.
Inflammation
of
QO
ON
INFLAMMATION
of
Inflammation
when
it exists
its
by
or
known
to
lower
exist
of
in
by
the
like the
irritation
of
the
the
its
of
is first
felt
and
part,
feeling,resembling
the
almost
if
much
On
mination
exa-
found
be
is also
It
from
is therefore
uterus.
will
uterus
termittent
in-
the
arises
uterus
the
size.
common
creases
in-
are
whilst
patient complains
to
the
at
depending like
uterus,
of the
applied
the
gradually
labour,
the
of
and
Afterpains
of the
externally the
than
marked
distinguishablefrom
constancy.
pains
uterus,
about
pain
which
is
nerves
be
pressure
any
and
The
constant.
of
sensation
inflammation
of
delivery,
after
contractions
upon
the
tolerably well
abdomen,
its
of
usually begins
a
violence,
Afterpains by
pain
is
It
day
UTERUS
substance
simply,
third
part
them
the
symptoms.
second
THE
OF
ger
lar-
harder
firmness
to
o,f
a
stone.
I
know
examination
any
not
but
of
examine
it in
where
inspecting the
body
one
of
it, but
found
once
confirm,
after
or
state
and
it
so.
it
after
may
rightto
Farther
because
and
it
tage
advan-
no
nity
opportu-
an
than
by
it is
cases,
death,
not
uteri
os
with
I had
harder
delivery.This
I think
such
attended
case,
period
state
have
in
contracted
more
that
to
of the
state
livingbody,
probablybe
most
;
of the
of the
customary
would
a
nothing
it
in
was
is usual
at
be the general
mention
observation
it,as
I
will
rejectit.
Soon
62
INFLAMMATION
ON
will
take
If the
very
and
nseum,
in the
disease
it becomes
a
place
then
mixed
In the progress
times
in the
and
disease
it
after
pulse
and
irritation
off
in
a
pulse
short
the
skin, which
relaxes, and
now
comes
The
chance
shiveringshave
face,
nor
jmy
of
the
the
the
taken
those
is
quency
fre-
general
often
:
symptoms
cut
been
a
"
a
the
flushingsappear
becomes
had
cooler
recovery
of
the
tongue
before
in
then, however,
"
and
of
and
scarlet
or
by aphthae.
patient
frequent
is
on,
these circumstances
followed
relives the
less
"
comes
patient be-
symptoms
Now
lochia
seldom
the
various
generally increases
time.
take
as
at
fieryred,
a
weakness,
becomes
more
and
on
succeed, and
foetid
of
flow
this
place
Under
is often
which
appearance,
The
puts
tongue
perito-
pens
frequently hap-
face of
the
occasionallyflushed.
the
if they
case.
of the
day,
the
run
considered, and.
next
slightshiveringstake
that
not
but
;
ployed
em-
it ofF.
arise, such
be
to
draw
attacks
symptoms
new
to
swell
not
inflammation
the
then
should,
does
abdomen
be
should
inflammatory symptoms
high,the
uterus
must
day
times every
three
or
the
both
catheter
the
that
place, so
two
when
or
with
communicated
suffered,that suppressionof urine
have
bladder
and
UTERUS
THE
has
bladder,
of the
neck
disease
the
foundj where
the
OF
hot
paler"
and
spontaneous
dry,
arrhoea
di-
patientrecovers.
is far greater when
place,
nor
flushing of
unfavourable
no
the
symptoms
^sscribed
last;
described
less
the
uterus
tender,
where
dischargereturns
in its usual
and
of
secretion
the
is not
in this
symptom
to
so
met
disease,
secreted
travasated
or
the
of the
cavity
cases
;
in
that
free
has
uterus
covering
the
loaded
affected
The
in
with
in
will
uterus
its substance,
contracted.
the
uterus,
cases
I
veins
of
pus
have
that
ex-
found
in
disease
has
and
of
the
bladder.
running along
the
will
be
are
ten
of-
cut
open,
ovaria
too
way.
commonly
be
found
largerthan
cutting into
found,
with,
part, and
some
which
peritonseum
The
same
have'
in
disease
when
is often
met
the
from
observed
but
Upon
no
partiallyinflamed,
blood.
the
who
or
been
posterior part
Fallopian tubes, which,
seen
have
the
been
is often
Inflammation
ally
usu-
women,
little
when
others, however,
the
covers
next
peritonasalsurfaces
The
discovered
also
been
fluids
abdomen,
simply.
existed
is
kills, it is
of
-bodies
disease,
this
under
fatal
a
as
which
that
rium,
deli-
irritation.
the
examining
died
have
with
in
as
by
strength and
this disease
of
lochia!
succeeded
pain,
commonly
by symptoms
Upon
from
When
the
begins again.
of
be described.
gradually
quantity and quality,
depression
of
marks
evident
milk
cessation
sudden
A
63
CHILD-BED.
where
but
and
softer
becomes
IN
OVARIA
AND
is
not
when
the
i::
naturally
any
of
substance
which,
situr^^d
firm
very
in
in
all
the
the
large
circumscribed
c*ivity
64.
INFLAMMATION
ON
cavity like
the
sometimes
found
and
1
s
so
the
substance
of
the
distended
by
flammation
in-
in bulk
equal
to
as
cavity of
a
egg.
with
met
never
the
where
uterus,
there
cervix
was
but
:
in
place
in
gangrenous
to
be
tification
mor-
of
part
any
except
a
it is
vv^hich
in
case
any
taken
of
substance
the
the
is also
Pus
the
cases
some
matter,
had
of
in
are
in
also in
and
UTERUS
abscess.
an
contained
Fallopian tube,
pigeon
of
cavity
ovaria, which
THE
QF
the
stance,
in-
one
appearance
remarked,
that
in-
by
the
r
had
struments
I
well
am
said
but
to
I
happen
adhered,
only
of
the
for
gangrene
placenta, and
the
upon
of
not
place
where
of the
coagula
of
the
to
mining
exa-
died
in
of
blood
of
placenta.
had
commonly
portion
large vessels
separationof
chiefly
placenta
it is
maternal
rus
ute-
appearance
the
whereas,
been
the
have
mistakingthe
the
in
habituated
who
women
;
has
that this has been
uterus,
of the
extremities
the
of
their
remainder
the
taken
persons
bodies
case
mortification
having
by
child-bed, from
part
that
as
that
in
labour.
persuaded
am
the
that
the
aware
described
often
;
attended
who
person
employed
been
of
the
formed
at
the
A
uterus
very
tle
lit-
attention, by scrapingoff gently this substance,
will
detect
the
sound
internal
surface
of
the
rus
ute-
beneath.
This
disease,
as
far
as
I
know,
has
never
been
epidemic
in the
but
;
it
curs,
oc-
the country
difference
of the
account
on
atmosphere disposing more
the
of
state
should
frequentlyin
more
large towns,
in
than
whole,
the
on
it
likelythat
is it
epidemic, nor
65
CHILD-BED.
IN
QVARIA
AND
t(?
inflammation.
also is found
It
in
more
weak
constitutions, and
have
indulged
an
spirituous liquors
than
of robust,
women
who
those
especiallyin
appetite for heating food
and
both
and
during
pregnancy,
immediately after delivery.
reasonable
is
It
inflammation
dispositionto
with
a
attention
proper
subside, will be very
I have
seen
degree
of constant
has
have
well
too
known
into
vity
acti-
I think
that
called
has been
there
tenderness
delivery,in
those
to
to
subdue
of
to
some
the
at
tom
bot-
ease
the dis-
which
a
careful
circumstances, which
the causes,
inflammation,
or
but
practicalman
every
might
shorten
which
to
are
require
descriptionhere.
any
The
prevention of
much
very
labour,
assisted
to
to
and
after
directed
continuance
the
and
Sec.
altogetherprevented by
tendency
a
be
slight
a
viscus, which,
any
regimen,
where
pain
belly
been
attention
to
likelyto
cases
many
the
of
in
Indeed,
irregularities.
such
by
believed, that
be
to
third
Of
the
the
the disease
by
altogethermay
attention
management
of
plan suggestedin
before
and
the
woman,
the
be
during
cording
ac-
first,second,
Essays.
all the serious
complaints
F
which
attack
wo-
mefi
60
INFLAMMATION
ON
in
men
the
the
pain
puerperal
fatal, and
least
from
relief
to.
The
and
often
attack
which
will
if the
the
has
the
at
Bleeding, therefore,
in
of the
hy
the
of the
of the
it
must
found
In
of
the
the
be
the
not
success
manner
any
and
arteries,
the
flammation
in-
the
the
especially)
more
Almost
this
upon
be
and
the
it will
only a second,
patients,it will
be
but
violence
The
pulse.
must
formed
per-
regulated
the
of the
state
the
being
be
woman,
upon
that
(in strong
system,
omitted.
operation
observed,
necessary
less robust
of
evacuation
former
distinct,
subdue
to
circumstances,
same
in
quantity must
and
symptoms,
mode
circulatingfluids,
country
be
constitution
repetition
by
the
The
is
with
heart
the
depends
success
early.
of the
from
scarcely ever
whole
the
outset.
very
constitutions, and
then
simple.
order
in
employed
and
attended
of
action
ent
pati-
suflficiently
tendency
a
with
the
to
attempted
be
quantity
the
weaken
be
be
disease
which
art,
diminish
should
both
disease,
tended
at-
constitutional
by
symptoms
frequently be
o^ the
Every
the
should
very
form
should
of
early
being accompanied
The
'^be
to
of
possibility
the
succeeded
soon
nature
this
assistance, if it be
physician.
of relief
and
within
gives quickly alarm
the
mark
to
I believe
J
and
UTERUS
THE
state,
most
medical
symptoms,
and
OF
ed
governthe
disease
effect
;
and
frequently be
a
third
time.
expedient, if
the
symptoms.
tirely carried
ofF
blood
more
leeches, inclosed
or
niore
or
by cupping
desired
the
upon
the
by
leeches
of
of
with
the
patient to
care
the
the
anoint
should
be
clothes
that the
such
as
with
two
drachm
of
oil of
From
I
me
to
say
expect
much
the system
very
at
mixture
The
est
great-
and
ing
apply-
wetted,
not
it will
found
be
some
an
nor
the operation
quite dry,
of
also
disposing
when
with
to
occasions
cannot
pulse
skin
applied
have
and
purpose
and
then
oily-
warm
of
ounce
of
camphor,
the
abdomen,
vantageous
ad-
oil of
and
a
cloves.
other
they
the
the
a
;
be
the
and
and
removing
finished,
drachms
blisters
in many
belly.
spirit)are
pain
sheets
abdomen
olives
ful
is
in
cold
to
make
whole
liniment,
-
taken
fomenting
the
the
gentle perspiration.
a
to
eflFected
for the
camphorated
patient exposed
of
on
used
blood
be
flowers,
camomile
belly,
the
may
laid
alleviatingthe
in
service
it
six
if it be
:
discharge of
poppies, (the cloths
being sprinkled
take
the
to
abdomen
flannels
of
Fomentations
heads
bason,
a
falling off,
of warmed
use
en-
bleeding, to
the
of
the
continue
to
in
skin
the
not
are
topicalapplicationof
the
by
first
the
by
6/
CHILD-BED*
diminished,
been
having
symptoms,
away
IN
OVARIA
AND
that
my
of internal
own
increased
considerably,and
use-
tions,
inflamma-
experience leads
On
advantage.
often
so
the
the
trary,
con-
frequency
the irritation
of
in
large.
F
2
Besides.,
68
INFLAMMATION
ON
I have
Besides,
producing
evidenth'^
the
On
these
of
blisters
using
they
of
are
"c.
neumonies,
I would
find
to
as
?sleither
in
delivery.
the
instance,
rightin
the
of
be
the
from
evacuations
it will
first
enough
bowels,
to
with
saline
I have
which
that
it has
It is
found
kept
than
This
up,
any
will
if it
do
internal
more
observation
may
which
three
time, small
to
The
mixed
objectio-n
purging is,
preventing
can
towards
remedy
believe,
regular motions
time
of
uterus,
afterwards,
continued
effect
the
tunate
for-
purging
or
little rhubarb
a
long
practicalopinion
againstan
but
purgative*
to
always
or
gentle perspirationwhich,
and
the
I
two
procure
preserve
the
always,
;
so
of
of
intestines
oil,
castor
of
them,
course
by giving, from
quantitiesof
some
from
a
to
ety
propri-
cases
been
not
inflammation
follows
with
rage
stronglydiscou-
I have
benefit
the
the
other
too
I recommend
can
serviceable
which
much
in
;
pleurisiesand perip-
not
although
their use,
kid-
the
nevertheless,
;
many
in
as
of
symptoms.
of
sure
in
use
that
ureters
other
this disease
in
great
not
am
inflammations,
internal
as
I
the
to
fect
ef-
attended
urinae,
meatus
accounts,
in
of the
course
addition
in
pain
great
as
and
bladder
be
to
inflammation
an
the
known
once
absorbed
whole
nies, along the
UTiRUS
THE
than
more
cantharides
the
of
OF
be
produced
curing the
which
seem
I have
that
ease
dis-
I know.
to
militate
made
above,
that
^O
INFLAMMATION
ON
ing.
three
About
with
half
the
grains of
should
UTERUS'
the
antimonial
quantity
same
succeed.
be
not
The
The
of
opium
in
the
disease.
the
from
sleeping,and
of
will
will
be
be
ing.
vomit-
on
in
both
repetition,so
the
aggravate
relief from
will
patient
antimony
increased
alone
Besides, unless
the
bring
frequency
quiet the pain, which
and
dose, will
a
of
be
may
rhubarb,
for
to
as
der,
pow-
,
dose
great
so
quantity, and
to
THE
grain of purified opium,
a
commonly
as
OF
pain
be
cured,
pro-
entirely prevented
attacked
by symptoms
of irritation.
Indeed,
the
existence
substances
ing
in
should
it
muscles
If
the
adds
on
during
interfered
by
should
proper
the
mflamed
the
course
be
come
mixture,
and
it
as
agitation
by
the
than
by taking
be
frequent
not
the
and
opium,
a
very
so
as
some
small
to
be
not
that
care
reduced
too
evacuations
copious,
administer
with
ous
spontane-
a
should
it
on,
woman
occasionallyto
stopping
disease
If, however,
very
'
uterus.
farther
the
vomit-
made
pressure
of the
should
it.
Ipecacuanha
the
of
the
pain by
pect
sus-
indigestible
inasmuch
avoided,
be
to
reason
action
the
stomach,
the
with
is
undigested, or
to
strength of
much
there
occasions, and
diarrhoea
the
of
always
constantly
which
where
except
it will be
of the
taceous
cre-
quantity of
moderate
out
with-
the diarrhoea.
If,
GVARIA
AND
If,by
of the
any
the
whole
is
plan
of
course
it,
is free from
tient
continue
unabated
has
as
been
constitution
shall
first,we
pursuit
of
the
In
of
of the
of
sort
we
par
the
of
use
recommended
in
the
to
trust
do
we
for
be
of the
food
such
nature,
and
Animal
food
fermented
of
succeed
of
at
ground by
length
great
any
efforts
of
kinds,
should
ture.
na-
hardly be
peitientshould
all
liquor,
another
is of very
as
best
powers
not
interrupt the
medies
re-
should
of this disease, it need
the
the
symptoms
plan
same
may
that
mild
a
that
l?e likclytogain much
course
mentioned
the
it will
since, if
;
not
time, and
dued,
sub-
through
force,
and
Sydenham,
by
the
the
the
above,
with
wait,
the
believe
we
been
danger.
advised
case
till
or
if, notwithstanding
But
to
continued
I
above,
have
should
be
to
7
recommended
means
disease
of the
violence
the
CHILD-BED.
IN
easy
and
be
gestion.
di-
every
be
strictly
avoided.
the
If, after
several
taken
that
little
under
the
almost
place.
these
can
certain
such
In
be
a
be
in
Fallopian tube,
F
4
the
be
of the
pus
may
tient,
pahas
feared
Many
necessarilydie.
veins
the
to
medicine.
by
for
suppuration
it is
case
will
the
attack
that
done
circumstances
suppuration
"pa the
continued
shiveringsshould
days,
it is
have
symptoms
uterus,
If
or
jDOssibiy
escape
INFLAMMATION
ON
72
the
into
escape
should
only
modes
general cavity of
the
abdomen,
the
matter,
Of
it
1 much
or
by
it's
and
be
the
adhesions
by
parietesof
the
before
discharged externally.
have
positiveevidence,
no
if it often
doubt
either
into
breaking
or
ova-
be
absorption going
so,
can
the
will
abdomen,
if it
But
it)in
seen
evacuation
may
we
UTERUS
uterus.
ovarium
and
the former
and
the
the
of
the
between
THE
have
(as I
by absorption of it,
forming
of
cavity
situated
be
ria, the
OF
Of
happens.
the
'
second,
ca^es
I
has
of
navel
I
stage
of
the
unfortunate
As
and
the
are
as
the
recourse
opinion
in
This
the
at
the
ledge.
know-
suppurative
destroys the
several
in the veins
dies
bo-
of the
ovaria.
of
excite
matter
under
irritation, such
usuallyemployed
in internal
decoction
with
to, but
the
any
broke
my
opened
suppuration
the
effect
that
I have
of
delivery, but
commonly
most
patient, as
is to
as
disease
confined
with
uterus
of
be
stance
single in-
cavity
fell within
never
case
to
apt
am
the
after
months
rience
expe-
following
abscess
in
Many
own
a
puerperal patient.
a
the
My
with
me
affection
some
of
event
instance.
an
latter.
circumscribed
a
of
abdomen
the
furnished
only
inflammatory
the
of
recorded
are
with
met
never
of
sarsa
such
sedative
means
suppurations,
opium,
little I believe
stances
circum-
is f o
may
be
be
had
expected
from
their
from
flesh and
and
with
of the hands
and
burning
heat
and
of
wiry
and
the
;
the
at
countenance
when
it is
patches
face
;
of
snxious
length the
patientsinks
colour
and
;
;
the
are
the
;
pale
,
eyes
palms
affected
small
pulse becomes
hardness
loses
becomes
feet
soles of the
the
daily
occasionallyflushed
red
a
75
woman
the
strength;
hectic
a
The
exhibition.
sallow, unless
CHILD-BED,
IN
OVARIA
AND
become
with
frequent,
hollow,
colliquative sweating
extremities
become
sues
en-
cold, and
dies.
""CTION
7-^
INFLAMMATION
GN
OF
SECTION
OF
INVESTING
OR
For
great aptitude in the
which
body,
the
excite
in
frequent,
is very
Puerperal
It has
conceived
been
parts,
to
of the
to
so
the
cause
the
the
state
an
*
labour,
Yet
it
seems
of
Mature,
exposed,
been
the
in
not
called
to
a
occurrence,
uncommon,
and
the
be
to
ble
conforma-
which
they
of
or
parts
must
cessarily
ne-
health, should
an
the
immediate
alteration
is
the
abdomen
this
complaint
that
ceedingsuc-
contraction
construct
state
of
state
abdomen
to
Moreover,
cavity of
in
the
or
predisponent,
a
so
'
this
predisposition
of the
cavity
of
disease.
of
also
change
circumst?inces
prove
of
this
to
Hence
this
act
wisdom
the
be
either
of the
or
that
some
upon
uterus.
that
has
to
be
to
seem
operation,
child-bed.
and
to
Fever.
might depend
these
of
time
part, during the
inflamed
tendency
a
parts,
their
a
applied
causes
of internal
peculiarly directed,
disease
that
be
to
be
to
generally have
inflammation
OF
seems
peritonaeum
delivery, so
after
women
NAEUM,
PERITO-
ABDOMEN.
other, there
or
reason
some
THE
MEMBRAl^E
THE
OF
CAVITY
THE
in
III.
INFLAMMATION
THE
ON
THE
it is
so
is
hardly
of
quent
fre-
paratively
com-
credible
that
hie
liable
so
some
head
in
cases
entering
uteri,
if it do
not
believe
that
it
does.
of
head
which
is
after
Besides
this
the
have
added
been
would
to
of
to
any
have
bring
also
in
many
cases,
should
be
where
cases
great
is of the
can
the
the
degree
a
disease.
the
to
usual
size,
hardly
take
disease
does
peritonaeal inflammation,
cold
is
externally
by labour,
of the
brought
of
belly
on
the
may
which
and
disease, will
inflamm.ation
another,
which
slight injury
Tight binding
has,
fact, that
in
labour.
produced
on
frequently
it
so
It
cause.
proportiou
in
why
reason
;
occasion
to
pressure
of
cause
occasioned
not
likely
the
every
application
which,
in
pelvis,or
of
I
hand,
as
small
of the
degree
occur
not
is
and
disease
find,
only
the
to,
more
we
pelvis
predispose
occasional
other
happen
the
covering
the
also would
it is
of
may
an
the
on
can
violent
place,
be
child's
the
by
either
disease, than
aperture
any
few
so
aperture
comparatively large,that
the
upper
made
bladder
this
that
pressure
Where
upper
that
But
is
the
is often
it
remembered,
head
pressure
actually produce
the
produce
the
the
or
said,
be
may
and
escape,
peritonaeum,
the
against
cervix
should
many
7^
its influence.
to
In
CHILD-BED.
IN
PERITONEUM
alone
be
very
the
naeum.
perito-
after
delivery
disorder
large quantities of heating liquors
drunk
;
as
after
delivery,
76
INFLAMMATION
ON
delivery,against the
have
one
the
it
in
part
whilst
;
the
it would
once.
ticular
small
a
tenderness
of
the
abdomen,
the
last,
whole
of the
size
arise in the
characterize
it and
it
All
in
becomes
smallest
clothss.
the
from
to
a
pressure
of
the
made
All motion
the
e^^tends
disease, is
belly before
from
strongly
other
tions.
affec-
pain distinguishes
liningof
state, the
pain
degree
disturbs
very.
deli-
symptoms
inflammation
upon
the
as
of
unii^^ersality
the
the
violent
and
disease, which
of
derness
ten.
very
constitutional
internal
inflamed
an
general
a
in
usually increases
the
After-pains, and
discriminates
find
begins, and
of
par^
This
distinguishit
constancy
some
earliest symptom
the
course
of the
progress
The
being
and
local
in
belly.
tumefaction
the
at
great part of
a
commenced,
the
Various
uterus.
abdomen
swelling, in
to
of
in
the whole;
to
commonly
disease
tions
sensa-
begins
pain,
we
the
once
the
membrane
is the
cavity
it has
nearly equal
the
attack
to
appear
of
when
of
first instance
in
from
inflammation
the
pain increases,
it from
judge
In
of the
till the
to
cautions
some
commujiicated
commencement
rapidly
which
part
is afterwards
others,
at
of
patient,the
cases,
first,and
in
allowed
be
may
of
some
use
already given.
been
If
THE
OF
of
the
it;,even
her
very
the
abdomen
of the
increased
it
woman
by
the
the
bed
much,
es-
by
pecia
yB
INFLAMMATION
ON
and
stopped,
of
the
the
disease
The
a
of it
constitution
and
dry, parched,
of the
and
the
In
strucion
hourly
and
lie
to
For
towards
up
frequency,
length, when
acute
most
a
is
body,
of the
for the
and
is
arterial
and
affected, by
frequency
and
skin
the
;
heart
eyes,
white
very
the
siderable
con-
a
quickness
part small,
most
the
all the
the
in
more
violent.
the
the
belly.
belly
The
becomes
She
back,
is
from
legs
the
pain
patient
for many
of it.
frequent,and
has
days,
From
loses its
to
in
increases
pulse
been
the
drawn
are
respiration is difficult,
the
pelled
com-
attempt
any
the
reason
de-
become
symptoms
pain
same
the
disease, towards
excruciating on
total cessation
more
with
whole
thirst
be
to
entirely upon
pain becoming
move.
of
The
more
the
redness
The
patient,
the
aggravated.
consists
hard.
progress
of
of
insatiable
is also
seldom
very
dergoes
un-
affe6led
becomes
in the
pulse, which
reason,
commonly
face, and
hot.
increase
same
becomes
themselves
shew
system
come
milk, be-
altogether.
tongue
with
attended
dry,
this
soon
the
The
on.
comes
with
the
general heat
A
flushing of
with
tumid
discharge,for
this disease,
before, the onset
empty.
suppression
The
become
alteration, and
an
in
and
lochial
THE
breasts, which
had
flaccid
OF
and
at
sufferingthe
there
this time
is
at
the
once
pulse
strength; paleness,
coldness,
clammy
coldness, and
fasces
come
patient
the
when
The
almost
and
mind
comes
be-
death.
into
mortal
a
tom
symp-
disease, suddenly
this
in
pain,
as
tremities,
ex-
delirium, and
slides
insensibly
the
urine
The
violent
any
considered
in
appear
face.
the
without
almost
be
It may
79
involuntarily.
away
unstable
the
sweats,
about
and
CHILD-BED.
IN
iPERITONJ^UM
vanishes.
When
it is
of nature,
the
in the
pain
can
scarcely he
is the
symptom
of
that
noted,
patient
frequent
than
in
The
some
and
the
is
skin
the
The
urine
is
voided
moister
respiration gradually
is
Towards
natural.
the
other
be
comes
never
less
apparently fuller,
even
disease.
moist, and
more
to
pulse.becomes
usually becoming
is found
whilst
latter
stage of the
violent
it is also
suppressed, though
once
free, and
more
tongue
;
been
the breasts,
into
but
the
cases
recover.
may
whiteness,
edges
the
in
favourable
very
discharge;
again, having
the
its
lochial
the
there
decrease
of the
milk
of the
art,
diminution
which
than
Another
return
of
particularlyby
evidence
stronger
a
and
posture,
inflammation.
the
on
her
either
recover,
gradual
a
abdomen,
having changed
and
by
to
the assistance
or
generally indicated
her
of
likely
is
woman
efforts
the
from
of
the
in
and
less
gradually loses
first
clean
cool.
laborious
symptoms
the
larger quantity
more
the
at
end
of
are
;
The
till it becomes
the
plaint,
com-
subsiding,
So
and
known
in the
but
never
it will
whole
which
that
and
the
for
common
for
The
a
engaged
this, in
in
functions
the
necessary
of
former
than
Essay,
of
some
part, and
one
to
life
that
;
not
whereas
great variety of parts,
a
which
indispensably
are
well-being,and
existence
even
the frame.
The
appearances,
who
women
those
diflPerent
the
neck
have
died
and
uterus
there
not
of the
sometimes
is
no
part
found.
the
bodies
disease,have been
peritonaeum covering
Upon
generally inflamed
more
of the
of the
viscera.
of the
examining
upon
of inflammation
the
is
the
Upon
the
in
necessary
afFefts
the
to
very
fatal disease
more
only
function
its extent,
not
reason.
attacks
any
is
recover.
of
treated
gree
great de-
any
belly, it
to
a
obvious
plethorichabits,
delivery.
the
of
found
was
former
much
rarelyin
very
;
produced
patient
be
very
been
not
it is found
But
country
has
tumefaction
of
former, has
instrumental
or
disease
the
When
disease.
robust, and
most
after violent
supervenes,
particularlyin hospitals,indeed
and
large towns,
of
the
frequently in
more
of
epidemic.
be
to
off the
like the
complaint,
This
or
carries
then
and
now
THE
sometimes
diarrhoea
considerable
a
OF
INFLAMMATOIN
ON
the
bladder
than
on
The
whole,
will
of other
which
be
that
of
found
parts,
vertheless
ne-
inflammation
peritonaealsurface
stomach, liver,spleen,omentum,
great and
small
IN
PERITONifiUM
the
intestines, uterus,
small
of
lining
of
muscles
the
8
CHILD-BED.
internal
the
1
peritoneal
abdomen,
will,
in
^
their
the
turns,
disease, and,
judge,
to
it
all
or
as
my
have
authors, v/ho
laid
affection
of
I
stress
great
A
part.
in
the
in
v"dth
matter,
in
the
marks
of the viscera
Respecting
tlie
out
been
recommended
it is
to
will
no
be
gangrene
abdomen,
bling
resem-
it differs
but
it is
difference
in the
that
geneous
homo-
not
tions
porof
the;
surfaces
will
died
be
of this
and
of
more
disease,
tnortificatiou
the
abdomen.
treatingthis disease,
from
that
which
preceding Essay.
the
remedies
gcneraily to
C.I
from
with
the
on
cavity of
of
manner
found
generally
of hereafter;
ot the
observed,
affection
fluid
a
expe-
particular
any
of which
nature
of
tum.
omen-
resembling pieces
patient who
any
of
be
disease,
exclusive
the
intermixed
but
notice
any
point
of
that
is found
as
found
can
to
;
respect,
matter,
particularlytaken
any
of this
that
the
pus
its texture,
peritonaeum,
I never,
and
of
cavity
think
extensive
very
confined
this
solid
solid
a
me
this, because
supposed
a
error,
not
the
in
of them
same
an
mixed
a
upon
large quantity
very
serum
of
is
least
at
is collected
both
I
treated
have
satisfied,from
am
general,
another.
particularparts, especially the
rience, that this
is
leads
remark
to
partake of
to
experience
than
more
particularly necessary
different
I
far
as
part
no
found
togetherbe
be
to
much
be
has
But
ployed
em-
less
^suecesiful.
82
INFLAMMATION
OxV
OF
"C.
THE,
successful, particularlyif they have
ployed
domen,
disease.
the
of tumefaction
degree
been
early in
very
has
especially if
the
cleaTlyascertained
vasated
the
there,
rarely
Where
taken
from
place
from
will,
patient
generally
it is
possible, the
and
topically are
repeated according to
attending
fution
of the
life ;
town,
woman
be
to
extra-
both
employed,
and
most
admit
of
cases
laid
down,
ahvays
has
and
a
an
the
consti-
then
vailing
prehabits
her usual
;
hospital, in
a
large
the
sideration
con-
of
which
It
very
very
pain less.
thick
and
;
must
th-e
crust
upon
any
thing
general
happens
pulse
The
this,
frequently
not
often
in
few
medicine,
bleeding, that
the
into
enter
conduct
the
exceptions.
free,
any
should
direct
after
be
the
as
of
stances
circum-
the
country.
other
be
Can
such
:
attend-*
of the
all
nature
in
be
points
and
the
if there
fhe
in the
these
more
it has
bleeding
of
use
disease
;
whether
or
Air
rules
ab"
very
judgment
the
the
epidemic,
iri
the
believe,
I
ing practitioner, regulated by
as
in
recover.
Where
Oi
great
fluid
a
em-*
a
fluctuation
be
to
been
not
becomes
blood
the
mediately
im-
drawn
surface
of
it.
I do
not
of
manner
same
with
Essay,
to
mean
to
add
treatingthis disease,
that
which
already
therefore
farther
the reader
in
the
it is the
because
described
on
the
former
is referred.
In
ON
the
In
preceding
.
the
and
uterus,
exist.
from
the
the
Mixed
same
the
other
be
in
the
both
or
But
it is
they
often
are
mixed
with
the
;
in
which
will
This
patient, and
by
is
is
the
the
a
the
be
that the
of
degree
aggravated
the
as
of
fections.
af-
different
two
danger
of the
violence
met
complication
dangerous
very
ritonaeum
pe-
found.
commonly
a
the
here, that
observe
found
be
per
pro-
the
sometimes
are
state
that
quantity
the
to
be
must
mated
esti-
described
symptoms
already, always remembering
will
of
and
uteriis
ths
of
treat
to
most
arisingfrom
symptoms
it
should
is that which
case
there
together, insomuch,
mixed
flammation.
in-
I considered
they
I
with
of
of the
right that
it, and
complication,
Sections
separately as
of
surface
circumstances
diseases.
of inflammation
states
of
substance
affected
such
former
two
where,
occur,
the
viscera, become
of
symptoms
some-.i
,
peritonasal
combination,
a
of
been
they
as
however,
both
Under
will
other,
each
cases,
tiie
have
peritonaeum,
causes,
and
uterus
of
the
inflammation
the
account
of
83
GASES.
distinct from
described
times
MIXED
the
of
danger
parts
flamed
in-
is greater.
this
Before
beg
leave
to
experience
careful
of
fever
in
part of the
caution
may
subjectis
those
have
of
been
my
to
G
labour,
2
I
must
readers, whose
short,
distinCTuishins these
consequent
closed
diseases
to
be
from
occurring
very
cases
in
de-
bilitated
84
IN
PERITONEUM
CHILD-BED.
bilitated constitutions, in
more
to
particularlywhen
particularcaution
of
the
will
there
epidemic complaints,
tendency.
low
largetowns,
lancet.
justifyit,
Under
all
should
Nothing
and
that
be
but
these
and
pitals,
in hos-
is any
which
position
dis-
have
sl
circumstances
observed
extreme
in
the
use
fnecessity
necessityvery
rarely
occurs.
SXCTIO^
ON
00
of
tory affection
of
it, the
the
be
system
the
of
state
WITH
INFLAMMATION
LOCAL
only
a
consequence
patientwill
the
nearly
be
same.
this
with
attended
acted
with
attended
head,
The
heat
does
nevertheless
of
Rambling
do
disease
in
presence
is to
of the
the
of
seems
heart
to
waste
is
a
of absolute
disease
be
that
if
indicate
local
nates
termi-
only
of
an
out
through-
although
exertion,
greater
there
will
with
be
a
when
strength than
accompanied
the
also
but
Now
a
patient
not
arteries
and
body.
remembered,
greater
only
local
the
a
occurrence.
complaint,
a
out
this
to
delirium
of
there
be
the
rare
a
becomes
symptoms*
and
strongly
whole
time
the
symptoms
action
increased
this is
but
mania,
these
the
destroy her,
not
minent.
pro-
head, which
the
instances
other
In
and
face
bursts
in which
kind,
violent
the
in
the
;
sweat,
succeeds,
mind
dies.
sometimes
the
profuse
felt
body
mitigate
not
the
of the
delirium
the
a
whole
become
to
v/ild
patient especiallyabout
the
All
the
frame
whole
ears
appear
eyes
over
Sometimes
greater.
on
the
and
red,
becomes
in the
noise
a
plethoric
is often
pain
part
most
apt
are
eyes
throbbing
a
the
the
of
is
outset
robust
a
marks
The
upon.
l^loodshot,
(ifin
its
at
is for
it
rigor,
considerable
habit) With
disease
throughout
accompanied
being
the
however,
When,
an
at
it
much
there
increased
actioii
of
ac^on
part of the
a
the whole
as
This
will
wJiich
ought
of the
be
to
this is unattended
reduce
the
i.epeatingit
will
disadvantage
no
because
when,
by such
.the
malady,
of the
this
the
as
whole
certain
should
point,
continue
but
;
is
will,
the
in
a
incapable
in
in
smaller,
the
this
of the
disease,
more
should
fiom
if it
the
fall
false idea
a
in
a
indeed
will
hausted,
being ex-
it
into
a
;
the
tient
pa-
of
state
termination
seem
(from
to
have
with
be
from
quantity
eight or
be, it will
small, than
be
must
than
symptoms)
relief, it should
; or
local
of the
thereby ensured^
seldom
unless
the
powers
supporting
then, although blood
Here
and
;
patient beyond
action
fatal
a
the
treatment
same
the
consequence,
will be
some
the
on
to
disordered^
not
if
but
;
of
of the
conduct,
cured
whos,e
body
disorder
of
well
when
and
such
have
we
part
a
intervals
is
increased
irritation, and
and
from
reduce
extreme
early
arise
frame
patient is
we
only
larg-elyfrom
short
necessityof pursuing
case,
treatment
immediately
at
plan,
a
the
great affection
any
disease, by bleeding-
and
system,
part.
in
right to attempt
be
tion
propor-
by inflammation,
with
it will
system,
the
When
pursued.
is attacked
body
.than such
difference
a
in
body, just
is greater
make
Sf
AFFECTION.
"C-ONSTITUTIONAJ.
be
the
4
away
should
ten
ounces
to
;
able
consider-
great caution
better
be
diminution
given
large vessels;
G
taken
peated
re-
take it away
and
that
by
leeches,
88
ON
leeches,
this
LOCAL
the
the
Opium
it is
because
which
a
do
with
increase
to
will
Where
there:
found
the
than
geous
advanta-
legs
and
feet,
blisters,because
irritate the constitution
not
caution,
disposition
any
be
to
better
are
weakened,
more
delirium.
to
disposition, it
believe
I
they
be
may
less
By
equally efficacious.
be
apply cataplasms
to
which
liable
very
there
is such,
will
cupping.
be
employed
be
must
and
will
patient
bleeding
too
WITH
scarification
by
or
means
whilst
INFLAMMATION
much
so
as
the
of cantharides.
use
Shaving
the
on
in
and
the
head, and
outside
of
applying
afford
it, will sometimes
of great urgency
cases
alkali
volatile
should
relief,
be
never
neg"
lected.
This
that
which
has
section
second
This
is
in the
two
with
in
occurs
because,
affected
of disease
or
even
which
there
with
states
need
in
the
not
be
but
towns,
the
of
appears
to
endemic, unless
be
generally
described
in
much
is
seldom,
more
more
apt
irritation,than
at
that
any
on
the
also
It sometimes
pi the
None
more
states
constitution
symptoms
frequently appears
is much
and
parts of this Essay.
inflammation.
diseased
therefore
Essay,
either of the
large
resembles
respects
place.
country,
than
former
of this
form
a
other
already recommended
been
this
repeated in
met
in
treatment
to
be
of general
three
preceding
time
epidemic,
the
whole
they
will
"
will be
and
with
met
more
frequently in constitutions,
favourable
circumstances,
under
89
AFFECTION.
CONSTITUTIONAL
complaints,rather
than
to
in those
of
matory
inflam-
opposite
tendency.
But
of
none
experience
ainder any
in
them,
as
judging,
far
as
I
is in any
am
warranted
by
degree infectious
circumstances.
fiscTioir
THE
or
AFFICTION
90
OF
AND
OF
the uterus
another
from
that
point
to
the
will
which
it away
by
of
such
a
art,
it, or
it
by
no
found
placenta
nature.
It
that
any
there
of
account
of
reason
mischief,
to
so
the
difficultyin
ducting
con-
shall be
sometimes
will
the
all
be
a
cessity
ne-
seldom) for bringing
but
a
has
timidity,
placenta adhering
of
entire
necessity exists, it
do
cally
lo-
taken
have
notwithstanding
occurs
on
I
importance
of
taken,
practitionersfrom
it could
the
happen,
(though
above,
both
effects
Essays
the
out
be
of
constitution.
pov/ers
can
affection
described
I have
different
that
labour
expelled by
however
which
part of these
former
a
care
the
upon
occasion
LEFT
different
and
produces
and
a
PLACENTA
THE
is
which
In
FROM
UTERUS.
THE
There
and
UTERUS,
ARISING
SYSTEM
THE
PORTIONS
IN
THE
OF
AFFECTION
THE
IKQM
V.
SECTION
ON
"C.
UTERUS,
have
an
unnatural
tention
re-
When
flooding.
happenened
that
idea
that
and
an
left parts
uterus,
'
if
of
the
they have
separating the
whole^
Thii"
I know
This
the
and
ought
PLACENTA
OF
PORTIONS
often
may
v/iil
that
observed
be
to
done
be
left
portions
REMAINING.
9I
with
come
impunity,
away
known
I have
but
;
it
fatal
some
o
arising from
cases
I
hand
whole
ought
:
the
if
as,
uterus
that
opinion,
be
brought
should
be
care
be
from
doincr
from
cumstance
cir-
with
if
the
possible,
culty
little diffi-
some
harm
no
the
placenta,
away
taken,
this
whensoever
the
detach
to
to
it
though
even
to
of
am
introduced
is
practice, and
this
arise
can
it.
o
If it
part of the
fourth
I
should
and
it
will occasion
it, unless
in
fortunately it
the
For
that
expel
first three
to
seems
woman
which
than
or
the
both
former,
cause
beit
upon
efiPorts
it
expel
to
enveloped
which
the
uterus
together.
four
days
after
delivery
iriconvenience
no
that
except
the
behind,
become
upon
suffer
remains,
larger discharge of
be, and
should
left
a
is left behind
part
a
of blood,
and
contract
may
if
but
or
contract
frequent unavailing
coagulum
a
the
ofF;
the
prefer
to
whole
be
might probably
uterus
throw
the
should
placenta
hesitate
nQt
the
whether
question
a
were
lochia
there
than
after-pains are
rnore
from
is rather
there
a
ought
to
troublesome
usual.
The
next
perceptiblealteration
of
bad
colour,
very
abominably
offensive
to
become
quantity, and
The
is, that the
patient
now
a
begins
to
charges
dis-
large
the
complain
in
smell.
of
pain
in
"^2
AFFECTION
the
in
will
and
tracted,
The
east,
of
in
countenance
the
and
become
lids
becomes
The
palms
with
heat.
minute,
a
assumes
;
pale,
the
often
quick,
the
also
as
hands
pale
a
loses
woman
of the
uterus
con*
hardness.
glassy, and
eyes
FROM
exceedingly frequent,
wiry
a
of the
region
beats
140
or
130
the
found
be
"C.
UTERUS,
THE
in
and
back,
pulse
to
OF
flesh
rapidly.
inner
canthus
the
and
sallow*
and
The
of
and
tongue
the
lips.
soles of the feet burn
-
.
To
these
and
'
these
then
patient goes
then
for
she is
If it be known
it may
the
retention
have
An
done,
then
constitution
of
already
it,
or
taken
injectionof
into
the
will
be
ties
extremi-
be
the
at
very,
delition.
irrita-
of
placenta remains
picked
state.
But
away,
if this
to
affected
being
and
after
endeavour
must
remove
vent
pre-
by
ill effects
the
whicl^
place.
the decoction
vagina, (and
found
of the
putrid
from
the
way
last she
at
symptoms
part
we
till
weeks
sometimes
a
this
clammy,
three
ceed^
suc-
yawn-
In
;
and
any
partially,in
be
cannot
constant
a
days,
these
by
that
behind,
least
cold,
off
cut
vomiting
stomach
fortnight or
a
by
few
a
her
on
become
length, in
and
hiccoughing.
on
keep nothing
can
at
followed
are
ing first, and
the
sickness
symptoms
uterus,
useful, if
it be
of
Peruvian
if it be
bark
possible)
only by washing^
away
ON
94
LOW
THE
FEVER
OF
SECTION
THE
ON
CONNECTED
we
when
ipg
;
the
child's
the
consider
the
we
head
these
the
in
preservingcare
of
beforehand
the
the
upon
the
admire
course
in protecting
Providence
should
we
inevitablybe produced-
must
expect
and
;
which
againstthose injuries,
womfen
tions
exer-
agitation
great
system
of
size
violent
attends
of
good
a
the
the
;
the
must
we
DEMIC.
EPI-
comparative
which
pain
process,
it
THE
of child-bear-
nature
pelvis;
expel
to
occasion
of
^acuteness
the
to
OF
SOMETIMES
IS
reflect upon
employed
whole
AFFECTION
WHICH
W,HEN
CHILD-BED,
OF
WITH
ABDOMEN,
which
VI/
FEVER
LOW
"C.
CHILD-BED,
thereby.
In
a
former
observe
to
nature
that
this laborious
in
it
as
very
by
what
to
a
extent,
be
women
The
a
may
bad
be
chiefs,
mis-
fall victims
to
at
who
of death
large
loses
as
to
many
practitioner. This,
considered
of
Author
infrequency
man
casion
oc-
all these
mankind
the
taken
the
counteract
rarely
fact, that
I have
means
induced
has
patients must
certain
this work
process.
child-bed
assume
of
contrived
has
so
part
true,
to
a
be-
cause
EPIDEMIC,
SOMETIMES
probably,
most
cause,
unsuccessful
be
length
of
time, without
has
been
foresee
the
avert,
or
human
that
appear
fatal diseases
most
skill
which
to
and
puerperal
tuations
si-
women
and
"when
could
prudence
human
nor
great
a
seasons
particularly alarming,
more
it would
of
mortality
for
of misconduct.
been
have
there
the
when
and
kind
some
uniformly
can
person
midwifery,
in
nevertheless,
Yet,
no
95
relieve,
human
not
of
one
is
nature
subject.
One
of the
epidemic
which
first accounts
in
lying-in women,
the
Memoires
de
for
the
1746, which,
and
year
analogous
very
observation,
to
in
which
II
"
ladie
ladie
par
;
un
pendant
a
regne
pendant
Jussieu
elle
a
le
disposition au
la
Sciences,
correct
very
fallen
under
my
ing,
transcribthe
referringto
:
de
femm.es
les
work
le
par
la matrice
de
loureuse,
elle
leur
devenoit
etoit enflee
cours.
oc
:
ma^
devoiement
ou
continuoit
qui accompagnent
eaux
naissance
ma-
cette
qui
devoiement
une
couche
en
observe
premier
les
1746,
;
seche,
les
sortoient
Tenfaht,
le travail de I'accouchement
temps
pas
is
libertyof
Thiver
commencoit
ordinairement
ont
of
des
in
it is contained.
couche
pendant
has
the
trouble
la
ce
take
it
as
what
to
epidemique parmi
de
M.
I shall
the
save
Royale
FAcademie
any
found
be
may
of
have
we
mais
dure
vuidanges
apres
"
do-
n'avoi-
ordinaire.
Ensuite
q6
on
low
the
Ensuite,
dans
etoit
"
tendu,
d'une
accompagnes
la
etoient
mammelles
les
dans
ment
roient
temps
ce
le
entre
"
qui
ont
enfin
dans
cet
des
vertre
Col
cadavres
idea of
and
io error,
as
the
the
elles
;
de
ces
attache
avoit
de
"
of
separation
will be hereafter
que
mes
fem-
pauvres
parmi
que
de
cel-
on
;
a
vingt de
Dieu,
maladie
cette
n'a
a
pas
I'hiver.
Medi-
Fontaine,
rapporte
qu'a I'ou-
ils avoient
la surface
to
it into curds
vu
des
externe
serosite
une
translation of milk
de
aussi vio-
ete
T Hotel-
a
femmes,
a
mou-
attaquee
Fevrier
reste
ont
filtre alors
I'Hotel-Dieu
de
Villars
qu'il y
intestines; "
This
de
Hopital, nous
lait caille*, "
*
le
dans
si meutriere
Messieurs
les
couche
en
echappoit-ilune
en
parmi
ie mois
malades
n'a
pas
a
au
septieme jour
le
chez
Tac^
apres
femmes
ces
elle n'a
accouchees
qwe
femmes
"
commune
ete
remarque
de
"
accouche
ont
que
du
quelquefois
qui s'y
maladie
Cette
ni aussi
iente,
cins
etoient
fletrissoient,
le lait
par
femmes,
les pauvres
ete
le
;
gonflent naturelle-
?e
ciqnuieme
Faccouchement,
pein
Sc
tete
se
plus grande quantite:
ces
la matrice
quatrieme jour
le
qu'ellesdurcissent
les
de
partiesqu'
accidens
ces
douleur
"
troisieme
couchement
en
les
toux.
Le
lieu
dans
tons
douleurs
prises de
fles ligamens larges de
occupant
de
femmes
ces
"C"
CHILJD-EED,
of
entraiiles, sur-tout
les
ventre
fever
laiteuse
the
cavityof
and
whey
the
domen,
ab-
is f6unded
experienced.
epanchee
EPIDEMIC.
SOMETIMES
6panchee
aussi
de
ques
unes
ils
dans
le bas
serosite
cette
"
paroissoientavoir
examinees,
sorti
des
Dans
plusieurs
avoir
the
In
Dr.
of
have
some
extracts,
the
In
of
the
women,
all, and
at
liberty
to
epi--
which
at
notice
after
1760 (which
the
in
first
of
making
when
time
they
June,
till the
"
informs
us*,
of it in the
In
the
Practical
end
British
year
of
that
From
Lying-in
the
Dr.
December,
twenty-four
fever
12th
of
Leake
died
women
Lying-in Hospital.
1761,
Obscrrations
of
puerperal
the
London.
eleven
is about
institution
England),
epidemical in
was
*
Joseph
Dr.
lying-in
the
take
chieflyas
year
Hospitals
"
periods
taken
shall
I
*'
"
the
are
1790,
year
by
among
been
roissoient
pa-
published by
for the
observations
on
ovaires
les
prevailed.
years
*^
des
suppuration."
Edinburgh,
have
which
**
il
"
I'ouverture
a
femmes
occurred
from
"
bien
enfl^mmees
ete
sang,
ces
en
Dublin,
they
"
pourrie.
matrice
la
Commentaries,
some
since
have
ete
of
contained
demies
de
Medical
Duncan
Clarke
quel-,
la matrice.
de
canaux
de
grumeaux
de
poumons,
"
laiteuse
intestines, "
les
L'estomac,
les
coupoit
en
trouve
meme
poitrine
le
lymphe
une
ils ont
;
dans
losqu'on
degorgoient
est
ventre
97
on
Mr,
Child-
H
White
bed
of
Fever,
Manches*-
last page.
ter
98
ON
*'
says*,
ter
depend
"
LOW
THE
*"
small
*'
the
"'
July
OF
veracityI
whose
gentleman,
informs
"C.
CHILD-BED,
that
me,
can
attended
he
a
in
private lying-inhospital^in London,
latter end
was
*'
A
on,
;
of
during
"
''
FEVER
May,
which
time
fatal there.
very
lost
month
They
June.
in
*'
women
beginning
of
puerperal fever
the
to
of
best
his
the
patients in
twenty
buried
sometimes
coffin, to
one
the
That,
recollection, they
of
and
June,
conceal
two
their bad
suc-
*'
cess.
the year
In
*'
"
in
"
Westminster
*'
1769
several
of
the
May
died;
*'
and
"
the
In
"
which
is
nearly
British
fourth
every
in the
of
woman,
eightyhundred
of
course
this
fourteen
in
one
or
fourteen
fever, and
Hospital,
ninety delivered
de-
women
sixty-three
the
had
thirty-fivedied,
"'
of
1770,
the
In
November
between
hospitalt,
and
raged violently
hospitals.
London
livered, nineteen
*'
this fever
1770,
year,
and
a
half.
"
In
''
*'
third
a
hospital,which
not-thought proper
of
"
1771,
^'
vered,
In
"
*
ten
the
Treatise
Chap.
VI.
"f Leake's
two
on
Page
the
and
in
one
1773,
the
Management
eighty
year
deli-
two
twenty-eight.
puerperal
of
has
fever
Lying-in Womep,
ap-
"c.
165.
Practical
to
:|:Postscript
or
White
J, during the
name
hundred
died,
year
to
Mr.
Mr.
Observations, Page
White's
241.
Treatise,Page
305.
"
.
peared
EPIDEMIC.
SOMETIMES
in
peared
of
the
about
woman,
all
did
well
the
the
as
year
six
make
a
fatal
ever
year
1774;
to
every
report,
which
fury,
this
near
societyby
not
that
ver
reco-
scarcely
there
was
to
shut
This
I
and
person
that,
new
method
a
This
public,
that
H
months,
women
were
method
2
of
Paris
ed
provther
fur-
They
raged
new
quently
fre-
always
disease
hundred
peral
puer-
more
it attacked.
four
spectable
re-
very
Dieu
that ithad
in
the
of
Hotel
the
of
Memoir
fever.
the
ety
Soci-
King
it's appearance
in
Doulcet's
did
the
a
containing
epidemic
two
ease
dis-
Medical
by
of
report
made
than
found
me
Royal
the
puerperal
has
I
removed.
be
societyinforms
fever
thod
me-
women.
Doulcet,
treatingthe
every
think
me
ordered,
was
with
This
determined
and
1782,
year
seized
but
formerly ;
till it could
to
since the
town.
this made
losing
Dr.
the
every
perhaps
or
disorder.
lying-in ward
was
Paris
France,
late
It
after
In
the
last
ward
of
of
after, was
the
began
It
almost
died, though
in
infection,
local
did,
*'
in
when
mary
Infir-
Professor
:
delivered,
was
them
exist
died.
any
up
she
t'o cure
not
women
so
a
of
late
the
February,
as
used
was
the
of
soon
Royal
following account
twenty-four hours
and
;
end
as
about
it
the
gives
which
of
Edinburgh,
Young
of the
lying-inward
the
gg
of
during
with
great
saved
treatment
to
;
*"
of
ON
300
of
*'
the
shall
"
give some
the
*'
in
*'
Royal
*'
plan
a
*'
disease
^'
which
''
reappeared
"
cold
*'
men,
by
which
seized
with
of
*'
Their
*'
quelquefois plus
twelve,
attacked.
perd
done
qiui
femmes
in
"
about
*'
the
"
December
*'
dredand
ten
after it
years
reception
of
of
end
1767,
the
year
first
opened
May,
first of
the
From
of
for
three
hun-
delivered, sixteen died.
sixtywomen
years
was
patients.
till the
Seven
in
Dublin
of
Hospital
Lying-
the
first visited
puerperal fever
*'
"
wo-
that,
and
;
des
la moitie
all
accoucher.
The
"
de
die
Mr.
hy
that
Dieu
is, L'Hotel
Me-
from
frequently
are
seven
conclusion
vont
V
epidemic,
;
less in the
taken
it also appears,
this
1781
year
or
are
that it
;
this Committee
to
"*
"
facts
These
communicated
Tenon;
till the
prevails more
still it
seasons.
moirs
greatest ravages
winter
every
epidemic
an
lying-in women,
the
the
a
this report, it
1774,
year
among
committed
that
and
*'
prevailed
the
into
enquire
to
In
Dieu.
the
in
stated, that
published
was
appointed by
Sciences,
Hotel
new
is
*'
of
we
country,
sequel*.
report
a
Committee
a
Academy
*'
^'
1786,
Paris, by
of
in the
account
year
this
in
which,
of
"C,
CHILD-BED,
OF
FEVER
success
In
"
LOW
THE
afterwards,
this
fever
reap-
[
*
1783,
1
am
informed
the
disease
Street, and that
by
my
friend
appeared in
in four months
the
ten
Dr.
Osbom,
that
in the year
Lying-in Hospitalin
women
Store
died of the disease.
"
peared.
ON
102
and
THE
who
LOW
FEVER
of
fewer
had
that those
Finding
experience
women,
disease,
I
had
others
knoxyn
whose
and
;
the
puerperal
of
perform
it, so
ing
delineat-
that
least it
at
means
effect, in order
of
the
duty
a
by describing what
without
barrassed
em-
of
treatment
tried, in the hope
be
of
profession, by
features
and
age
and
fatality,
I should
the
to
employed
might
in
that
thought
prominent
been
ences
conveni-
and
men,
the
at
perplexed
unacceptable
be
medical
staggered
and
might
the comforts
great in the diseases
were
were
the
"C.
CHILD-BED,
life.
of
not
OF
that
succeeding
better.
observations
My
hastily
the
spur
of
occasion
the
the
by finding, that
Joseph Clarke,
Dr.
by
(though
that
history of Epidemics,
Essay,
had
which
own.
my
that
in
the
London
The
some
such
This
nature
and
contents
so
*;he time
when
the
not
he
nearly in
of
the
quoting
never
in
Dublin,
of this
of
that
observations
that
was
fore)
be-
years
the
with
strong proof
a
and
Section
my
points
as
were
it in his
seen
two
most
epidemic,
tered
flat-
epidemic,
same
had
on
written
account
be considered
may
of the materials
additional
of
very
much
am
published
been
corresponds
short
his
from
it appears
'
I
but
;
time,
published
and
together,
thrown
that
at
were,
its
fatality,
same.
will
consist
of
Essay, together with
as
have
occiirred
since
published.
Towards
EPIDEMIC.
SOMETIMES
its appearance
made
London,
of
patients.
In
of
many
whole
it
course,
which
in
in
that
this
Essay
the
in
I think
that
to
exist
in
and
progress,
the
described
been
is
its
and
;
it is
the former
of
Sections
in
attack,
withstanding
not-
analogous
material
so
a
its
rence
diffe-
general
it" termination,
of
manner
essential
an
distinction
will
found
be
them.
between
therefore
Instead
in
of
nature
materiallyfrom
respects
some
its
through
and
has
yet still there
;
great number
a
parturient state
a
described
diseases
the
to
to
differ
to
seems
attackingwomen
as
fatal
symptoms,
disease
other
any
its
disease
a
parturient women
among
proved
which
in
1787,
of the year
the middle
Towards
IO3
of
endeavourinsr
the
rank
to
o
under
disease
of
result
have
received
labouring
readers
is necessary,
is
it
and
:
being
well
facts, than from
any
Derhaps by
attachment
It has
usual
on
not
the
H
4
as
trouble
I
my
subject than
tage
advan-
more
society generally,and
of
medicine,
some
the
from
relation
speculative opinions,
before
the
patients
seen
unprejudiced
to
by
to
hints
such
satisfied that
the cultivation
faithful,impartial, and
been
shall
to
accrue
myself
have
reasoning
more
likelyto
especiallyto
and
others, who
from
under
with
confine
observations
own
my
rather
shall
nosologists,I
described
particular class,
any
a
of
biassed
system.
description of
any
epiden^c
104
O^
THE
LOW
epidemic complaint
the
air, as
jneter,
it has
the
upon
There
succession
of
in
subjectthe body
our
those
of the
heat,
buscunquefrustra
exantlatis
Sydenhamopariter,ac
"
sophantium
modo
turba
priusad
v"ro
res
nugatur,
rite
eaque
in
;
of
the
eties
vari-
but
the
air, which
of
to
us
may
subtile
being
tected
de-
judge
ther
ei-
atmosphere*.
scire,concrequsestione
tandem
labpribus quiest
necesse
cum
timo
Op-
nos
Quse qualisquesit ilia aeris dispositio,
philosophum dedecet
cognitishabere,
id
."
pend
de-
as
of disease
the
omni
fateamur
complura alia,circa
*'
observed
lead
of
hac
certain
such
of
raetitur circumscriptio,
"
ditur, angustft admodum
virura
de
quicquidnobis
Profecto
it)a long
to
infinitelytoo
which
that
ing
dryness, be-
incapable
weight
or
doubt
differences
states
are,
means,
epidemics.
or
influence
investigation,and
hitherto
varieties
effects
these
probably
most
by
*
Such
an^
the
to
tions,
observa-
climate, has
the
readilyseen
peculiarproperties of
of
analogous
any
atmosphere,
be
may
for
to
alterations, or
obvious
of the
be, and
reason
heat, cold, moisture,
upon
thermo-
been
of
bodies.
human
(effectsupon
very
is very
seasons
has
nature
much
be
(which
or
this kind
or
of
previous state
affect the
light
cause,
cannot
climate,
state
little
the
to
from
j
however,
thrown
found
been
"C,
CHILD-BED,
relate
to
barometer
or
OF
FEVER
quas
vecors,
ac
arrogans
plane ignoramus."
nescire
ea
fateri quse
Neque
philosane
nesciat, adhibita
at incognitapro
:
perpendendasdiligentia
incertissima
quas sint,pro
certis venditare*
dedecet.
Sir
George
Baker's
Opuscula Medica.
Octavo, Lend.
1771.
For
EPIDEMIC.
SOMETIMES
these
For
I shall avoid
reasons
and
minute
very
observe
and
the
is
though
in
the
be
may
succession
of
attributed
epidemic
diseases
they
now
the
occurred
those
of
under
without
the
were
in both
this
mate
cli-
there
of
actions
their
of
at
all, they
which
and
of
diseases
the
were
attended
had
attacked
ulcerous
also
capital.
rity
peculia-
some
above,
v/hich
had
of the
appearance
Inflammatory
infrequent ;
if
or,
principallyof
the
larly
Eruptive diseases, particuare
The
admitted
be
mentioned
extremely
scarlatina, had
London,
from
to
consideration
been
strength,
patients.
the
understood,
all
to
seasons
sort
erysipelatous kind.
in
mode
.
had
long
which
the
Perhaps
latelyprevalent, before
been
of
in
the
at
some
upon
and
imperfectly,if
ters
win-
neither
;
perfluous
su-
.
fact in medicine.
a
was
hot, but
sufficiently established
is
yet
very
there
connection
seasons
body,
animal
two
is customary
The
certain
the
were
rains
very
than
season.
between
action
as
that
summers
rain
more
was
at
an
frequent
preceding
two
there
is
with
mild,
whole
they
contrary
be
weather
cold
a
tution
consti-
not
may
in
that
the
was
the
on
;
it
1786.7, although
frost, yet in neither
duration
of the
Nevertheless
barely to
1785-6
entering into
particularaccount
of the air.
of
10$
sore
been
in the
Most
of
with
throat,
very
fevers
of
numbers
great
country
the
sion
great depres-
with
general
at
a
had
or
both
distance
been
of
the
low,
the
ino-
that
to
of
ber
of
those
of
the
About
die
places,
both
of
the
small-pox
had
'
and
the
place
the
number
former
of insertion
of
state
the
the
about
confined
are
which
the
says,
that
*'
"
neral
and
very
were
usual,
*'
'*
difficult
to
venesection
the
were
more
and
of
in Ireland
year
in
;
and
he
was
in
same
air
from
the
geeast
diseases
patients than
our
rheumatism.
In
any
observations
winds
pains
severe
we
the
at
account
some
inflammatory
respiration.
complaints,
and
situation.
his
of
among
large
matter,
appearance
particularlyacute
and
course
of
sharp
that
with
there
same
but
its
prevalent
affected
these
made
cold, with
v/ere
"
*'
more
;
prevailing diseases
spring
and
great
far exceeded
given
temperature
north-east,
both
the
time,
the
disease
"the
and
tion
inocula-
the axilla
in
died
has
same
to
"
'*
air,
marshy
with
variolous
in
even
Clarke
and
low
place,
patientswho
Joseph
ons
situati-
some
recovered
of the
proportion,
Dr.
the
took
sloughs
of
in
patients under
formed
Abscesses
num"
constitutions.
especiallyin
generality
large
dren
especiallychil-
but
period also,
same
called
some
very
delicate
more
country,
difficulty.
by
a
sexes,
the
for
ulcers
off
swept
people
and
in
had
been
has
which
type
and
putrid,
malignant kind, approach-
and
nervous,
"^C.
CniLD-BED,
OF
FEVER
LOW
THE
ON
ISO
Some
the
in
thorax,
consequence
obliged
to
have
of
re-t
frequently during
*'
February
SOMETIMES
the
*'
twelve
This
*'
^'
than
"
"
had
*'
it
*'
tribute
As
Dr.
of
the
Joseph
to
apt
that
had
been
seasons
patients attacked
the
cold
have
that
a
had
And
seasons.
the
case
;
the
time
seem
laid
been
to
so
litate
debi-
to
lity,
irritabi-
most
of the
weakly
state.
that
spring,
in subverting
power
long
foundation
succession
to
have
sharp
winds
far counteracted
the
although
have
a
the
am
continue4
arisen in the
this appears
indeed
because
by
I
the
predispositionto disease, the
which
state
hardly expect
much
"
length of
here,
in
have
might
the
of
increase
can
we
case,
"
complaint,
us
con-
patients."
our
was
admitted
winds, could
a
of
the
were
it
informs
he
were
effects, which
from
as
wards
might
general eflFect
there,
a
thought
I
considerable
of the
As
"
mentioned
not
for any
the
especiallyas
If that
has
constitution, and
the
of
state,
our
circumstances
approach
think
since
the
in
weakly
a
whitewashed,
recovery
Clarke
the
in
elapsed
these
slow
of bed
out
fatiguing labours.
had
atmosphere
before
time
the
nurses,'
Joseph Clarke
Dr.
place
painted and
that
of the
get them
to
that
recovered
patients attacked
and
time
probable
to
language
admitted
tedious
been
the
our
were
considerable
had
our
difficult
of
1787,
year
during
with
patients
:
In another
Most
"
than
year,
reconcile
to
"
use
more
usual."
'*
or
to
or,
much
was
writes,
**
it difficult
directlyfollows
slowly;
it
of this
March
10
preceding months."
I find
which
"
and
February
*'
EPIDEMIC.
of
been
for
pre-
vious
108
LOW
THE
ON
complaints had
*'
the
the
itself,
as
of
state
admission," when
could
have
had
circumstance,
that
before
effect
no
thtm.
on
It is
curious
a
of the
the
epidemic of lying-inwomen
1746,
year
been
in
But
had
which
low
coming
overcome
the
afterwards
;
was
as
on
the
in
published
which,
the
written
nature
of the
in the
I shall
recital
only
instead
of
confuse
I
in
low
a
the
result
of the
which
of the
air,
under
shall
which
avoid
would
of the reader;
a
manner
whole,
characterize
occasionallyof
lent
preva-
disease
case,
clear
and
seasons
descriptionI
as
it is
kind.
been
the
patience
of
I'Acad.
had
describe
to
shall, in
symptoms
occurred
on
individual
the
taking notice
which
matism,
rheu-
account
this constitution
tire the
and
able, collect
of
was
much
this
every
of which
the
of
In
"
de
diseases, which
proceed
consideration.
the
thus
period
now
winds,
acute
the
from
Mem.
evident, that the complaint
Having
sore
to
predisposition
demic
proved by the puerperalepi-
not
diseases,
there had
ulcerous
an
and
pleurisies
on
tack
at-
Paris in
north-east
cold
February,
the
at
January
fever, with
low
brought
had
of
in the month
epidemic
an
throat.
am
them, yet
exert
to
of their
wards
of the
state
of
general weakly
"
the time
patientsat
pneumonic
that
the consequence
been
proved by
find
his
diseases
continued
predisposition
still the
we
low
dispositionfor
vious
"C.
CHILD-BED,
OF
FEVER
any
as
and
the
I
merate
enu-
ease,
dis-
varieties
particularpatients.
The
no
ON
has
It
which
is
LOW
THE
in the
fevers, and
in
sympathizes
with
have
of
the
Indeed
is
to
refusal
their
remember
suckle, and
part
of the
cured
so
in the
catalogueof symptoms,
a
of it
frequently,I
the
at
in
the
a
time,
ing
respectconsider
thought
it has
as
to
of
complaint,
not
but
'
many
even
inclined
am
if
~
noticed
;
minution
di-
a
even
it.
disease, and
not
servation
ob-
patientmight
first I did
might
the
carelessnesss
a
At
that it
probable
have
have
to
irritability
that
the
any
great
so
afflicted with
were
children.
any
place,
I
was
patient, and
complaint,
which
who
it
there
slightas
being sensible
afterwards
not
as
If
so
of the
take
it, or,
the women,
this
of.
and
general sensibility
symptom
a
inflammations, which
been
whole
other
constitution
of the
observe
A
the
attendants.
the
in
case
a
many
of her
slightrigorshould
might
of
those local
has
see
fit,which
shivering
a
where
cases
attention
accompany
not
to
me
commencement
rigor,it
the
escaped
with
alreadytreated
been
degree
to
began
the disease
"C,
CHILD"BED,
occurred
hardly
common
OF
FEVER
set
oc-
it down
believingit to
make
part of the disease.*
*
A
farther
seems
of which
circumstance
A
to
prove
favourite
that this may
animal,
in
whelping, became
ill.
violently
his
her, when
was
servants
to
see
I informed
was
by
be esteemed
his
Dr.
Dr.
a
Garthshore,
of disease.
system
house,
immediatelyafter
G.
desired
was
enquiringupon
for the
by
parts
away,
were
refusingto
suckle
becomingcold, and
them.
At
she died the
this time
next
of
puppies,he
told that the animal had lost her milk, and that she had
them
one
the
pushed
extreme
morning.
There
SOMETIMES
There
intended
their
to
be
cannot
nature
has
render
the office of
regard
a
only
been
much
so
would
;
make
in
it has
but
in
it
dislike
observed,
of these
extremely probable,
possible
im-
tions,
descripattention
my
under
of strong
women
some,
suckling had
engaged
occurred
to
character
to
patients
have
not
and
to
If the
observed
it
of
preservation
others.
to
situations
suckling inconvenient
the
to
suck
luxury,
by
before
been
of
employing
Particular
has
as
author
give
of
custom
introduced
been
life, however,
and
The
children.
own
the
should
women
certainly unnatural.
is
of
all
111
that
doubt
any
that
hirelingnurses
and
EPIDEMIC,
all
stances,
circum-
affections,
that
it is
a
so
as
tom
symp-
of the disease.
Whence
be
may
be
the
child,
considered
it would
to
in
and
brain
in the
not
detect
.pertiesof
little
proof
former,
to
or
they
whether
of
to
easy
I have
any
the fluid
most
cases
none
ever
never
it
beginning
from
the
become
rather
of the
complaint,
regard
been
observation
apparent
quantity
in
be
to
of affection
With
In
far
so
nourishment
not
in the
secreted
it may
be
may
determine.
diminished.
is
whether
the
ifc
depends,
slightdegree
a
not
but
for
ought
alteration
;
:
it
milk
the
it unfit
a
be
the
able
or
as
of the
ascertain
to
make
to
as
what
upon
propertiesof
the
changed
of
difficult
very
that
arises, or
it
of it is
some
the
protainly
cer-
cases
breasts,
tumid, especiallywhere
the
112
ON
the
accession
in
THE
and
the
is probable that
the desire
with
the
of
the
in
has
countenance
before
the
.
pale
and
ance
of
theface
rather
a
:
florid red
the
face
that
general cast
in
patients who
disease, and
the Father
which
:
of medicine
health
cheeks
a
long
strength
is
out
worn
so
clammy
well
eyes
the
and
and
hue,
which
appear^
well
so
by
of
there
is
known
some
or
lose
rest
described
dew,
of
muscles
of the
of
becomes
is the
all the
the
the
disease
visage
there
of
been
:
in
this
the
angles
been
has
for
pendently
pleasure,inde-
a
the
of features
have
and
;
appearance,
cadaverous
a
tes--
probable by
absolute
the
colour,
in the
disposition
of
outset
ghastly, and
acquire
as
particular
lips and
secretion
when
general relaxation
the
of the de-.
duty.
a
exhausted
be
to
nected
con-
propagation
farther
children
gland,
way
of the
women
very
a
some
the
affects
conceive
can
we
patient
their
the
at
the
of secretion
for
appears,
dis-
flaccid. It
existence
presence
that
being
in
"
cretion
se-
soon
soft and
is rendered
of its
the milk
be
passion
its turn
after the
of the milkin
power
suckling their
Generally
place,
the
the
as
This
consider
begun
become
upon
consideration,
this
has
other, and^the
produces
secretion.
early after delivery
sucklingmay
each
passion
is
the secretion
in like manner,
tides
breasts
depend
may
taken
has
"C,
CHILD-BED,
the disease
of milk
sire
OF
of the disorder
where
others,
and
FEVER
LOW
long
by
moisture
commonly
SOMETIMES
commonly
the
sweating:
to
dilated,
the
light:
lose
but
and
lustre
turned
wander
to
it
by
any
dry,
the
it
this
whole
instances
a
days,
it is
but
;
of the
In
happens
out
to
over
the whole
in
some
disease
is in
lasted
for
some
brown
:
soever
when-
teeth
will for
with
encrusted
and
soft
from
produces
which
disease
fur
a
much
is also
they
constant
will
The
appear
mouth
and
sils,
ton-
all become
irritation
dispositionto
partly occasioned
X
will
of the
swelled.
a
runs
palate, the uvula,
that
so
and
cause
the
surface
perfectlywhite
cough,
fo^'
white, and
has
where
internal
pharynx,
this
through
common
length, aphthae
greater
the hard
and
be
to
instances
some
tongue,
more
not
colour.
same
a
continues
quently
fre-
but
quite pale,
surface of the
the
of
Most
the
and
dergoes
un-
appearance
constantlybecomes
part be found
most
even
little while
a
cases.
When
rough.
very
this
and
dry afterwards
it almost
is
it often
of
state
malignant form,
more
the
in all
beginning it
progress
become
to
a
attentively
in-
are
the tongue
is the
nor
uniform
means
and
acquire
and
in
it, but
complaint
changes,
in the
and
time,
object, and
any
to
short
very
vacant,
seem
confined
of this
course
many
a
strong
a
other.
some
the
In
in
towards
long
not
are
to
exposure
quickness,
they
;
amounting
not
is usuallymuch
eyes
upon
themselves,
glassy appearance
then
of the
pupil
contracts
eyes
their
the face,
upon
appears
ll^
EPIDEMIC.
by
the
se-
cretiofi
114
ON
cfetioti
which
LOW
THE
of
FEVER
thick
a
choaks
similar
the
aphthous
has
whole
of
track
has
however,
and
I
I
intestinal
the
have
never
the
The
skin of the
The
face,
to
the
in
a
is
sort
observable
as
The
cither
her
to
be
i-ather
not
patient
been
former
the
on
sensation,
those
the
to
is
fevers, and
Essays,
in
is
the
sickness.
on
long time,
a
is found
even
has
with
been
tioned
men-
seldom
increased,
of
it has
her
dants
atten-
appeared
feelingsof others,
complained of,
Thirst,
also
covered
that
or
where
cases
like
face.
patient
the
greater
herself.
in many
of
own
in
even
:
the
of
heat
it
which
of clamminesss
not
like that of the
is sometimes
state, and
natural
is
frequently appears
than
relaxed
it
idea,
tonsils.
body,
but
tense,
or
feeling more
same
lias
hard
not
of the
rest
the
irritation
for
and
neral
ge-
thing
brings
the uvula
particularlyabout
this
any
continue
aphthae usually
very
Dissection,
that
The
about
through
to
seen
sometimes
pharynx
a
canal.
stool.
perpe^
instances,
to
go
think
to
a
be found
sanction
given
aphthae discharged by
about
will
aphthas
disposed
because
so,
the
not
am
pharynx,
some
given occasion
that
opinion,
to
In
appearances
This
anus.
the
trachea, keeping up
difficultyof breathing.
tual
the
about
mucus
the
up
"C,
CHILD-BED,
OF
which
or
the
expressed by
is
affections
very
it
common
described
in
generallylittle complained
in this diccase.
Tlie
SOMETIMES
The
at
a
the
were
found
be
than
for
before,
the
the
and
few
hours
but
in
disorder,
is
pulse
in
insomuch
often
the
first
the
complaint.
of
the
plethoric, the pulse
will
the
attack
apparently
short
a
is affected
arteries
before
strong
a
and
of
who
patients,
some
Jig
is observable
which
disease
heart
of
frequency
symptom
In
the
early period
very
that
of
action
EPIDEMIC.
will
it
time
strong
more
become
weak.
In
of
most
observation,
my
the
heart
in
the
and
the
the
of
number
of
the
disease.
the
some
ideath
on
purple spots
cases
in
as
upon
to
escape
of the
into
alteration
some
hy
retained
hardly
more
and
mulous,
tre-
be
bered
num-
;
have
before
appeared
either
petechial fevers, depending
great weakness
fluids
In
and
more
can
no
perceived.
or
In
pulsation
tions
pulsa-
from
frequent, irregular, intermitting, weak,
till
of
action
increased
been
become
it, it will
the
commonly
beginning
under
fallen
of
has
being
very
of
course
have
frequency
arteries
minute
a
in
130,
the
which
cases
surprising degree,
a
in
to
the
reason
or
vessels,which
the
cellular
in the
of which
partly on
are
and
one
the
membrane,
or
of the
state
they
the
allow
fluids
not
so
partly
selves,
them-
easily
on
the
other.
From
the
of the
circumstance
pulse
alone
without
I
any
2
of
the
quency
great fre-
apparent
reason,
I have
Il6
ON
THE
i have
the
find
lid,
refreshment
labour,
without
there
some
is
though
sufficient
his
upon
the
recruit
from
reason
for
the
and
and
insidious
till it has
disease,
to
attendant
watch,
to
the
efFected
even
a
be
to
that he
so
ments
encroach-
treacherous
when
that
least be
at
it has
once
constitution, seldom
the
upon
fatigue of
the
suspecting
medical
narrowly
ed
allow-
time
It will
appear.
disease,which
a
the number
reasonable
a
disposition
to
guard
of
hold
strong
should
inay detect
fastened
and
reason
that it is very
observing
after
latent
none
complaint.
no
pulse beating to
a
upwards,
or
attack, when
the
little or
made
refrain from
to
uncommon
detect
to
herself has
I cannot
for
able
ScC,
CHILD-BED,
OF
FEVER
often
been
woman
Here
of
LOW
fairlyits
loses
th"
of
destruction
patient.
The
cavity
of
of the
disease
beginning, in
other
This
the
upon
the
is
state
begun
belly
followed
made
over
of contraction.
increases
will
delivery.
by
become
The
upon
the
The
very
as
in
a
belly
the
of
hy
the
cles,
mus-
cavity, during
swelling having
it had
pain, however,
pain
consequence
the parts
as
tient.
pa-
of
sense
the
vanced
ad-
the
rapidly, insomuch
large
at
more
a
hardly perceptibleby
soon
pass
till
not
slightestmotion,
compression
which
it is affected
general swellingof
A
first
at
on,
cases
cipates
largely parti-
veiy
sometimes
:
period.
comes
abdo-men
is
once
that
been
not
their
the
before
proporti-
oned
Il8
ON
THE
patient.
The
complaint
very
offensive
third
the
to
has
fourth
insta:nces
The
from
the
colour, and
bad
a
smelL
in
most
of
day
appeared
cases
the
the
on
in
disease, but
some
/
of the urine
This,
discharges.
I cannot
with
mixed
commonly
as
freqaently passed
describe,
some
portion
well
as
of
the
discharges u'suallyare
quantity
generally acquire
a
The
rine
ute-
or
nished
dimi-
suppressed,
they
they
not,
are
putrid
and
offensive
very
also
larly
particu-
disease;
When
it is
uterine
faeces, is
the
.
as
of the
involuntarily,more
the -last stages
in
in
intestines
later.
state
in
8cC.
CHILD-BED,
generallyof
are
purging
or
OF
evacuations
this
The
FEVER
LOW
smell.
',
j
..
Vomiting
the
about
to
remain
is
such
smallest
the
quantity
the
general;y
of
rable
that
of
has
woman
and
food,
or
The
medicine,
a
will
sometimes
disagreeable
very
'
(
.
.
brain
share
or
vomited
matter
colour,
often
times
some-
kind,
scarcely any
porraceous
a
and
in
the
disease.
muscular
depressed, and
powers
in
the
The
more
energy
in
Hence
arc
have
to
seem
nerves
jnanifestlydiminished.'
the
purging,
the
stomach.
and
nearly black,
The
degree,
a
upon
smell.
with
time
same
the
attacks
unfrequently
not
found
to
an
a
ci)nsideof both
earl^stage
be very
advanced
is
much
the
"stages,
sensibility
,
SOMETIMES
with
sensibility,
that
make
that
they
will
that
they
are
of
allowed)
seems
whole
it
of
however
;
conversant
how
soon
that
asked
are
make
they
and
she
known
in
is
be
may
the
almost
of
instance
kind
low', and
are
through
this, I
saw
ease,
dis-
of the
day
that
afternoon, begged
rise
of
out
died
the
degree,
any
re-
any
expression
seventh
at
bed, (which
three
swelling
and
at
answer
permitted) alledging
I have
yet
complaint,
that
she
the
of
next
the
domen
ab-
the
patient
unless
when
firmly pressed.
was
delirium
Violent
complaint,
to
they
an
to
scarcelyuttered
into
if
or
the
allowed
enormous
has
common
in the
not
was
morning.
it
As
on
nearly well,
was
ease
dis-
scarcely any
little
their
(if the
it.
who
be
might
she
tributed
at-
this
observe
to
continue
o'clock
twQ
;
only
to
patient,
at
is
apathy
course
one
well
very
state
often
attack, if they
sensations,
complaint
this
surprised
be
may
under
labour
who
after the
their
it
ofF, having complained hardly
cut
Early
pecting
of
be
paired.
evidently im-
circumstance
practitioners,
be
it, would
II9
stimuli,
to
complaints,
few
with
all.
last
persons
so
insomuch
regard
this
To
EPIDEMIC.
a
low,
be
the last
but
very
the
patient
stupid, or
disturbed
monients
;
seldom
comatose
yet,
if
more
appears
commonly
state,
roused,
give tolerably clear
I 4
in
this
falls
wishing
she
and
will
not
to
rational
answers
ON
120
to
answers
FEVER
LOW
THE
questions which
any
ScC"
CHILD-BED,
OF
made
be
may
to
her*.
There
another
is
comes
the
in
early
on
which
symptom
sometimes
disease, and
continues
.
through
the
whole
of
course
it, which
(which patients call
noise
a
is
stant
con-
a
singing) in
the
ears.
there
Perhaps
is
whose
acquainted with,
are
fatal
more
this
than
of those
it have
sacrifices
than
The
is
have
had
the
considerable, the tumefaction
It has
to
see
*
any
Dr.
what
never
in
an
with
private
better
at
with
the
of
later period,
a
lence,;
vio-
same
been
less
the abdomen
less
has
recovery
been
better.
occurred
I had
before remarked,
unfavourable
nervous
sphere of
the
whom
in his account
read), says,
the functions of the
in my
in
recover
Joseph Clarke,
to
he had
not
disease,
of
chance
their
and
consequently
In
much
a
strength has
depression of
extensive,
severity.
attacked
been
not
the
seized
after labour.
sooner
have
vv^ho
observed,
greater in proportion
be
to
seems
accession
Those
are
hospitals.
danger
the
as
in
its
to
have
been
patients have
practice, however,
chance
I
as
have
who
we
consequences
far
as
;
three-fourths
fallen
disease, which
scarcely any
observation
swellingof
alreadyreferred
(but which
the
mably
to, confor-
it appears
l;hat
Such
dered
always consiinsensibility
we
light,as
marking great derangementin
"
systems'*
belly
EPIDEMIC.
SOMETIMES
great degree.
very
any
hardly possible,when
it is
all the
injurywhich
of
effusion
the
in
been
belly has
cavity,
will
as
of
of
and
weakness,
death.
is also
abdomen
the
of
is marked
the
by
it's
the
creasing
in-
increasing
of it, which
irregularity
before
on
comes
size
the
by
into
poured
pulse, by
the
great
described.
danger
frequency
the
suffer from
must
matter
hereafter
increase
The
of it
contents
Indeed
consider
we
extraneous
be
121
The
quently
fre-
increasing
another
rous
dange-
very
symptom.
always
are
fewest
in
the
in
frequent
and
the
at
the
that
the
of the
from
all
and
having
from
its
of
often
And
I
uterus,
than
disease,
the
in which
diminution
be
gree
de-
to
other
cases,
pain)
great
I
cannot
the
these
the
paired
im-
so
periton;"um
or
them
to
latter
very
more
with
nion,
opi-
patients
inclined
the
is
solutely
ab-
sensibly
very
nothing
of
;
very
some
in
mind,
general correspondence
the
the
disease
from
with
heard
am
the
pulse
(which
the
made
make
is
sensibility
I lean
but
questions
rationally.
patients
belly considerable.
attended
impression to
determine,
the
the
distention,
is
the
arises
that
or
already described,
no
those
of
time
same
inflammation
conveys
that
course
swelling of
delirium,
of
answer
the
this circumstance
Whether
in
remark,
greatest danger who
complaints
especiallyif
as
of
worthy
It is also
to
it
ter
charac-
more
parent
ap-
sensibility.
The
122
ON
The
LOW
THE
rapidity
I have
seen
from
the
first
day
state
of
and
then
cases
in
the
to
the
the
out
death
or
a
more,
dying
attended
those
in
of the
domen
abborious.
la-
generallybecome
and
with
a
careless
objects,and
and
the
in
London,
to
nie,
such
of
as
the
light upon
probable
or
therefore
the
not
in
on
difficult and
weakly
beats
at
led
disease
tional
before
extraordinary
The
new
the
on
irregularly;
indifferent
and
with*
ofte^
dies
then
ture
mois-
clammy
groan.
a
demic
of
tumefaction
pa,tientappears
all external
died
pain, except
is covered
body
pression
de-
mere
eight days,
respirationvery
pulse
the
lingered
act
extreme
extremities
the
alarming.
died.
the
known
made
whole
;
for
and
sunk
which
The
;
have
struggling or
has
sometimes
most
have
Many
however
some
never
much
is
attack, apparently by
have
with
this disease
course
stupid existence
1 have
cold
which
strength.
;
"Co
CHLD-BED,
hours
patient destroyedin thirty-six
a
of
third
v.ath
its whole
through
runs
OF
FEVER
all stages
of
which
the
of
1 have
or
epi-^
whether
the
section
dis-
throw
point
to
dead
the
opened
complaint,
a
and
out
me
any
any
The
cure.
occurred
in
last
it would
in
subject,
appearances
neglected.
inquire
method
was
it
when
time
died
in this;
rapid destruction
ra-"
tunities
opporof
tigating
inves-
body,
were
in
great number
as
appearances
are
EPIDEMIC,
SOMETIMES
often altered
are
at
patient has died,
short
The
first
means
of
It is of the
same
nature
former
Section,
its sensible
remarkable
in
which
body,
either
health
in
all the
large quantity,
and
of
the
with
the
will
it will
however
with
quantity
the
large
accurate
cast
of
this
If
fluid
of
such
Its
crust
tion
agitaparts
are
viscera
not
of
frequently
are
same,
making
The
interstice.
extravasated, and
ticles
par-
interstices
other
the
of this
little
any
they
of
a
found
The
or
be
viscera
part
matter.
the
or
abdomen,
masses
by
coat
there
intestines,
cavity of
filled
an
the
fluid
the
under
inflamed.
between
that
so
slightly,
with
mix
lying
always
the
but
it is in
be
resembling coagulating lymph.
cohere
human
all the
solid
a
other
Where
matter,
of
is peculiar
any
in
of
very
which
with
formed
by
something
fluid,
surfaces
in
ascertained
covered
crust
of it.
described
peritonaeum generally
a
sorbed,
ab-
I have
disease.
or
very
quarts
is
met
the
in
often
have
I
be
of this
ever
of
several
can
as
fluid
it from
distinguishes
I have
was
sometimes
There
smell
the
itself,and
to
which
qualities.
if there
of
that
sponge,
far
very
greater number
abdomen,
a
as
that
collection
quantity, insomuch
in
hy
fluid
in the
the
of
at
detected.-
be
a
after the
some
in order
which
itself is
general cavity
large
might
thing
presents
cases
a
examined
1 have
it
of time
distance
some
periods afterwards,
difference
any
323
of
the
solid
part
"^'^
124
'^^^^
'^^^^-
when
sometimes,
also,
seem
find
the
been
general.
means
of the
cavityof
confined
times
the
have
muscles,
hardly
in
a
of
the
had
have
death
;
and
uterus,
to
be
an
I never
ovaria
and
degree
or
in
but
than
the
inflamed
in
opportunity
foUnd
any
:
of
could
I
vering
peritonasalco-
partake
frequently,
more
other
of
the
degree
sometimes
not
liver,
inflamed
some
The
any.
uterus
greater
found
been
I
the
was
times
Some-
lining
extensive
and
been
not
the
of
partially
any
case,
any
part
some-*
intestines,
sometimes
found
inflammation,
the
or
there
say
of
of
of the
investingmembrane
been
in
inflammation
it has
no
been
some
particularpart.
scarcelyseen
have
I
the
in
but
;
any
stomach,
sometimes
but
abdomen
by
has
there
inflammation
of
redness
the
instances
most
or
often
we
inconsiderable, and
surface
peritonaeal
of
bear
to
inflammation,
of
both, where
of
invariablyto
the
and
the
days. They
judge,
to
short
of
been
surface, since
very
In
prodigious
is
three
or
able
am
slightdegree of
some
two
inflamed
has
surface
has
degree
largequantity
a
any
I
as
to
of
extent
disease
the
far
as
proportion
the
incrusted,
or
"C,
CHILD-BED,
OF
exceeding
standing, not
no
it,
floating in
part
FEVER
The
parts.
intestines, has
any
of
of
those
not
whom
examining
signsof
side
in-
after
gangrene,
mortification.
or
*
In
many
of these
examinations
I
v/as
assisted\"yMr.
WiU
"son.
Sometimes
126
ON
(i.)
"'
has
"
fetid.
(2.)
After
"
took
**
somewhat
"
most
(3.)
of
ing
thrown
per,
about
"
"
"
upon
*'
hours
from
a
which
not
at
all
deposition
a
and
opaque,
and
brown
a
a
had
meat
was
copious
was
al-
and
curdy
somewhat
the
the
It had
matter.
(3.)
above-m.entioned
smell
slightlyturbid^
was
"
thick
very
a
filteredFluid
fleshy
pa-
passed through
filter
the
upon
of
folds
three
fluid
whole
(2.)be-
sediment
had
"
a
very
salt taste.
(h)
coagulatedin nearly the
It
"
"
of heat, and
*'
than
(c)
the
of
serum
It
'^
in the
betrayed
juice of
sole and
"
former
"
evidently reddened.
(d)
"
Lime
less
firmly
blood.
no
the
indicated
degree
same
but
manner,
same
alkali
violets;
"
*'
few
filter of
a
'. of the
viscid
was
but
fluid
Properties of
"
days,
fluid
brown
yellowishand
(a)
that of
like
very
a
slowly, leaving
"
and
to
fluid.
The
"
yellowish cast,
several
curdy
clear
a
it
standing a
place
*'
"
kept
been
of
me
fleshysmell
strong
very
*'
**
fluid
cream-like
*'
delivered
first
When
"
"C,
CHILD-BED,
IN
FEVER
LOW
THE
water
to
on
the
the
occasioned
no
turn-
contrary,
of
presence
of
test
the
acid, being
clouds,
nor
turbidness.
(e)
*'
Acid
of
sugar
instantlyproduced
""
mud-
diness.
*^
diness, and
*'
ish matter,
"
of the
glass.
(j)
Fixed
"
adhered
that
a
deposition of
the
closelyto
occasioned
alkalies
Muriated
"
(g)
standing
on
I27
E-PIDEMIC.
SOMETIMES
barytes
whit-
bottom
change.
no
"
immedi-
occasioned
ately turbidness.
"
(h)
**
''*
'"
*'
alkali
volatile
clouds
white
mixture
fluid
white
**
there
was
[K)
f /j
"
the
"
with
the
reous
earth
ric,
fixed,
to
*'
volatile
"
tallic matter.
It
blood
;
combined
alkali
therefore
in
a
blood,
f
experiments
or
which
a
acid
carbonic
with
I have
phospho-
state,
much
but
the
not
either
both,
to
made,
calca-
;
united
acid
I do
of
free state, which
alkali, or
however
ap-
that
like
matter
marine
combined
therefore
(3.)
acid in
resembles
in which
"
;
volatile
or
fluid
probably
vitriolic acid
or
soda
alkali.
coagulable
phosphoric,
*'
"
filtered
of
is not
minutes
few
a
phosphorated
of
prussic
contain
serum
in
this
rendered
alteration.
no
above
to
pears
"
muriatic
sediment.
white
addition
the
Nor
*'
and
opaque,
copious
a
was
The
"
and
With
"
there
^'
this
over
with
instantly
silver
Nitrated
"
*'
"
glass wetted
slight
acid.
(i)
"
of
holding
on
seen
were
bit
a
and
just perceptible,
was
of
smell
the
lime
with
triturated
Being
"
no
serum
and
me-
oi?
find, in the
any
vitriolic
*'
acid,
128
ON
acid,
*'
^^
LOW
THE
calcareous
or
OF
FEVER
"C.
CHILD-BED,
earth,
acid
or
in
disen-
a
gaged' state.
iiitered fluid
Tiii^
'"
"
from
*'
brain, in
*'
brane
in
*'
these
cases
different
(3) is essentially
hydatids,
the
and
is
fluid
"
precipitable by
*'
mistaken
for
*'
tain any
coagulable matter,
*'
olic
acid, but
*'
with
marine
The
"
"
agrees
lime
fluid
in
of
the
thorax,
with
the
above
thojigh
matter,
"
dropsicalfluid
the
often
acid
*'
do
find that
"
vitriolic
*'
the contrary,
fluid
*
See
acid,
or
(3.)because
of Anasarcous
is
con-
vitri-
impregnated
are
dropsiesof
of
the
in
the
abdomen,
much
less pro-
containing marine
impregnated
it contains
acid
sometimes
differs
Medical
in
precipitableby
phoric
*'
been
not
liquids difl^er,inasmuch
"
Ufine
has
liquid (3.) in containing
salt
"
acid
perhaps
of
and
"
not
eolour-
does
nor
cases
portion, in being viscid,
but
and
fluids
*'
:
and
which
acid*,
all the
in all
as
phosphoric
water,
carbonic
mem-
salt.
coagulable
"
water,
watery
cavities
*'
inasmuch
contains
less
spring
cellular
transparent
*'
as
the
in
dropsy,
anasarcous
of the
in the ventricles
liquid found
watery
in
lime
with
phosand
water,
earth,
calcareous
disengaged
a
the
as
state
I
or
; on
alkali.
essentially
it contains
Transactions,Vol.
a
IIL
from
the
above
great proportion
my
Paper
on
Cage
a
Dropsy.
''
of
*'
of
*'
and
**
and
muscular
'^
not
nearly
"
examination."
fluid in all
water,
strong
so
the thick
but
fleshy smell,
a
vjhich
(3)
Matter
under
fluid
of the
that
as
blood,
of
serum
cases,
have
parts,
Proptrilciof
could
not
the Filter.
pass through
""
mixed
1
was
and
"
"
"
the
behind
a
it
dried
"
*'
fluid,
**
tained.
[a)
''
"
"
"
'"'
;
flakes
*'
'""
odour;
the
from
of
a
brittle
yellowish co;
had
taste
no
readily detached
was
paper
whole
the
originally con-
was
was
being-
on
it
which
was
dried.
(b)
'
it
matter
any
of
^i. part
in it's texture,
scarcely
and
in
close
This
matter.
about
which
in
dried
This
"
lour
weighed
(1.)
spiritof v/ine, leaving
the
curdy
whitish
the
passed readily through
now
with
along
paper
it
before,
separated completely
I
means
fluid, which
serous
''
this
by
its
which
than
coagulated
more
.
times
by
spirit of wine,
apparently
"
.
six
with
substance
this
rectified
of
bulk
"
29
coagulable matter.
no
Dropsical
"
lime
precipitableby
acid
phosphoric
1
EPIDEMIC,
SOMETIMES
"
Under
it first turned
rcumatic
the
blow-pipe
with
black, emitting a
a
gentle heat,
smell, like burning cheese,
K
empy-
strong
resem-
or
"
bling
'tgd
ON
LOW
THE
"
bling still more
"
with
and
emitted
*'
heat
suddenly
*^'
it left
"
by
*""'
in
only
and
;
flame,
a
withdrawirng the
on
flame,;
the
by continuing
which
substance,
carbonaceous
a
heal
applicationof
farther
a
fumes
white
'''
melted:.
and
with
it burned
heat
"C.
CHILD-BED,
burning oyster;
a
stronger
a
OF
FEVER
totally
ofF
went
vapour.
CONCLUSION.
"
be
to
a
in
serum
part of the former
*'
of
"
latter,
*'
tween
^^
the
'^'
phatics,
"
other
animal
*''
thent
without
one
3\xt
the
to
as
mucilages,
farther
not
have
fail
to
and
open
always
been
and
lymand
mucus,
dislinguisb
cannot
Sir,
Yoiirs, Sec,
have
soon
after
head
the
in
a
Fe arson."
George
nerves
cases
some
and
matter,
experiments.
^'
in
we
dear
I am,
brain
pus,
the
be=
qualities
in
blood
the
of
matter,
caseous
"
the
proportion
sixty-threeof
to
difference
coagulable lymph
'^^
As
the
like
fluid
a
seemingly coagulated
this
appears
appearance^
and
matter
properties,in
many
in
of,
mixture
mechanical
slightlycoagulated
"
*'
a
fluid
animal
cream-like
above
The
*'
seemed
the
also, but
natural
be
to
attack,
its
fected
af-
I did
contents
state,
I have
1 have
endeavoured
now
which
the
next
attempt
a
statement
than
I
fear
then
if
that
chance
some
With
of
not
epidemic
disease
patients
The
strong
and
of
and
the
of
lying-inwomen,
the
its
its violence.
attacked
been
with
larger proportion,
have
seen,
similar
the
complaint
so
than
that the
The
inferior
London,
and
too
much
the
have
where
is
have
orders
been
laborious
a
K
too
from
exempt
of
space.
2
that
among
of women,
orders
small
I
which
cases
largemanufacturing
in
the
much
by
prevalent
more
higher
oftei\.
have
apparently under
they were
former
crowded
in
the
sacrifice
a
It is observable
the
all
in
the
been
unfortunate
as
latter
much
and
have
too
well
as
respect.
plethoric
fallen
women
least
at
circumstances.
the lower
not
even
of
body
vaded
in-
it has
that
those
the
but
single women,
dependent
as
that
of
it
of the
in
Married
have
causes
variety
attack, and
subject
least
at
observe
state
I wish
do, because
to
predisponent
weak,
opposite
subjectsof
to
the
of every
posing
predis-
the
disease.
to
must
ble
proba-
as
the
might
we
cure,
constitution, I
upon
able
be
shall
here
and
;
preventing the
respect
complaint,
light upon
shall
I
could
we
causes
toms
symp-
and
of
power,
farther
throw
I could
this
readers
my
is in my
as
occasional
and
that
before
lay
the
dissection,
on
appearances
to
describe
to
characterize
commonly
and
I3I
EPIDEMIC.
SOMETIMES
yet
it.
people in
towns,
The
are
streets
and
ff.J^
and
ON
THE
lanes
in
which
and
narrow,
least
a
being
this it
this
city at least, are
renders
have
it
it has
all
the
that
gives
the
train
to
place
of
in
damp
that
of
low
a
by
called
low
the
these, added
other
weaken
the
occasion
the
;
the
a
'
i
.
to
apt
are
to
tend
as
that
sore
of
lieve
be-
disad-
air,
to
haust,
ex-
it irritable,
render
production
state
arc
we
facts sufficient
which
ulcerous
Such
we
soil, a confined
description, such
Typhus
we
among
of warm,
neither,
and
body,
to
which
are
particularlocal
to
marshy
*a
to
Whether
effects.
whole
tjo.si;ch4is"ases
t(?w(ien.c:y
i
rank
possession of
in
Upon
scarlatina, "c.
the
inclitied
these
or
circumstances,
the
very
succession
and
of
last
which
tendency,
their
both,
or
seasons,
give
private
in
committing
What
causes.
as
oi*
This
circumstances,
vantasges, such
many
disease
am
considerable
a
determine.
I
external
except
scarcely at present
t^o
low,
fevers.
putrid
without
then
epidemics
scarcely know
or
free from
public hospitals, in
predisposing
it consists
quarters of
ravages.
first
rise
con*-
cleanlinessi.
to
these
frequent
rarely appeared
considerable
In
in
than
practice
that
called
less
much
very
impure by filth, or
rendered
scarcely ever
been
much
a
usually
are
necessityvery
added,
be
must
"C,
LB-BED,
general inattention
very
what
CHI
live
they
To
or
OF
air is of
the
fined, besides
"at
FEVER
JLOW
of diseases
kind
of fever
throat
with
atmosphere,
has, if we
may
or
be
allowed
134
be
ON
relief those
though
even
FEVER
OF
complete indeed,
very
from
LOW
THE
imprudence
The
of his
it
specieswho
married
above,
deserted
their
by
in distress
;
but
also
by
who
have
of
them.
their
becomes
liable
withstand
It
to
been
been
and
as
a
such
the
in
minds
wholly
been
latter
abandoned
attacks of
should
have
the calamity
this
the
the
cause
of the
powers
become
disease, and
fortunes
mis-
their
of
upon
they both
that
only
not
part
From
and
fortunate
un-
complicated
employed
situations.
dows
wi-
are
Such
are
and
debauched,
have
as
they
unfrequently
not
so
such
or
have
as
remarked
in
lying-in hospitals, that
frequent among
who
but
mitted
ad-
are
less
more
able
to
it.
has
so
of females,
assigned as
single,they
enervated,
the
to
mind
either
are
Under
exhausted,
system
if
and
seduced,
are
own
extreme,
be
husbands,
women
young
pregnancy
their
greater frequency of it in hospitals.
been
their
distress,
disease, which,
perhaps
may
patients, if married,
protected
of
state
this
to
The
those
from
hospitals, is frequently
for the
reason
in
single,who
or
probably disposes them
observed
exclude
are
arisen
previouslydistressed
into
would
folly.
or
whether
body
who
have
may
":C.
CHILD-BED,
it is
are
to
be
delivered
remembered
the
at
the
the
that
objection
disease
poorer
their
of
way
classes
own
their
has
of
not
men,
wo-
habitations
situation
;
is
hardly
loMETIMES
laardlyever
distressed
so
without
who
when
and
of life before
of subsistence
prospect
miserable
looking
stained
will
bodies
that
sufficient
last should
in
be
cause
account
rare
a
the
child-bed
of her
the
never
she
time
that
slower
owing
previously
to
I
than
the
distressed
the
in
in
pitals
hos-
their
at
of
own
the
fact, why
if
was
120.
occasional
an
it.
escape
that
formerly
one
died
the
During
die
in
her
possessed
pre-
lying-in.
delivered
her
This
most
was
pulse
bably
pro-
produced by
irritability
of mind.
state
K
4
in
whole
constantly
was
should
cept
ex-
private practice,
had
mind
she
rity
dispastate
observe
may
born.
was
too
in
hardly
can
die
to
her
great
the
why,
mother
she
pregnancy,
that
this,
I knew
when
and
a
of
subjectsof disease,
first
of
whose
person
for
the
cases,
applied,
whom
woman,
From
to
confirmation
In
was
few
a
delivered
women
but
delivered
women
of
become
not
a
of
minds
and
from
houses
both
probably exist,
most
them
wretchedness.
of situation
difference
this
their
consequences
and
poverty,
;
without
and
is before
the
to
mon
com-
admitted
were
themselves
othing
bands,
hus-
the
without
they
for
forward
character,
From
the
N
in future,
children
women
hospitals,often
the
leave
they
are
friends, without
protection, and
necessaries
was
of those
that
as
without
home,
a
without
a,
l^g
generalobjectsof charity in hospitals:
the
a
EPIDEMIC.
The
her
stimuliis
136
ON
lus
of
labor
then
low
with
type,
and
Another
in
food,
of
cause
improper
rity
regula-
to
living towards
'
disease, is
in
little attention
of
into
days.
the
too
is
time
the
conclu-.
and
state
of
therefore
in
therefore
livinr^
be
as
so
they
at
habit,
part
when
been
strongly
they
Essays,
fall
not
into
insisted
upon
it would
that
pregnancy
in
be
a
manner
of
state
This
labour.
in
and
Women
their
to
to
be
labour,
their
of
a
but
cannot
of
and
introduce
least
order
least
at
as
suit
pur-
irregularhours,
the
life
a
rest,
studiously avoided.
latter
the
disease
these
unvaried
pay' particularattention
to
so
an
fatigtie,
natural
the
raged
discou-
be
exertions,
into
irritability
injurious to
to
violent
broken
pleasure,
should
certainlynot
but
;
intemperances,
of
nature
bellyalready
few
a
and
other
of
in
great indulgence
hurry
constant
ought
of the
too
exercise
this
at
of
the
fei^er,
pregnancy.
Moderate
of
affection
the
the mode
of
of
consequence
predisponent
of
of
degree
9.
destroyed her
probably
kinds
on
prevailingepidemic constitution,
described,
sion
in
8cC.
^HILD-^ED,
OF
brought
degenerated
of the
most
FEVER
LOW
her
vv^hich
a
THE
a
has.
former
part
superfluous to
be
repeat it here.
1
been
time
1
saw
was
desired
delivered
had
never
her, very
to
two
been
see
another
day^ before,
well
:
her
frequent, and
had
patient who
and
pulse
this
that
from
was,
when
frequency
'
of
the
SOMETIMES
the
pulse
followed
was
distressed
in
violent
exercise
and
a
in
It is
state
of
great
more
liable
addition
In
two
likely
that
to
causes,
the
the
account
the
:
occasional
fatigue fell
these
on
presence
into
in
labour.
she
accounts
that
of the
of these
came
be-
would
last
these
taken
be
always
into
circumstances,
arise if the
always
applied, which
were
disposing
pre-
epidemic disposition
otherwise, under
causes
much
disease.
likewise
disease
same
been
employed
been
the
must
season
had
had
the
to
symptoms
days preceding parturition,
for
most
other
woman
and
mind,
137
the
by
This
enumerated.
above
of
EPIDEMIC.
is
same
tha
not
case.
I
the
Now
which
had
of the
nature
prevailed
Paris
prevalent at
was
J
787-8
;
as
has
been
was
a
should
above
certainlyput
pear
often
It
immediate
be
to
very
is
the
very
exertions
temporary
in
of
act
well
of labour
fever,
to
known
every
or,
many
any
that
woman
in other
in
debility,
such
position,
predis-
a
especiallyfeverj
it wouldl
woman,
which
the
fullyjustifies.
would
cases
parturition ;
trace
of
character
this disease
cause
difficult
state,
that
on
preceding historyof
The
with
parturient
a
in London
diseases
;
disease
this
and
1746,
diseased
in
when
time
dispositionto
any
appear
almost
in
remarked
if
the
at
constitution,]
epidemic
at
ap
least
it
is
other.
during
suffers
words,
the
the
strong
kind
of
action
of
a
the
138
ON
THE
the heart and
arteries
influence
above
to
of
and
;
occasional
is
the
arising will
the
be
ed.
considerablyaccelerat-
very
happen
these
the
from
the
ihe
adverted
circumstances,
of
that
as
thence
type,
to
aptitude, which
irritable
or
any
such
occur,
greatest
having
violence
under
woman
susceptible of
has
action
a
infection, the disease
or
here will be that of the low,
pierhapsan
to
should
fever
most
system
SiC.
CniLD-BED,
predisposingcauses
of
cold,
to
OF
if, under
cause
exposure
which
FEVER
if this should
Now
the
LOW
kind.
Or
originated simply
once
is continued
labour,
from
acquired irritability
already described.
In
those
examples,
immediately follow
ahe
third
fourth
or
of
^nerality
"of the
the
observed
"breasts
disease
and
caused
was
by
imprudently,
very
of wine
and
before
been
flaccid
I have
cases
causes
and
:
the
the
distention
from
have
dered
consi-
but
I have
milk
no
or
secreted, the
empty.
to
reason
in
system
frequently little
if it had
become
soon
two
or
occasional
that
above,
secreted,
In
the
as
been
had
might
we
not
generallyabout
in the
disturbance
or
is
previous
much
does
attack
If there
day.
flowing into them,
these
is
the
delivery, it
patients
breasts,
milk
where
believe, that
the
patient having secretly,
taken
spirits,by
a
considerable
which
a
several
in
tity
quan-
fever
was
excited.
But
after all
occasional
cause
I have
could
seen
be
traced, except
which
the
no
act
Gt
EPIDEMIC.
SOMETIMES
I35
-
parturitionwas
of
the
attack
been
has
at
be
to
of
cause
the
other
some
It has
of
suggested
been
disease
labour
has
time
one
would
pect
ex-
were
the
occasional
must
attribute
of which
we
this
it
that
me,
perhaps
to
I
times
some-
before
the
termine
de-
absolutely
cannot
it is
experience, although
own
my
to
really commenced
but
;
from
distance
of fever.
cause
the
act
complaint),
When
of
if that
immediate,
such.
great
a
delivery,(the effects
from
improbable*.
not
Another
which
be
circumstance
is the
it is
such
had
who
with
any
as
Nevertheless,
for
once
generated,
when
is
it has
very
prove
*
cause
Dr.
apt
fatal
like
make
to
to
a
to
in
cause
be-
patients
that
me
of
the
there
is
disease
is
being progagated
fever;
and
thence,
lying-in hospital, it
a
considerable
progress,
of
Has, in his paper
it rather
in
ceive
re-
it.
when
malignant
great number
Clarke
renders
under
capable
begun
once
Joseph
which
it is
to
of communication
the way
appears
mere
evident,
very
believing that
reason
may
the
ready
originaldisease
an
it
good
by infection,
is
labouring
persons
by
on
constitution
a
in
been
not
omitted,
complaint
brought
in
arisen
it has
be
to
far this
impression,
an
not
infection.
sometimes
of labour
stimulus
ought
how
question
propagated by
That
a
esteemed
be
to
and
women.
above
quoted,mentioned
probable.
Another
to
140
LOW
THE
ox
qLiestion also
Another
the
as
To
explain
after
which
days,
from
arise, either
and
of the
if the
low
the
the
a
belly will
time
very
case,
v^ith
a
of
patient immediately
the
her
the
abdomen
with
the
Upon
the
same
same
pulse
the
became
cause
be
"
to
a
aflPections
At
on.
I have
seen
before
disease
The
delivered,
very
deli-
had
after
not
which
amazingly frequent,
and
the
day
affected
became
usual
was
the
scarlatina, combined
throat.
she
labour,
other
writing this
with
should
should
I
am
its former
other
any
certainlycome
disfippearedwhen
time
the
it, and
fever
a
ease
dis-
no
to
of
fever
and
If
returns
time
such
seized
been
soreness
it
in
that
from
almost
when
where
had
results
mean
tumefaction
am
surfaces
from
time.
irritation
of
1
larly.
particu-
more
state
milk, infection,or
tendency
type,
of
weeks^
the
that
peritonasal
another
B".t if in the
state.
coming
the
at
tomatic,
symp-
affection
the
own
little
a
different
a
or
I
sidered
con-
supposition.
incoiy/enience
no
some
in
found
are
occurs,
after
that
delivery
they
fast
be
the fever
dist:ase and
meaning
my
consider
I
are
the
favour
to
ther
is, whe-
should
symptom.atic.
abdomen
inchned
arises, which
abdomen
the
fever
"C.
CHILD-BED,
primary disease,and
the
or
of the
of the
affection
the
OF
FEVER
on
second
symptoms.
whole,
decree
length of
hr
as
as
experience
my
of fever
would
time
patient not
a
not
destrov
in the
goes,
in
the
puer-
peral
bN
142
LOW
THE
then, in
the fever
Does
,
the
of
peritonaeum
Does
of
if
case,
from
the
by
Or
lastly,are
the
eff"usion
each
other,
to
peculiar
is diff'erent from
*
I have
bodies
wounded
of
of the whole
two
who
hand.
limb
eff^usion
follow
or
the
excited
itself *
matter
effect, and
is
good
and
a
since
nature,
Dr.
other
the
Pearson's
animal
instances
had
The
of the
died
consequence
T
and
of
they
sui
neris
ge-
for believ-
peritonaeum
found
matter
experiments)
fluid.
in which
in
are
disease
reason
already observed,
known
their
be
to
any
been
.women
where
inflammation,
the
and
from
(asappears
has
"c.
no
in the vessels of the
of
a
fever,
seems
the action
It
the
whole, which
kig that
there
precede
cause
one
be
logy
ana-
fluid, entirely independent
of
of
but
an
latter,is the inflammation
as
to
appear
draw
to
the
out
described.
the
There
?
is
not
inflammation,
inflammation
only parts
ferent
dif-
on
throw
to
would
stimulatingquality of
any
ing
be-
part dispose
strangulatedhernia,
that above
? If the
effusion
coat
a
small
a
allowed
be
local
the
Does
of
This
?
of
cases
to
fluid, which
forms
peritonaeum
may
we
is much
similar
pose
dis-
?
coagulating fluid
there
eflPuse the
inflammation
an
whole
the
to
"C.
CHILD-BED,
puerperal woman,
a
coagulating nature,
a
surfaces
the
OF
FEVZR
that
some
au-
gentlemenopening the
this
disease, accidentally
of which
axillary
glands,and
was,
low
swelling
fever,with
frequentpulse.
thors
thors
who
have
confounded
written
have
all
where
name,
has
When
fell
that
I
till
my
and
into
the
had
mind
of
with
is
inflammatory
there
with
is
that
I trust
the
have
and
medicine
is
from
disease
than
so
very
perceived,
so
sudden,
and
am
cessity
ne-
the
to
that
finding
inflammation
the
is
system,
abdomen
this doctrine
that
sure
will
they
fancy,but
or
This
I
made
been
practice,because
bedside
the
see
both, connected
or
of the
fallacyof
and
already shewn,
which
to
ceedingly
ex-
epidemic disease,
the
ih
not
was
or
along
fever.
low
a
the
by experience
in
of
affection
an
in
it
upon
proper
state
detrimental
where
and
began
peritonseum,
or
of
particularly
more
which
uterus
an
I
discrimination,
of
treatment,
of the
that
this
acknowledge
to
corrected
attending
symptoms
free
am
of
method
engaged
error,
been
ral
gene-
of
same
first
same
same
affection
any
all the
I
Fever,
consequence
was
observation,
more
the
I
midwifery,
of
practice
been
in
false idea recommended
the
under
havff^ in
and
treatment.
Puerperal
on
cases
there
abdomen;
the
I43
EPIDEMIC.
SOMETIMES
be
not
are
have
to
founded
be
on
true
in
thesis,
hypofrom
drawn
been
been
distinctions
the
found
has
the
nature.
is
less obedient
almost
insidious,
that the
time
and
the
I know.
which
any
its fatal
to
Its
tack
at-
entirely un-
often
termination
of
powers
is
VF^hen medicine
frequently
could
be
useful.
^^
144
^"'^'^'
^^^
*F
FEVER
useful, has often elapsed before
that
known
If any
thing can
of
expectation
the
have
almost
to
to
it
put
of
be
beyond
reasonable
a
be
in
early
very
mischief
much
so
even
will
locallyor
generally,as
the
of
power
cine
medi-
any
service
-
first
the
In
either
with
must
delay,
we
done,
been
it
been
all.
at
effected
success,
If
disease.
be
it has
existed
disease
the
ScC,
CHILD-BED,
let
place then,
caution
me
not
younger) practitioners
the
tumefaction
the
lancet
the
of
with
the
abdomen
so
expectation
misled
be
to
by
employ
to
as
of
cially
(espe-
curing
a
posed
sup-
inflammation.
from
Bleeding
it has
tried
been
in
instances, for
some
pain
the
and
;
taken
operation ;
and
hasten
in
it do
yet has
contributed
The
taken
always
been
It
parently
aphas
time, diminished
short
supposed
to
the
I have
cases
the
on
appearance
generallylowers
some
in
the
blood
justify the
tremely,
patient ex-
known
it evidently
death.
the
Bleeding from
though
a
been
it
but
have
who
plethoric before.
bufFy
has
away,
been
disadvantage, although,
patients
and
strong
has
system
manifest
with
attended
the
the
produce
not
in
skin of
no
in any
the
the
objectionswhich
in
same
within
instance
degree to
belly hy
the
a
degree
my
cure
former
againstblisteringthe abdomen,
leeches,
of debility,
knowledge
of the
patient.
Section
1
beg
were
leave
to
repeat here
to
of the
and
might
nevsr
myself
is found
as
Sec.
mony,
that
it
and
before.
was
short
time
this relief is
to
sufficient
In
one
parts
tried, and
was
a
similar
conduct
of the
desired
effect, and
which
the
but
of
event
a
repetition of
A
t)y Monsieur
disadvantages.
necessary
the
exhaust
made
the
are
rally
genetage.
advan-
one
of blisters
ferent
dif-
to
patient recovered
the
in
others
those
destroyed
had
the
on
the
on
the
of
powers
pain,
failed
hopes
raised.
with
obvious
the
the
operation
has
tended
farther
already
woman,
the
of
contents
the
and
;
plan suggested
attended
during
abdomen
always aggravated
but
agitalionof vomiting by
The
pressure
cavity of
was
a
enough
not
this
solitarycase
Doulcet
pain,
ill effects
pursued
vomits
for
seem
is
and
succession
a
case,
blisters
wonderful
of
counterbalance
to
ficient
suf-
not
frequent than
they
their
as
them
from
a
sensation
temporary,
their use,
warrant
fiad
disease
more
then
the
relieve
only
pulse
and
I
was
in
irritability
Nov/
to
this
In
the
render
ters
blis-
pleurisy, peripneu-
experience
my
the
certainlyincrease
degree,
of
cases
that
though
advantages
conclusive.
be
to
in
but
;
useful,
be
decided
such
seen
I stated
peritonaeum,
possibly
inflamniation
In
strongly.
more
uterus
I45
EPIDEMIC.
SOMETIMES
to
ciently
suffi-
reduced.
The
in
exhibition
different
of
relaxants,
form.% though
L
such
as
employed
antimony
in
the
be-
ginning
1^6
THE
ON
of
ginning
of
of
All
the
medicines
curing
object to try
would
I
"
offer
where
been
judgment
this
goes,
irritability,
warrant
to
must
plan
a
that,
say
will
cisive
de-
very
far
as
the
on
have
not
may
as
my
whole
be
successful.
most
As
then
soon
frequency of
that it is
as
the
quantities as
with
opium
three
an)^ veiy
pulse
is
considerable
increased
discovered,
I
rightto begin immediately
bark
Peruvian
or
yet I
;
the
to
ally
likelyto mislead, especi-
extensive
sufficiently
opinion
an
tendency
a
experience
own
my
next
practicalsubject,to
any
is
thing which
any
in
effects.
better
loth, upon
very
inflammation,
have
as
diminish
with
employed
therefore
became
such
whether
been
experience,Jailed
my
It
attended
be
am
of
course
strengthand
the
support
brought
once
of
diminution
disease.
the
effect
dispositionto
when
have
which
the
to
the
in
have,
also
restrained.
great difficulty
view
a
has
usually the
increasil^the
or
apparent
their use,
purging, which,
with
are
with
and
the
have
They
ScC.
CHILD-BED,
where
cases,
success.
vomiting
OF
patient favoured
producing,
on,
FEVER
some
the
of
^itrength
failed
LOW
the
hours,
if, however,
.sickness,
we
stomach
in the
I
will
bear.
proportion of
have
there
must
freely, and
very
given
should
be
in
In
drachm
it with
be
contented
a
with
any
with
believe
ing
exhibitas
large
substance
in
two
advantage.
tendency
to
employing
the
SOMETIMES
the
decoction
and
opium
confection
is
it
where
is
if
hours,
it's
that
no
ter,
taken,
in
the
milk
and
a
to
the
of
wine
sufficient
A
the
pain,
much
not
diluted
food
such
it do
as
disease,
continuance
of
these
the
a
and
pain
with
strengthby
wine
some
the
diarrhoea
the
use
L
be
2
food,
fourth
or
on
Peruvian
if the
not
for
or
drink.
coming
circumstances,
belly should
also
;
sary
neces-
Broth,
for
third
of the
be
wine.
employed
be
may
be
may
the head
often
it will
wa^-
panada,
sago,
disorder
not
disease
with
water
pend
de-
dispensed with,
that
bread,
barley
cavity of
will
constitution,
appease
is
four
should
precise dose
theKe
in
ple,
exam-
every
offered.
be
given
with
support
Under
or
strength, and
can
of the
with
the
six,
every
cases
for
as
;
pain,
given
consequences
Very frequently about
of
be
it may
the
quantity
provided
course
to
and
jelly, tapioca, rice-gruel,":c.
root
arrow
in
Where
be
mixed
aromatic
some
dispensed with,
but
age,
be
may
sition
dispo-
a
the
given
;
on
moderate
or
use
should
opium
A
be
sleep.
procure
the
be
to
general rule
quantity
If
relieving
in
inconvenient
much
so
on,
frequently repeated
or
no
arise from
come
is great,
grain may
a
hours.
efficacious
^o
pain
large doses,
three
bark
of
added.
hardly
the
or
tincture
some
should
be
may
Opium
that
two
diarrhoea
to
with
along
every
l^J
EPIDEMIC.
very
day
prevents
bark.
pain
of the
considerable,
148
ble,
if it
will
more
than
from
of
dose
there
Here
be
be
must
afterwards
and
first,
Should
bark
acid
the
and
distention,
the
other
a
Columbo
be
given
tum
root,
in
once
cervi
cornu
aromatic
with
tincture,
there
should
opium
will
there
Where
may
be
or
four
be
used
mistura
be
may
be
be
thrown
a
for
up
tute
substi-
a
drachm
of powdered
The
may
decoc-
drink,
common
taken.
with
If
but
some
with
rhoea
diar-
glysters
tenesmus,
purging,
with
and
tion,
original inten-
cretacea,
necessary,
can
Peruvian
As
hours.
much
is much
we
grain of opium,
a
may
occasionally the
and
disagree.
^ith
three
men.
abdo-
of decoction,
that
the
to
the
the
to
of half
composed
nation
combi-
violent,
still pursuing the
it, and
bolus
will
that
been
return
than
form
even,
for
have
the
case
the
of
pain
we
much
alkali, adds
the
increases
If
and
has
this
during
the
advantage
in any
sometimes
with
diarrhoea
with
seldom
extricated
of vapour
pected
ex-
with
rhubarb
in
but
be
to
purging,
then
efficacyin allayingvomiting,
of
the
;
vomiting
opiate.
an
with
given
satisfied
effervescingsaline draught
The
quantity
of
advantages
any
vomiting
emetic
an
be
may
exertions
we
rhubarb," and
give
opium.
the
outweigh
it.
should
must
ipecacoan
should, then
"C.
CHILD-BED,
IN
of
gentle emetic
a
but
a
FEVER
LOW
THE
Ox\
wise.
other-
not
emollient
advantage
once
ters
glysor
twice
ON'
IKO
venting the
in
some
farther
cjuiredjin
which
respectingthe
found
be
I
very
offered
the
these
the
baifle
the
the
reach
is
time
of
labour;
kind
of
have
to
a
the
of fever
above,
ai
to
by
of
is
cure
I trust,
are
cases
almost
yond
be-
prevented,
art
any
is
to
all
as
in
it is
to
fever
should
They
to
the
as
be
evei-\'
possible;
to
seem
subjecting women
disease.
exposure
keep
to
free from
as
already observed, they
the
a
before, during tlie
uneasiness
forwards, because,
a
be
attended
be
delivery,and
if
not
accurate,
there
to
seem
influence
material
before
be
to
that
afterwards,
and
lias been
carefullyavoid
fever
and
anxiety
attacks
of
have, will,
patients both
all
of
be
to
thing
minds
as
method
lament
and
have
I
of medicine.
obvious
since,
instances.
hastilycondemn
not
who
it will
e-xperience,and
my
will
lying-in
done,
great many
a
description
art,
If this disease
very
be
certain
a
they equally
which
re-
Section
of
profession,who
my
the
this
in
can
oi
Those
acknowledge
the
result
because
Essays
whilst
which
complaint,
laid down.
not
contained
fatal in
of
those
with
met
having
absolutely
not
was
disorder
a
for
of this disease
all
be
that
hope
is
after
to
have
it
treatment
and
women,
fatal
so
others.
all
After
of
amply compensate
it, where
administered
":C.
CKILD-BED,
progress
it will
cases,
O?
FEVER
LOW
THE
the
should
infection
occasional
has
also
been
excited,
of
causes
ed
remarkit will
be
very
-SOxMETIMES
endemic
or
If the
disease
should
others,
and
should
in-the
Street,
after
circumstance,
done
surprise
It
dictates
likelyto
Since
made
the
its
it
shall
this
the
on
of
under
will
state
a
;
sj-stem shall be
fevers,
or
in
the
be
apt
puerperal
from
iu
been
agreeableto
if
is
so
as
giving
has
hardly
in
a
if the
ulcerous
will
any
and
and
few
the
be
effects of
ance
appear-
throat,
found
that
slov/ly,
recover
this
time
damp
sore
slightcauses
in
at
warm
proved by
state
0fdisc3.se described
has
only
or
it will
very
done
nothing
that
;
the
circumstances
been
presses
ex-
already happened,
of
winters
this
Clarke
it is
whatbas
succession
of mild
low
such
women
the
be
I mention
complaint
all
at
think, from
and
seasons,
this
Store-
ones.
fairlybe presumed,
may
there
old
tice
prac-
in
of infection
progress
1788,
scoured,
the
was
that
sense,
appearance
I
be
probably
because
be
ed,
again employ-
not
and
cleaning
j^ear
But
cases.
the
or
be
Joseph
it has
that
common
prevent
should
should
Dr.
Hospitals,
of
"c.
This
have,
may
surfaces,
new
wards
all
from
epidemics.
because
in other
the
the
both
England.
mic
epide-
removed
Lying-in Hospital
General
his
the
white-washed.
and
painte^
they
before
aired
destroyed, and
or
the
hospital, the
an
bed-clothes,
bed,
and
in
occur
immediately
be
the
all washed
of
nature
constitution.
patient
or
the
likely to partake of
very
I5I
ZPIDEMIC.
to
fall into
Section,
espe-
ciall
ON
152
THE
in
cially
the
their
FEVER
OF
distressed
admission
have
that
the
given
conclusion
minds
before
force
greater
violence
occasioned
of
the
to
make
rather
and
what
with
be
to
evacuations
when
sink
this
that
much
all
point
impressed,
the
prudent
which
very
propriety or
requires
nothing
his
ing
employ-
reduce
to
patient
the
impropriety
woman
to
the
in
the
of
will
sioned.
occa-
ber
remem-
strength
This
admitted.
be
late,
too
fail
never
nicety
more
life of
into
that
An
carrying
discover
cautiously
because
demands
will
which
very
of
depression thereby
man
remedies
be
must
medicine
the
under
A
will
is
possible
im-
is
guard.
seduced
be
these
patient
it
idea
the
done,
been
with
the
our
upon
he
but
:
has
sooner
a
much
might
inflammation,
of
gacity
sa-
determine
to
critical, that
so
too
greatest
accord
situation
practitioner, under
unwary
off
and
best
which,
sometimes
the
required
will
The
dangerous
so
Here
are
of treatment
circumstances.
fever, may
case.
judgment
mode
peritonaeum,
low
a
duce
pro-
may
mation
constitutions) inflam-
or
mixed
a
such
observed
be
labour
during
uterus
existing along
should
it
(though rarelyin
and
single
among
epidemic disposition.
Before
is
and
of whose
state
may
ScC.
CHILD-BED,
lying-in hospitals,
wome",
the
LOW
particularly
practice
of
discrimination,
hangs
upon
the
of the decision.
Section
*53
SECTION
On
chrq^^ic
VIL
childbed.
after
In
of these
the
first
upon
the
necessityof keeping
from
time
time
to
of the
pressure
faeces
of the
contents
gravid uterus
has
bulk
no
her
the
woman
of
heat
more
the
fever,
hue.
brown
fur
The
upon
tongue
it.
The
and
subsiding
a
pink
M
thinner
mild
the
purgative,
the
tion
exacerba-
is natural
skin
is
clean,
not
her,
to
up
above
acquires
but
is secreted
high coloured,
reddish
of
time
usual
The
or
parts
of
pulse keeps
urine
is
fectly
imper-
thing is left behind,
than
The
skin.
Their
hardened
occasional
thirst
quantity,
on
some
through
standard.
natural
dusky
by
some
more
of the
The
passage'
diminution
that any
with
the
of
the
small
a
passes
confinement
stances
circum-
very
quantity
a
If
suspicionremains
and
cause
of
also
these
impedes
this
from
occasioned
been
and
Both
allowing however
them.
by
pass
regular
great intestines.
and
evacuated,
to
the
therefore
fasces remain,
bowels
the
lai/1
was
frequently neglected.
through
are
stress
pregnancy,
delivery.
however
are
Essays great
during
after
clearingthem
abx"omeK
the
of
pain
has
in
a
a
minished
di-
siting
depo-
sediment.
"
The
CHRONIC
ON
154
bowels
The
stools
the
PAIN
sometimes
patient
will
the
touch,
fasces
the
often
-latter.
in
is
very
at
cold
distressed
this
the
of
with
ensues,
and
a
a
and
or
the
period of
patient
the
hardness
abdomen
to
the
The
still
takes
tient
paany
hot,
or
nothing
wastes
the
and
the
rence
occur-
Emaciation
of
the
burning
more
to
the
place, and
fauces.
continues
last, and
often
appetitegenerally
hectic flush
flesh
the
frequent draughts of
but
the
sore,
taking
aggravatedby
about
and
the
and
disease, and
often
is
cases
burning
The
spices.
constant
feet.
som^e
sides of
upon
pulse greatlyaccelerated,
hands
but
aphths
liver, and
it, especiallyif it be
sickness
dispositionto
ing
accord-
mouth
the
stomach,
the
Vomiting
water.
the
In
and
sorenes
much
salt
hard"
colour, and
down
of
into
pleasant to
red
region
with,
fails
streak
of
for
the
but
dice
Jaun-
pale,
colour.
high
a
sensation
the
seasoned
is
of
drink
or
saffron
to
continues
becomes
or
amination
ex-
tender
side.
affection of the
the
jaundice,
no
white
a
A
occurs
food
a
become
tongue
with
be
right
coloured
clay
acquires
will
the
by
on
and
tense
very
liver often
degree of
urine
there
The
become
now
to
the
time.
abdomen
unfrequently,and
not
on
long
found
be
thin
as
considered
not
are
The
"
especiallyon
comes
a
loaded.-
be
to
costive, yet
they
pass
ABDOMEM
THE
whole
the
on
are
OF
and
cheeks
of the
more,
maifitain
patient worn
its
out
glowly expires.
Upon
AFTER
examination
Upon
death
and
there
the
principal
each
organized,
The
other
each
internal
the
duodenum.
than
usual,
of
to
in
time
of
had
been
This
the
the
The
sufficient
On
patches
flammation
in-
preceding
surface
of the
testines
in-
healthy
be
but
as
of it.
the
with
any
for the
the
opened
nation
discrimi-
affection
other
of the
early stages
by
previous
hours
afterwards
with
tincture
This
should
a
jalap
"
repeated
dose
freely by
very
of infusion
Epsom
every
ease
dis-
following plan.
eight grains of calomel,
four
very
of
body,
from
of relief
six
acted
v/hite
guide
the
should
be
larger
diseased.
appeared
period
admits
of
into
have
giving first
has
and
of
long standing they might
In
or
marks
plaint
com-
complaint,
bowels
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ing
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at
history,will
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description, together
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prove
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the
of
made
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there.
at
inflammation,
extending through
peritonaealcoat
seemed
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by coagulated lymph
they
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patient after
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presenting
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part
inflammation,
the
of
circumstance
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found
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so
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body
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to
on
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intestines
the
united
CHILD-BED.
of
salt and
third
completely in emptying
hour,
the
and
in
senna
manna.
till it
bowels.
After
156
After
this
small
doses
they
of
calomel
and
Epsom
salt
rubbed
in
or
When
half
or
time
mean
whole
very
of
small
all the
will
restored
but
it must
that
where
-health and
the
even
great
minutes,
diet in the
be
the
given in-
time.
a
unless
of the
some
take
of
will
distance
of
patient
of
of
the
relief,
understanding
of
functions
whose
admit
every
some
the
Some
viscera
to
structure
life
place, and
those
is
viscera,
necessary
to
is materiallyderanged, the
itself,
fail
to
give relief,and
submit
of time
to
awaits
the
the
by E. Hemsted,
Great
New
fortunate
un-
fate, which
her.
o
Printed
which
constitute
should
they
obvious
be
of medicine
no
to
decoctions,
should
of the
patient must
at
tv/elve
carefully regulated-
very
perfecthealth.
to
regularityof
the
art
will
slightaffections
more
times
tion.
scarifica-
The
"
of treatment,
symptoms
be
be
materially suffered,a diminution
have
viscera
time
Farinaceous
quantitiesat
this mode
Under
be
food, and
her
the
singularlyuseful,
liiihtbroths
and
then
three
glasses with
lightestkind.
miik
asses
the
ocasionally applied
bed
to
days
mav
night for twtnly
every
ought
of the
and
is
before
hour
abdomen
of ammonia
cupping
tepid bath
an
three
repeated,and
be
by
open
is great tenderness
should
employed
After
The
there
or
The
be
be
before.
abdomen,
may
salt.
may
as
leeches
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kept gently
the liniment
"
the
Epsom
8cc,
ASl)OMEN,
THE
be
may
senna
with
day.
a
6f
PAIN
CHROMIC
ON
Street, Fetter l,ane"