PUERPERAL CONVULSIONS. 107 



alum ; and monesia. Pressure upon the abdominal aorta, and liga- 

 tures upon the limbs, are highly praised by some authors. Velpeau 

 recommends the application of a sinapism between the shoulders as a 

 revellent. Dr. Radford recommends galvanism as a powerful exci- 

 tant of the uterine muscular fibres. 



The hemorrhage may, however, be attended with partial adhesion 

 of the placenta to the uterus, with an irregular spasmodic or hour- 

 glass contraction of the latter organ. In this case, having placed 

 the left hand on the abdomen, so as to grasp and steady the womb, 

 introduce the right hand, in a conical form, gently through the con- 

 stricted portion of the womb ; separate the placenta, and then the 

 contractions of the uterus will probably expel the hand and placenta 

 together. 



The operation of transfusion has been recommended and practised 

 by Dr. Blundell in cases of extreme danger from loss of blood, and 

 has proved successful in fourteen cases, although it has failed in an 

 equal number. 



The patient should be kept in a strictly horizontal position, and if 

 syncope occurs, the head should be lowered and the feet elevated, so 

 as to allow the blood to flow to the brain. Stimulants should also 

 be administered, and the room kept cool and well ventilated. The 

 after treatment is the same as in the cases already described. 



PUERPERAL CONVULSIONS. 



There are three varieties spoken of by obstetrical writers, viz., 

 the hysterical^ the epileptic, and the apopdectic. The first occurs 

 generally during the early months of gestation, and in females of a 

 nervous or hysterical constitution. It is distinguished by the ab- 

 sence of insensibility, and frothing of the mouth, and the convulsive 

 movements of the lower jaw. There is no stertorous breathing, 

 and but slight contortion of the body ; although in many cases, the 

 muscles of the back are violently contracted, a symptom which is 

 looked upon by Dr. Dewees, as pathognomonic of this form. The 

 paroxysms often terminate in screams and tears, and the discharge 

 of a large quantity of limpid urine. 



Treatment. — If there be a quick, full pulse, or headache, vene- 

 section may be practised, or a {%yi leeches applied to the temple. 

 In general, the attack is relieved by antispasmodics, such as musk, 

 camphor, valerian, or assafcetida. Cold water poured from a height 

 upon the head will often break up the paroxysm. When it has 

 ceased, a small dose of opium should be administered. 



Epileptic convulsions. — The symptoms resemble those of an or- 

 dinary epileptic attack, and the patient often has premonitions of 

 what is coming, from the presence of pain in the head, ringing in the 

 ears, obscure or partial vision, loss of sensation, rigors, nausea, 

 &c. The aura epileptica is seldom felt. 



