THE EDITOR'S PREFACE.

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This System of Midwifery, complete in itself, was published in London, as a part of Dr. Tweedie’s “Library of Medicine.” The first series of the Library, that on “Practical Medicine,” recently completed, has been received with extraordinary favour on both sides of the Atlantic, and the character of the publication is fully sustained in the present contribution by Dr. Rigby, and will secure for it additional patronage.

The late Professor Dewees, into whose hands this volume was placed, a few weeks before his death, in returning it, expressed the most favourable opinion of its merits; and the judgment of such high authority renders it supererogatory to add a word farther of commendation.

It is only necessary for the editor to say that the production of the author is so complete as to have rendered his labour a light one. He has restricted himself mainly to such additions and references as he conceived would render the work more useful to American practitioners. The object of the publication being to present the most condensed view of each subject, he believed it to be inexpedient to depart from the plan by making extensive additions, and entering into the discussion of controversial points, most of which are of minor practical importance.


CONTENTS.

Introduction, Page13
PART I.
THE ANATOMY AND PHYSIOLOGY OF UTERO-GESTATION.
CHAPTER I.
THE PELVIS.
Ossa innominata.—Sacrum.—Coccyx.—Distinction between the male and female pelvis.—Diameters of the pelvis.—Pelvis before puberty.—Axes.—Inclination, 15
CHAPTER II.
FEMALE ORGANS OF GENERATION.
Internal and external.—Ovaria.—Ovum.—Corpus luteum.—Fallopian tubes.—Uterus.—Vagina.—Hymen.—Clitoris.—NymphÆ.—Labia, 22
CHAPTER III.
DEVELOPMENT OF THE OVUM.
Membrana decidua.—Chorion.—Amnion.—Placenta.—Umbilical cord.—Embryo.—Foetal circulation, 48
PART II.
NATURAL PREGNANCY AND ITS DEVIATIONS.
CHAPTER I.
SIGNS OF PREGNANCY.
Difficulty and importance of the subject.—Diagnosis in the early months.—Auscultation.—Changes in the vascular and nervous systems.—Morning sickness.—Changes in the appearance of the skin.—Cessation of the menses.—Areola.—Sensation of the child’s movements.—“Quickening.”—Auscultation.—Uterine souffle.—Sound of the foetal heart.—Funic souffle.—Sound produced by the movements of the foetus.—Ballottement.—State of the urine.—Violet appearance of the mucous membrane of the vagina.—Cases of doubtful pregnancy.—Diagnosis of twin pregnancy, 80
CHAPTER II.
TREATMENT OF PREGNANCY.
Sympathetic affections of the stomach during pregnancy.—Morning sickness.—Constipation.—Flatulence.—Colicky pains.—Headach.—Spasmodic cough.—Palpitation.—Toothach.—Diarrhoea.—Pruritus pupendi.—Salivation, 101
CHAPTER III.
SIGNS OF THE DEATH OF THE FŒTUS.
Difficulty of the subject.—Signs before labour.—Motion of the foetus.—Sound of the foetal heart.—Uterine souffle.—Signs during labour where the head presents—where the face, the nates, the arm, or the cord, present.—Fetid liquor amnii.—Discharge of meconium, 107
CHAPTER IV.
MOLE PREGNANCY.
Nature and origin.—Varieties.—Diagnostic symptoms.—Treatment, 112
CHAPTER V.
EXTRA-UTERINE PREGNANCY.
Tubarian, ovarian, and ventral pregnancy.—Pregnancy in the substance of the uterus, 117
CHAPTER VI.
RETROVERSION OF THE UTERUS.
History.—Causes.—Symptoms.—Diagnosis.—Treatment.—Spontaneous terminations, 126
CHAPTER VII.
DURATION OF PREGNANCY, 136
CHAPTER VIII.
PREMATURE EXPULSION OF THE FŒTUS.
Abortion.—Miscarriage.—Premature labour.—Causes.—Symptoms.—Prophylactic measures.—Effects of repeated abortion.—Treatment, 141
PART III.
EUTOCIA, OR NATURAL PARTURITION.
CHAPTER I.
STAGES OF LABOUR.
Preparatory stage.—Precursory symptoms.—First contractions.—Action of the pains.—Auscultation during the pains.—Effect of the pains upon the pulse.—Symptoms to be observed during and between the pains.—Character of a true pain.—Formation of the bag of liquor amnii.—Rigour at the end of the first stage.—Show.—Duration of the first stage.—Description of the second stage.—Straining pains.—Dilatation of the perineum.—Expulsion of the child.—Third stage.—Expulsion of the placenta.—Twins, 156
CHAPTER II.
TREATMENT OF NATURAL LABOUR.
State of the bowels.—Form and size of the uterus.—True and spurious pains.—Treatment of spurious pains.—Management of the first stage.—Examination.—Position of the patient during labour.—Prognosis as to the duration of labour.—Diet during labour.—Supporting the perineum.—Treatment of perineal laceration.—Cord round the child’s neck.—Birth of the child, and ligature of the cord.—Importance of ascertaining that the uterus is contracted after labour.—Management of the placenta.—Twins.—Treatment after labour.—Lactation.—Milk fever and abscess.—Excoriated nipples.—Diet during lactation.—Management of lochia.—After-pains, 169
CHAPTER III.
MECHANISM OF PARTURITION.
Cranial presentations—first and second position.—Face presentations—first and second positions.—Nates presentations, 199
PART IV.
MIDWIFERY OPERATIONS.
CHAPTER I.
THE FORCEPS.
Description of the straight and curved forceps.—Mode of action.—Indications.—Rules for applying the forceps.—History of the forceps, 216
CHAPTER II.
TURNING.
Turning.—Indications.—Circumstances most favourable for this operation.—Rules for finding the feet.—Extraction with the feet foremost.—Turning with the nates foremost.—Turning with the head foremost.—History of turning, 230
CHAPTER III.
CÆSAREAN OPERATION.
Indications,—Different modes of performing the operation.—History of the CÆsarean operation, 243
CHAPTER IV.
ARTIFICIAL PREMATURE LABOUR.
History of the operation.—Period of pregnancy most favourable for performing it.—Description of the operation, 250
CHAPTER V.
PERFORATION.
Variety of perforators.—Indications.—Mode of operating.—Extraction.—Crotchet.—Embryulcia, 256
PART V.
DYSTOCIA, OR ABNORMAL PARTURITION.
CHAPTER I.
FIRST SPECIES OF DYSTOCIA.
Malposition of the child.—Arm or shoulder the only faulty position of a full-grown living foetus.—Causes of malposition.—Diagnosis before and during labour.—Results where no assistance is rendered.—Spontaneous expulsion.—Malposition complicated with deformed pelvis or spasmodically contracted uterus.—Embryulcia.—The prolapsed arm not to be put back or amputated.—Presentation of the arm and head.—Presentation of the hand and feet.—Presentation of the head and feet.—Rupture of the uterus.—Usual seat of laceration.—Causes.—Premonitory symptoms.—Symptoms.—Treatment.—Gastrotomy.—Rupture in the early months of pregnancy, 264
CHAPTER II.
SECOND SPECIES OF DYSTOCIA.
Size and form of the child.—Hydrocephalus.—Cerebral tumours.—Accumulation of fluid and tumours in the chest or abdomen.—Monsters.—Anchylosis of the joints of the foetus, 281
CHAPTER III.
THIRD SPECIES OF DYSTOCIA.
Difficult labour from faulty condition of the parts which belong to the child.—The membranes.—Premature rupture of the membranes.—Liquor amnii.—Umbilical cord.—Knots upon the cord.—Placenta, 286
CHAPTER IV.
FOURTH SPECIES OF DYSTOCIA.
Abnormal state of the pelvis.—Equally contracted pelvis.—Unequally contracted pelvis.—Rickets.—Malacosteon, or mollities ossium.—Symptoms of deformed pelvis.—Funnel-shaped pelvis.—Obliquely distorted pelvis.—Exostosis.—Diagnosis of contracted pelvis.—Effects of difficult labour from deformed pelvis.—Fracture of the parietal bone.—Treatment.—Prognosis, 292
CHAPTER V.
FIFTH SPECIES OF DYSTOCIA.
Obstructed Labour from a Faulty Condition of the Soft Passages.
Pendulous abdomen.—Rigidity of the os uteri.—Belladonna.—Edges of the os uteri adherent.—Cicatrices and callosities.—Agglutination of the os uteri.—Contracted vagina.—Rigidity from age.—Cicatrices in the vagina.—Hymen.—Fibrous bands.—Perineum.—Varicose and oedematous swellings of the labia and nymphÆ.—Tumours.—Distended or prolapsed bladder.—Stone in the bladder, 308
CHAPTER VI.
SIXTH SPECIES OF DYSTOCIA.
Faulty Labour from a Faulty Condition of the expelling Powers.
I. Where the uterine activity is at fault—functionally or mechanically—from debility—derangement of the digestive organs—mental affections—the age and temperament of the patient—plethora—rheumatism of the uterus—inflammation of the uterus—stricture of the uterus.—Treatment. II. Where the action of the abdominal and other muscles is at fault.—Faulty state of the expelling powers after the birth of the child.—HÆmorrhage.—Treatment, 324
CHAPTER VII.
INVERSION OF THE UTERUS.
Partial and complete.—Causes.—Diagnosis and symptoms.—Treatment.—Chronic inversion.—Extirpation of the uterus, 345
CHAPTER VIII.
ENCYSTED PLACENTA.
Situation in the uterus.—Adherent placenta.—Prognosis and treatment.—Placenta left in the uterus.—Absorption of retained placenta, 354
CHAPTER IX.
PRECIPITATE LABOUR.
Violent uterine action.—Causes.—Deficient resistance.—Effects of precipitate labour.—Rupture of the cord.—Treatment.—Connexion of precipitate labour with mania, 361
CHAPTER X.
PROLAPSUS OF THE UMBILICAL CORD.
Diagnosis.—Causes.—Treatment.—Reposition of the cord, 368
CHAPTER XI.
PUERPERAL CONVULSIONS.
Epileptic convulsions with cerebral congestion.—Causes.—Symptoms.—Tetanic species.—Diagnosis of labour during convulsions.—Prophylactic treatment.—Treatment—Bleeding.—Purgatives.—Apoplectic species.—AnÆmic convulsions.—Symptoms.—Treatment.—Hysterical convulsions.—Symptoms, 376
CHAPTER XII.
PLACENTAL PRESENTATION, OR PLACENTA PRÆVIA.
History.—Dr. Rigby’s division of hÆmorrhages before labour into accidental and unavoidable.—Causes.—Symptoms.—Treatment.—Plug.—Turning.—Partial presentation of the placenta.—Treatment, 393
CHAPTER XIII.
PUERPERAL FEVERS.
Nature and varieties of puerperal fever.—Vitiation of the blood.—Different species of puerperal fever.—Puerperal peritonitis.—Symptoms.—Appearances after death.—Treatment.—Uterine phlebitis.—Symptoms.—Appearances after death.—Treatment.—Indications.—False peritonitis.—Treatment.—Gastro-bilious puerperal fevers.—Symptoms.—Appearances after death.—Treatment.—Contagious or adynamic puerperal fevers.—Symptoms.—Appearances after death.—Treatment, 415
CHAPTER XIV.
PHLEGMATIA DOLENS.
Nature of the disease.—Definition of phlegmatia dolens.—Symptoms.—Duration of the disease.—Connexion with crural phlebitis.—Causes.—Connexion between the phlegmatia dolens of lying-in women and puerperal fever.—Anatomical characters.—Treatment.—Phlegmatia dolens in the unimpregnated state, 463
CHAPTER XV.
PUERPERAL MANIA.
Inflammatory or phrenitic form.—Treatment.—Gastro-enteric form.—Treatment.—Adynamic form.—Causes and symptoms.—Treatment, 473
Index, 483


A SYSTEM OF MIDWIFERY.

                                                                                                                                                                                                                                                                                                           

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