MIDWIFERY. 
a hissing, and catcliing. The patient 
stretches Iierself ont, and immediately the 
convulsion begins. The next symptom 
which arises comes on after the convulsive 
motions have continued in their utmost 
violence for a time; the. woman foams at 
the mouth, and snores like an apoplectic 
patient, indicating great fulness about the 
brain. These symptoms are succeeded by 
a comatose sleep, out of which she awakes 
astonished, on being told what has hap- 
pened, not in the le^st aware that she has 
been in a fit ; .a'nd then she will fall into 
another fit, out of whicli she will again re- 
cover as before. It rarely happens that the 
understanding is taken away in this disease 
until it has been repeated several times. In 
the fit the skin becomes dark and purple, 
proving that the circulation throtigh the 
lungs is not free, which purple colour leaves 
tlie woman gradually after the fit is gone : 
and it is not only the external parts of the 
muscles of respiration that are affected 
here, but the uterus also. This is known 
by introducing the hand ; when the convul- 
sions come on the uterus will contract, but 
with a tremulous undetermined sort of 
force, perfectly different from what it does 
at any other time. 
There are two cases of puerperal con- 
vulsions which are very distinct -. one is a 
convulsion dependant on some organic af- 
fection of the brain ; the other on an irrita- 
ble state of the nervous system. Where 
puerperal convulsion arises from the former, 
but more especially from fulness of vessels, 
or extravasation, it is always preceded by 
some symptoms, . which, if watched, will 
enable us to relieve, if the patient send in 
time, which however is rarely done. 
In a patient strongly disposed to this 
complaint, there will be a sense of great 
fiillness in the region of the brain, which 
amounts even to pressure, giddiness in the 
latter periods of pregnancy, dizziness in the 
head, and a sensation of weight when the 
head stoops forward, which gives her the 
idea that she shall not be able to raise it 
again ; imperfect vision ; bodies dancing 
before the eyes, sometimes dark, at others 
luminous. This state of the eye denotes 
fullness of the vessels of the head more 
surely than any other symptom, and if al- 
lowed to continue, will lead to extravasa- 
tion and puerperal convidsion. The dis- 
turbed vision is a very strong symptom, 
and must never be passed over. If attended 
to early, even though symptoms of the 
complaint be present, still it may, by timely 
assiduity on our p,irt, be prevented from 
ending in premature labour. 
Here repeated bleeding and purgatives 
are all in all ; the sole object being to take 
oflF stimuli. After bleeding, and before any 
aperient is given by the mouth, w'e should 
give a solution of soft soap in warm water 
as an injection ; it is the quickest as well as 
the surest means : then a purgative mix- 
ture, with manna and Epsom sails. By 
these means, that is, by bleeding, purging, 
and the abstinence of all solid food and 
wine, no more blood is made ; what the 
patient has is diminished, and slie gets gra- 
dually better. 
When convulsion arises from a general 
irritable state of nerves, it is difficult to dis- 
tinguish the disease before it becomes esta- 
bli.shed. It is most frequent in large towns, 
and in those women who lead the most in- 
dolent life ; hence it is found in the first 
circles of fashion, in preference to the 
others ; and there is one grand circumstance 
which lias great influence in its production, 
that is, a woman’s being with child when she 
should not. Being obliged to live in a state 
of seclusion from society for some montlis, 
perhaps she reflects and broods over every 
thing which relates to her situation, and 
which gives her pain. She recollects she is 
not to enjoy the society of the babe she has 
borne, but on the contrary will be obliged 
perhaps to part with it for ever. She is 
afraid of her situation being known, and that 
she shall be considered an outcast in so- 
ciety. In this way she will brood in soli- 
tude, till at last the mere irritation of labour 
may be sufficient to excite puerperal con- 
vulsion. The difference between this kind 
of puerperal convulsions and the other, does 
not probably exist in any thing visible : it is 
not possible to tell the difference exactly ; 
but just as it is coming on, the woman will 
complain suddenly of a violent pain in her 
head, or stomach, which is expressed in 
the same way by all women ; they all say 
they cannot survive the pain if it return. 
The mode of treatment will not essentially 
vary from that already mentioned. Our 
plan, however, should be less active, and 
opiates may be allowed to succeed it. 
These observations relate to convulsions 
antecedently to labour. We now proceed 
to the same disease during labour. 
It has sometimes happened, that a woman 
has died of tlie first convulsion ; but it 
happens much more frequently that a miin- 
ber come on in succession, arising either be- 
fore or after delivery. The patient very 
