IXXERVATIOX OF THE GENERATIVE ORGANS 583 



The characteristic changes which occur in the breasts in connection 

 with the secretion of milk are described in the next chapter. 



The quantity of urine passed during the first two days of the 

 puerperium is generally above the average. The urine frequently 

 contains sugar, which may be either glucose or lactose. In the latter 

 case it is generally believed that the sugar has been absorbed into the 

 circulation from the changed mammary glands. When glycosuria 

 occurs, it is probably comparable to post-operative glycosuria (see 

 p. 539 and pp. 602-604). Albumen may also l>e present in the urine 

 in the first days of the puerperium. It is stated further that there 

 is an increase in the amount of acetone 1 (see also p. 535). 



As mentioned above, a marked leucocytosis occurs during lalxnir. 

 According to Hofbauer; 2 this becomes still more pronounced during 

 the first twelve hours of the puerperium, after which the number of 

 leucocytes in the blood falls again and in a short time becomes 



Fi<;. 160. Virginal external os FIG. 161. Parous external os 



(human). (From Williams' (human). (From Williams' 



'. Appleton & Co.) Obtteti'iw. . Appleton & Co.) 



normal. Henderson 3 states that on the fifth day the average number 

 of leucocytes per cubic millimetre is 12,000, whereas immediately 

 after parturition it is 21,000, as compared with about 8000 in a normal 

 woman. It is stated that there is a diminution in the numl>er of red 

 corpuscles during the first days of the puerperium, a circumstance 

 which is commonly ascribed to the loss of blood at delivery and the 

 lochial discharge. It is also said that the amount of haemoglobin is 

 reduced, ami that there is a relative increase in the quantity of fibrin 

 and serum. Experiments show, however, that there is no appreciable 

 shortening in the coagulation-time of the blood, such as has been 

 supposed to account for the thrombosis of tin 1 sinuses. 4 



The pulse rate during the early days of the puerperium is usually 



i, " Teher Puerperale Acetonurie," Hegar's />.;/, >/,/,- :-// <; 

 <!,/,'<ik., vol. iii., 1900. 



- Hofbauer. "Zur Physiologic des Puerperiuin-.. J/"/../rW//-./. '///,-/. -///./ 

 (/,////-., vol. v., 1897. 



3 Henderson, " Observations on the Maternal Blood at Term and during 

 the Puerperium,'" ./"/-. <>f nl,*t>-t. >i,.-l ([/,>:. vol. i.. 1!M):>. 



4 Longridge, ln<: <->'t. 



