Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
This subject is best discussed under three heads: (1) Signs of Recent
Delivery in the Living. (2) Signs of Recent Delivery in the Dead. (3)
Signs of Previous Delivery.
1. Signs of Recent Delivery in the Living
(_a_) Transitory Signs; (_b_) Persistent Signs of Delivery
(_a_) Transitory Signs of Delivery
1. _General Indisposition._--The face is pale or flushed; the eyes
sunken, and surrounded by a dark areola; there is considerable
debility, and a tendency to faint; the skin is warm and moist, and the
pulse quick. It must be borne in mind that a woman who is anxious to
conceal her recent delivery may, by an effort of the will, to a great
extent hide her real condition.
2. _The Breasts._--The breasts feel firm and “knotty,” and on
pressure yield a small quantity of _colostrum_ or milk, which may be
distinguished by the aid of a microscope.
3. _The Abdomen._--The skin of the abdomen shows signs of recent
distension; it is relaxed, and more or less thrown into folds, the
lower part marked by irregular broken streaks of a pinkish tint,
becoming white and silvery as time goes on.
4. _The Lochia, or the “Cleansings.”_--These consist in a discharge
from the uterus, which, for the first three or four days after
delivery, is more or less bloody. During the succeeding four or five
days it acquires a dirty-greenish colour--“green waters,” with a
peculiar sour, rancid odour. In a few days this is succeeded by a
yellowish, milky-looking mucous discharge, which may continue for four
or five weeks.
5. _External Parts of Generation._--The labia and vagina bear distinct
marks of injury and distension.
6. _The Uterus._--The uterus is enlarged, and may be felt by the hand
for two or three days after delivery, as a round ball, just above
the pubes. The orifice of the uterus, if examined a few hours after
delivery, appears as a continuation of the vagina. This condition
completely disappears in about a week after delivery.
7. _After-pains._--These are of no use from a diagnostic point of view,
as we have no means of testing their presence or absence.
(_b_) Persistent Signs of Delivery
1. _Entire obliteration of the hymen._--This is no proof of actual
delivery.
2. _Destruction of the fourchette._
3. _The vagina dilated, and free from rugæ._
4. _Dark colour of the areola round the nipples._--This varies among
women; and cases are known where there was no areola either during
pregnancy or after delivery.
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