In enumerating these various changes which are observed in the breasts, we
fully agree with Dr. Montgomery in saying, that the alteration in the
colour of the areola is by no means that upon which we can depend with
most certainty: in the first place, we frequently meet with so little
discolouration during the earlier months as to be altogether
inappreciable; we have also already shown that if the patient be a
brunette, and has already had children, the colour of the areola cannot be
trusted to, as it never entirely disappears after her first pregnancy. On
the other hand, we occasionally meet with a considerable change of colour
in the unimpregnated state, arising from uterine irritation, as in
dysmenorrhoea, &c. Where, however, this is accompanied by the other
changes above enumerated, there can be, we apprehend, no doubt as to the
existence of the pregnancy. Dr. Smellie, and also Dr. W. Hunter both
considered the areola as proof positive of pregnancy. The latter one
decided upon a case of pregnancy under very extraordinary circumstances;
the body of a young female was brought into the dissecting room, which at
the first glance he pronounced to be pregnant, but the accuracy of his
diagnosis was not a little doubted when it was ascertained that a perfect
hymen was present: to decide the point he had the abdomen opened when the
uterus was found to contain a small foetus.
_Movements of the foetus._ The sensation to the mother of the child moving
in the uterus, cannot be looked upon as a certain sign of pregnancy, for
even women who have had large families of children are frequently deceived
in this respect by the movement of flatus in the intestines, by occasional
spasmodic twitchings of the abdominal muscles, &c.; but when the motion of
the child can be distinctly felt by the hand of an experienced
practitioner, it will no longer admit of any doubt: this, however, is a
symptom which can seldom be made use of before the middle of the sixth or
seventh month.
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