The _treatment_ of extra-uterine pregnancy must be chiefly guided by the
prevailing symptoms: where any portion of the abdomen is very tender to
the touch, leeches and warm fomentations will be required; the pain during
the attacks can only be alleviated by frequently repeated opiates; and
constipation must be carefully guarded against by laxatives and enemata
between the paroxysms. Where an effort is made by nature to discharge the
foetus by means of an abcess, the case will require all our care to
sustain the powers of the system through a long protracted struggle.
Portions of the foetus come away from time to time, and if the exit
afforded them be by way of the intestine, the suffering produced is very
great, particularly when any of the larger bones are passing. The presence
of such a mass of semi-decomposed animal matter in the abdomen is of
itself sufficient to injure the general health materially: hence it is
that patients, during the process of expulsion, suffer greatly from severe
attacks of fever, which recur from time to time. Where the abscess opens
through the abdominal parietes, the whole is completed with much greater
ease and safety to the patient: in some instances the tumour has been
opened, and a foetus with a large quantity of putrid pus has been removed.
(_Medical Obs. and Inquiries_, vol. ii. p. 369.)
A case of ventral pregnancy has recently come under our care, a short
account of which will enable the reader to understand the subject better
than a mere enumeration of symptoms; the more so as we believe it to have
been the first case of extra-uterine pregnancy in which the stethoscope
has been used.
The patient, æt. 32, and the mother of four children, was admitted, May
26, 1837, into St. Bartholomew's Hospital, under Dr. Latham, who kindly
consigned her to our charge. She considers herself to be six months
advanced in pregnancy; is continually suffering from attacks of acute pain
in the lower part of the abdomen, both at the sides and front, causing her
to moan from its great severity; this is accompanied with a constant
dragging pain on the right side, and in the loins: the attacks of
abdominal pain go off at intervals, leaving her comparatively easy. She is
pale, with an anxious expression of face. Pulse 120, and firm. Tongue
moist. Bowels very constipated.
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