Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating itBurns, John
Science
Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it
Burns, John
Miscarriage
Mechanical irritations of the os uteri, or attempts to dilate it
prematurely, will also be apt to bring on muscular contraction. At the
same time, it is worthy of remark, that the effect of these irritations
is generally at first confined to the spot on which they act, a partial
affection of the fibres in the immediate vicinity of the os uteri being
all that is, for some time, produced; and therefore slight uneasiness at
the lower part of the belly, with or without a tendency in the os uteri
to move or dilate, whether brought on by irritation at the upper part of
the vagina or os uteri, or by affection of the neck, of the bladder,
&c.[10] may be often prevented from extending farther, and destroying
the action of gestation by rest, anodynes, and having immediate recourse
to such means as the nature of the irritation may require for its
removal.
Tapping the ovum, by which the uterus collapses and its fibres receive a
stimulus to action, is another cause by which abortion may be produced;
and this is sometimes, with great propriety, done at a particular
period, in order to avoid a greater evil.
It is now the general opinion, that contraction will unavoidably follow
the evacuation of the waters. But we can suppose the action of gestation
to be in some cases so strong as not to stop in consequence of this
violence, and, if it do not stop, contraction will not take place. I do
not, however, mean to say, that all discharges of watery fluid from the
uterus, not followed by abortion, are discharges of the liquor amnii,
and instances of this failing to produce contraction. On the contrary, I
know that most of these are the consequence of morbid action about the
os uteri, the glands yielding a serous instead of a gelatinous fluid,
and this action may continue for many months.
Sometimes the upper range of lacunæ yields water, whilst the under
secretes jelly, which confines the water for some hours, until it
accumulates, and comes out with a small gush. At other times, in the
early period of gestation, it collects in considerable quantity betwixt
the lower part of the decidua protrusa, which has not yet reached the
cervix uteri and the cervical efflorescence, which becomes a little
stronger than usual.
There is thus a species of dropsy produced, and the water is sometimes
confined until a little before labour comes on; at other times it is
discharged sooner, and an oozing continues for many weeks. In all these
cases, we may derive some advantage from injecting three or four times a
day a strong infusion of galls. The woman ought to use no exertion, as
the membranes are apt to give way.
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