Medical Jurisprudence, Volume 1 (of 3)Paris, John Ayrton
Science
Medical Jurisprudence, Volume 1 (of 3)
Paris, John Ayrton
Medical laws and legislation -- Great Britain
take care that he does not compromise his character for skill and
knowledge. “Notandum est magna hic prudentia opus esse medico ne facile
graviditatem vel affirmet, vel neget; peritissimi enim decepti fuerunt
toties; nunquam magis periclitatur fama medici, quam ubi agitur de
graviditate determinanda.”[371] History informs us, says _Capuron_,[372]
and it is attested by _Ambrose Paré_, _Moriceau_, _Riolan_, _Devaux_,
and others, that pregnant women have been brought to the scaffold, after
an examination by medical men and matrons, who have declared the absence
of pregnancy.
At about the _Fourth_ month after conception, that stage of
utero-gestation arrives, which enables us, by means of an external
examination, to place the fact beyond the reach of conjecture; for at
this stage the uterus may be distinctly felt through the integuments of
the abdomen; nor are we able before this period to determine the
question by any examination _per vaginam_, for the _fundus_ uteri is the
portion first distended in consequence of conception; while the
_cervix_, the only part that we can feel, does not begin to shorten to
any appreciable extent, before the period just stated.[373]
The following method of examining the uterus, in order to ascertain
whether it be gravid, is proposed by _Tortosa_,[374] and is well
calculated to accomplish the object. The woman, being fasting, and her
bowels and bladder having been previously evacuated, should be directed
to lie down, with the loins low, and with the head and buttocks
elevated; the knees are then to be raised and bent, so as to bring the
thighs to the belly, and the heels to the buttocks, by which position
the abdominal integuments will be relaxed; the midwife is then to place
the hand upon the epigastric region in such a manner that the little
finger may rest on the pubes, and the thumb on the navel, and ordering
the woman to breathe hard, he must press the belly gently during the
expiration: if the uterus be gravid, and is more than three months
advanced, he will at this moment feel above the pubes an equal, hard,
globular body; and if the same examination be made after the fifth month
of gestation, he will probably feel at the same time the motions of the
fœtus; but, in cases where no tumour can be distinctly felt, the
operator must be very careful not to be deceived by motion, for the
action of flatus may mislead him, and even where an obvious enlargement
exists, the pulsations of the aorta may lend to it a deceptive motion;
this is particularly striking where the ovarium is extensively diseased,
or the uterus is distended with tumours, an occurrence which has not
unfrequently induced the patient to consider herself pregnant;[375] in
such a case the ovarium may be felt through the parietes of the abdomen,
sometimes pretty high, like the uterus, or like a prominent part of a
child, but the round and circumscribed nature of the tumour can never
deceive an experienced midwife. _Avenzoar_, however, has left a
Public-domain text, read in full here on John Shaqi.
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