Abdominal and uterine tolerance in pregnant women : as shown by the low rate of mortality under severe lacerated and other wounds, the result of direct violence / by Robert P. Harris.

  • Harris, Robert P. (Robert Patterson), 1822-1899.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Abdominal and uterine tolerance in pregnant women : as shown by the low rate of mortality under severe lacerated and other wounds, the result of direct violence / by Robert P. Harris. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    WOMEN, AS SHOWN BY THE LOW RATE OF MORTALITY UNDER SEVERE LACERATED AND OTHER WOUNDS THE RESULT OF DIRECT VIOLENCE. We propose in this paper to confine our attention to wounds of the abdomen, and of the abdomen and uterus, directly inflicted, and to dis- card all cases in which the injury has been mainly or entirely received through the lower pelvis. This will necessarily limit the notice in large degree to cases of laceration, and these have been most frequently and frightfully inflicted by the horns of ruminants, as of the bull, ox, cow, bison, and buffalo, and, as would naturally be supposed, in the largest number by those of the cow. The wives of dairymen are particularly liable to injury in the field and barn-yard, and were all of the gored cases placed upon record, we should be amazed at the variety of their wounds, and the number of their narrow escapes from death, by abdominal, peri- neal, and other forms of injury. Perhaps in no sphere in life have more extensive lacerations of the abdomen been produced, than those which the country surgeon has had to treat in the wives of farmers, after horn-rips and picket-fence tears, when in advanced pregnancy; the tension and enlargement of the belly favoring the formation of a long wound in extreme cases. Many unimpregnated women have likewise been injured and escaped death, but the condition of pregnancy changes the prognostic conjecture, and makes the recovery more astonishing, particularly where the foetus has been violently liberated through the rent. When we look into our own experience, as to the producing causes of abortion and miscarriage, particularly in the higher walks of life and in neurotic women, we are amazed to find what trifles have, in some instances, induced expulsive contractions of the uterus. One of my patients, to all appearances a strong, hale woman, had a great abhorrence of tree-worms and cater- pillars, and aborted upon two occasions under their influence ; once when a caterpillar fell from a tree upon the crown of her bare head, and a second time, when stopped in the street to have some canker-worms re- moved from the back of her mantle; on each occasion she experienced a sudden shock, followed at once by the pains of labor. This woman managed to escape such mishaps during eight out of eleven pregnancies, and carried the fcetuses to maturity. Another woman, not of delicate build, but living in luxury, fell at once in labor, after lifting down a little boy over three steps in a curve of the stairway that she regarded as unsafe for him to step down. In this case, an increase of abdominal pressure appears to have opened a delicately closed cervix, brought on