Parturition and the principles and practice of obstetrics

Preface

I BEGAN to study Reflex Obstetrics in 1842, and the present work is the result of seven years’ close and earnest attention to the subject. I may say truly, that during this time, though much occupied by other matters, it has scarcely ever been absent from my waking thoughts.

I have no wish to deprecate criticism, but I trust I shall not be considered merely in the light of one who applies facts and principles already known to his own department of practice. I believe every candid person conversant with the cuiTent knowledge of the Reflex Function, and of Obstetrics, when I began to write, must admit that I have both added to reflex physiology, and made extensive applications in practice, which had eluded previous observers. Indeed, reflex obstetrics is a new department of the reflex function and its applications. Taking the whole range of reflex physiology, the Cause of Labour is only second in importance to the Cause of Respiration, and no one had perceived that the relation of the ovarian nerves to parturition is the same as the relation of the pneumogastric nerves to respiration; while, in the investigation of the causes of the

PREFACE.

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Genesial Cycles, in the Twelfth Lecture, I have entered upon a new field, altogether distinct from the reflex motor function.

Wlien I published my first “Observations,” reflex physiology had not found even a verbal home in any work on obstetrics, but I do not think it will be possible to say the same of future works in this department of medicine.

BoUon-street, March, 1849.

Introductory

LECTURE II.

Obstetric Ideas : — 1. Development. — 2. Mechanism. — 3. Motor Action. Present disunion between science and practice. Sketch of the progress of tlie nervi-motor physiology of parturition 15

LECTURE III.

The different forms of motor action observed in human parturition : volition ; emotion ; reflex action ; peristaltic action, or contraction from the irritability of the uterine muscular flbre 31

LECTURE IV.

The nervi-motor actions of the Fallopian tubes in menstruation, coitus, conception, and parturition. Nervi-motor actions of the vagina in the unimpregnated and parturient states . . . 51

LECTURE V.

The nerves of the uterine system ; distributive anatomy of the nerves of the ovaria. Fallopian tubes, uterus, vagina, and external parts of generation ; opinions of John and William Hunter. Growth of the uterine nerves during utero-gestation C2

X

CONTEXTS.

LECTL'EE Vr.

PACE

Puberty. History of the ovular theory of menstruation. Analogy between menstruation, oe.struation, and the oviposition of birds, insects, amphibia, and fishes. Nature of the catamenial secretion. Diseases of menstruation. Sterility, amenorrhcea, dysmenorrhoea, and ovarian convulsion. Practical applications 7C

LECTURE VII.

The principal motor phenomena of pregnancy — Emesis, cough, tenesmus, strangury, cramp, and the abdominal movements. Elucidation of the real nature of the movements generally considered to belong entirely to the foetus 92

LECTURE VIII.

Difiioulties attending the inquiry into the cause of labour. Sexual excitability in the frog. Cause of parturient action in oviparous fishes ; in oviparous insects ; in birds ; in mammalia ; in the human female. Relation between ovarian excitement, sexual excitement, and coitus. Relation between oviposition, oestruation, menstruation, conception, and parturition. The collective phenomena of ovi-expulsion 106

LECTURE IX.

Abortion a branch of spinal pathology. Ex-centric causes of Abortion. Irritation of the mammary, trifacial, vesical, ovarian, rectal, vaginal, and uterine nerves. Centric causes of abortion. Blood-poisons. The exanthemata, syphilis, scrofula, mercurialization, carbonic acid, specific uterine excitants. Emotion. Mechanism of abortion 127

LECTURE X.

The prevention of abortion. Removal of mammary, dental, vesical, ovarian, rectal, vaginal, and uterine irritation. Uterine, placental, and foetal disease. Respiration of the foetus. Intra-uterine pathology. Prevention of abortion from habit. Epidemic abortion ; haemorrhage in abortion ; treatment of abortion. Eradication of the abortive diathesis 138