Equally important is it (and perhaps in some respects even more so) to
determine the absence of pregnancy in cases where it has been supposed to
exist. In many instances the character and happiness of the individual
must depend upon the judgment which the practitioner pronounces; and,
painful as will be the task of communicating an opinion which implies
guilt and loss of honour, how infinitely revolting and inexcusable must
that step be considered, which turns out to have been founded upon an
incorrect diagnosis. Hence the importance of separating those symptoms of
pregnancy which may be considered certain, and therefore trustworthy, from
the crowd of others, which, although collectively they may warrant a
suspicion, yet never can justify a decision that pregnancy exists, more
especially in cases where so much is at stake. No two symptoms have led
more frequently to this cruel error, and therefore to the most unjust
suspicions, than the cessation of the menses with swelling of the abdomen,
and yet from how many different causes may they arise besides that of
pregnancy? Putting even the impulse of common feeling aside, we would ask
how a practitioner can dare recklessly to incur the responsibility of
injuring a woman's character by hazarding an opinion which involves so
much, and is based upon symptoms which, by themselves, prove so little?
Whether he exercise his profession in town or country, cases of doubtful
pregnancy will constantly come under his notice. We cannot, therefore, too
strongly urge the importance of ascertaining how many of the certain
symptoms are present, before we allow ourselves to be influenced by those
which are uncertain. In speaking of the enlargement of the abdomen as a
sign of pregnancy which is extremely equivocal, Dr. Dewees well observes,
"But little reliance can be placed upon this circumstance alone, or even
when combined with several others; for I have had the pleasure in several
instances of doing away an injurious and cruel suspicion, to which this
enlargement had given rise. Within a short time, I relieved an anxious and
tender mother from an almost heart-breaking apprehension for the condition
of an only and beautiful daughter on whom suspicion had fallen, though not
quite fifteen years of age: this case, it must be confessed, combined
several circumstances which rendered it one of great doubt, and, without
having had recourse to the most careful and minute examination, might
readily have embarrassed a young practitioner. This lady's case was
submitted to a medical gentleman, who, from its history and the feel of
the abdomen, pronounced it to be a case of pregnancy, and advised the
sorrow-stricken mother to send her daughter immediately to the country as
the best mode of concealing her shame. Not willing to yield to the opinion
of her physician (a young man,) and moved by the positive denials of her
agonized child, the mother consulted me in this case. The menses had
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