Essays In Pastoral MedicineWalsh, James J. (James Joseph)
Religion
Essays In Pastoral Medicine
Walsh, James J. (James Joseph)
First aid in illness and injury; Medicine
1. As soon as an extrauterine pregnancy is discovered remove the
foetus through an opening made in the mother's abdominal wall. Do
not use electricity or the injection of poisons into the foetal sac,
or the incandescent knife. Emmet and a few others approved of the
use of electricity at times, but this is against the teaching of the
great majority of writers at present. The reason for removing the
foetus at once is that it is apt at any moment to cause rupture and
fatal hemorrhage before surgical aid can be effective.
2. In a case of rupture with free hemorrhage and collapse the only
operation advised is an immediate coeliotomy to stop the bleeding by
ligatures. The rupture should not be approached through the vaginal
wall according to the common doctrine, but through the abdominal
wall.
3. If there is a rupture in which the bleeding is confined and there
is no collapse, do not operate at once unless the haematocele
increases steadily or shows signs of suppuration. Sometimes
evacuation of the haematocele through the vaginal wall is possible.
4. In the later months of an extrauterine pregnancy, whether the
case is intraligamentous or abdominal, perform coeliotomy as soon as
the diagnosis has been made, and remove the foetus, because there is
always danger of sudden and fatal hemorrhage before the surgeon can
reach the source of the bleeding. What is to be done in a case where
the surgeon is certain before operating that the foetus is {11}
dead, has interest only for the physician, and it involves no moral
question.
Operating for extrauterine pregnancy maybe a simple coeliotomy, if any
coeliotomy is really simple, but it commonly is the most dangerous
operation for the mother that the gynaecologist is called upon to
perform.
The discussion of the moral questions that arise in cases of ectopic
gestation which began in volume ix. of the _American Ecclesiastical
Review_ was very valuable, but as the moralists had not full data to
work on their decision as a whole is not satisfactory. The original
cases presented are in part obsolete in the medical practice of
to-day, and important physical conditions were not disclosed in some
of the other parts of the cases. Father Holaind tentatively agreed
with Father Lehmkuhl in one decision, Fathers Eschbach and Sabetti
directly attacked Father Lehmkuhl's reasons, and Father Aertnys
indirectly opposed Father Sabetti's chief argument. These men are all
eminent authorities, but as each, except Father Holaind, was
dissatisfied with the arguments advanced by the others, and as their
data were incomplete, we can not rest the case on their decision.
Public-domain text, read in full here on John Shaqi.
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