Statistics of obstetric practice in Montrose / by Samuel Lawrence.

  • Lawrence, Samuel.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Statistics of obstetric practice in Montrose / by Samuel Lawrence. Source: Wellcome Collection.

    10/12 (page 6)
    The first of these averages is exclusive, the second inclusive, of my own cases; and, even as compared with the higher of the two, my experience shows a pro¬ portion twice as large, while its relation to Dr Adams’ return (the highest in the above table) is as 2§ to lf| per cent. However, the great probability is, that the addition of one or two hundred cases to the 360 I have recorded, will very much diminish the proportion stated. I draw this conclusion from the reverse fact, that while the first 251 cases of my list gave only three twin births, or about 1 to 84, the remaining 109 gave five twin births, or fully 1 to 22. Just, therefore, as the proportion has been greatly increased by the last hundred cases presenting a run of twins, is it likely that it will be equally diminished during the next one or two hundred cases by a paucity of such births. Of the 16 children produced by the 8 twin births, 13 were girls and 3 boys : in 5 cases 2 girls being born together, and in 3 a boy and a girl. In 6 cases the placenta was single. In 2 cases the placentae were separate. In 5 cases the patient liad'reached the full term of utero-gestation ; in 2 the labour was premature ; in 1 it was an abortion. In 2 the labours were primiparous ; in <6 second or subsequent. Two of the cases occurred consecutively to the same patient, who twice gave birth to two daughters within a year ! (The first twins, born in the 8th month, did not survive.) The presentations cannot be classified, for in two cases they have unfortunately not been noted, and in two delivery was effected before my ar¬ rival. Of the remaining four cases, in one the child was delivered by the breech, the other by the head ; in another, one of the children was by the foot, the other by the head ; and in the remaining two both were head presenta¬ tions. The longest period between the delivery of the children in any of the cases was an hour and half; the shortest ten minutes. One of these twin cases (that of the abortion) deserves special mention from having been associated with a complication of not very frequent occurrence, dropsy of the amnion. The following is an abridgement of the notes I pre¬ served of it:—Mrs-is four months gone in third pregnancy. At the end of the second month, she seemed larger than in due proportion to the pe¬ riod of pregnancy, but there was no abdominal pain, and the general health was good. The only peculiarity was, that the sickness incident to her state was much more severe than in either of her former pregnancies. About six weeks ago (between the second and third month) began to experience fre¬ quent pain in right lumbar and umbilical regions, which still persists. Her size since the occurrence of the pain has been rapidly increasing, and now she presents the appearance of a woman at the full period of utero-gestation. ^Fluctuation is well marked over the whole abdomen. Diagnosis, tl Pregnancy with ascites.” With the view of removing the latter, she was placed under the usual treatment, and, failing to derive any benefit from it, after eight or ten days met a medical friend in consultation on the case. He concurred in the diagnosis, and in the pending necessity for the performance of paracentesis. This operation was accordingly performed on Saturday at mid-day, and about six pounds of straw-coloured fluid were withdrawn. The stream through the canula was never full, and never clear, being always more or less tinged with