Hyperemesis gravidarum with reference to its etiology and treatment : dissertation presented for the M.D. degree, the Victoria University / by John M.H. Martin.

  • Martin, John Michael Harding, 1847-1906.
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: Hyperemesis gravidarum with reference to its etiology and treatment : dissertation presented for the M.D. degree, the Victoria University / by John M.H. Martin. 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.

    16/32 (page 16)
    and size of the uterus which can be ascertained by examination and palpation, its sensitiveness and tenderness by' touch, and the intense hyperaemia visible in the walls even of the mucous membrane of the vagina. According to Helme an active process of growth goes on in arteries, veins, and capillaries, with enormous and rapid increase of the musculature and supporting framework of connective tissue of the uterus. I agree with Lee, whose beautiful dissec- tions I have seen, notwithstanding that men of note and experience are opposed to his view, that the nerves distributed to the uterus do enlarge pari passu with the general developmental activity, and that hence they are more liable to stimulation. As long as the impregnated uterus remains a pelvic organ its increase in size, assisted materially by a half-filled bladder and a rectum distended with hardened faeces—a condition practically constant in those cases into which I have enquired—interferes with the circulation in the vessels, which becomes more and more impeded; greater and greater pressure is exercised on the nerves until their stimulation ends in the reflex act of vomiting. It is easy to understand, as the venous circulation under these conditions is against gravity, that after the night’s rest there ensues a partial accommodation to the rapid enlargement, and when the upright position is again assumed a more acute hyperaemia results, with nerve stimulation and reflex vomiting. The weight of the intestines must also be recognised