PARTURITION. 705 
ten years of age, (he was in ftature not more than four 
feet fix inches high. Her breadth acrofs the (houlders 
was as much as fourteen inches, but her pelvis (contrary 
to what is ufually obferved in the proportions of the fe* 
male (keleton) meafured only nine inches from the olfa 
ilia acrofs the facrum. Her breads and nipples never 
enlarged more than in the male fubjed ; (lie never men* 
ftruated : there was no appearance of hair on the pubes, 
nor were there any indications of puberty, either in mind 
or body, even at twenty-nine years of age.” The re¬ 
moval of the ovaries has been mod rarely pradifed in the 
human fubjed : probably the only cafe in which it has 
ever been done is that recorded by Mr. Pott, where thefe 
bodies were contained in inguinal herniae. A healthy 
young woman, aged twenty-three, large-breaded, (tout, 
and mendruating regularly, had a painful tumour in 
each groin, near the abdominal mufcles. The ovaria 
were removed (by midake it is faid) from thefe tumours 
by a furgical operation: “She has enjoyed good health 
ever (ince, but is become thinner and more apparently 
mufcular; her breads, which were large, are gone; nor 
has (he ever mendruated (ince the operation, which is 
now fome years.” Pott’s Works, vol. iii. p. 319. Here, 
then, we have fairly reached the end of our enquiries 
upon this part of our fubjed ; for, without ovaries and 
without uterus, there can be no conception, no Partu¬ 
rition ! 
Of Labours attended with Convulsions. 
In fome irritable conditutions, the women become 
convulfed in the courfe of the labour. This accident 
more frequently occurs w’ith (ird than with fubfequent 
children. At whatever time convulfions make their at¬ 
tack, they never completely leave the woman until the 
labour is over, and fometimes not until the next or fub¬ 
fequent day. In very mild cafes, the brain feems but 
little affeded by the convulfions, which partake of the 
nature of hyderic complaints: thefe cafes are eafily cu¬ 
rable, or give way fpontaneoully when the labour is 
completed. Of whatever nature, or from whatever 
caufes, puerperal convulfions may proceed, they aflid 
very much in forcing down the child. 
At whatever period or date of convulfive labour the 
accoucheur may be called in, he will generally find it 
expedient to take away fix, eight, ten, or twelve, ounces 
of blood from the arm; and in the fpace of two hours 
after, (unlefs the child is coming into the world,) this 
(liould be followed by a clyder to empty the bowels. 
After the operation of the clyder, from twenty to thirty 
drops of the tindure of opium may be advantageoufly 
given, which will generally fucceed in making the fits lefs 
frequent and violent. The labour mud now be con¬ 
ducted in the fame manner it would have been, if it had 
not been interrupted by the convulfions. If the child 
prefents in a natural podure, and the pelvis of the wo¬ 
man is of the natural form and dimenfions, it will be 
found that the convulfions have affided much in dilating 
the os internum, and in accelerating the completion of 
the labour. If any other part than the head of the child 
prefents, as foon as the internal orifice is fufficiently di¬ 
lated, the accoucheur will pafs his hand into the uterus, 
and turn the child, and bring it by its feet. 
Sometimes, however, the convulfions become fo ex¬ 
tremely violent as to occafion extreme danger both to 
mother and child. The woman is quite infenfible during 
the fit, which confids of violent didortions of the mufcles 
which move the body, and of tliofe of the eyes, the face, 
and the lower jaw. The fit, as it may be called, lads in 
fome cafes only a few feconds, and in others for feveral 
minutes. After the fit has ceafed, it fometimes happens 
that the patient remains in a comatofe date 5 in other 
cafes, the fenfibility returns. 
Thus, then, what in a mild form may be called convul¬ 
fions, will now acquire the name of epileptic fits, for fuch 
Vol. XVIII. No. 1175. 
they really are, and occurring with dreadful frequency: 
and accordingly, Dr. Merriman, who, in the early 
editions of his Synopfis, names this order of labours 
Dvftocia eonvulfiva, now calls it D.epileptica ; and he adds, 
“ The cafes, alone deferving the appellation of puerperal 
convulfions, which have fallen under my obfervation, have 
borne a very exad refemblance to the epilepfy; and this 
accords with the defcription of the complaint by the 
bed authors on midwifery.” 
Dr. Hunter, Dr. Lowder, and other teachers of mid¬ 
wifery, ufed to date in their ledures, that more than 
half of the women died, who were attacked with con¬ 
vulfions in their labours. Dr. Parr, in his Medical 
Dictionary, dates even a larger amount of fatal cafes ; 
he fays that, “ fix or feven in ten elude the mod adive 
and bed concerted meafures.” And Jacobs, in his Ecole 
Pratique des Accouchemens, fays that it is always fa¬ 
tal ; fcarce an indance of recovery is known. In modern 
practice, the proportion of deaths is by no means fo great. 
It is probable, that hyderical paroxyfms have fome¬ 
times been midaken for the true puerperal convulfions ; 
at lead, if we may judge from the rapid cures, that have 
been faid to be made by, as it feems, very inadequate 
means. It is therefore of importance to didinguilh ge¬ 
nuine puerperal convulfions from hyderical paroxyfms, 
which they often very much refemble. They may be 
difcriminated by bearing in mind, that in hyderia the 
pulfe is rarely affeCted ; the paroxyfms come on without 
the ufual premonitory fymptoms of convulfions, and at¬ 
tack feeble irritable women rather than thofe who are 
plethoric and robud, the ufual fubjeds of convulfion. 
The fit of hyderia is alfociated with globus hyjlcricus and 
palpitation of the heart, and is not followed by coma. 
The management of puerperal convulfions divides it- 
felf into two leading indications: Fird, to unload the 
veffels of the brain; and Secondly, to remove the excit¬ 
ing caufe, whatever it may be. 
1. To fecure the fird indication, fays Dr. Conqued, 
the lancet mud be confidered as the dieet-anchor on which 
the practitioner mud depend. It is of the greated mo¬ 
ment that the blood'be abdraCted early, rapidly, and 
abundantly; that the veffels of the brain may be brought 
into a date of collapfe. If poflible, on the acceffion of 
the premonitory fymptoms, the temporal artery or the 
jugular vein (hould be opened ; if not, a vein in both 
arms, and the incifion (hould be fo large that a confider- 
able quantity of blood can be withdrawn in a (liort time. 
In this formidable difeafe, the quantity of blood mud 
not be meafured by ounces, but by the ed'eds it may 
produce on the convulfions; and it will often be necef- 
lary to repeat the blood-letting again and again within 
the fird few hours. Having unloaded the cerebral veffels 
in fome meafure, by the rapid and early detraction of 
from forty to fifty ounces of blood, (liould the fymptoms 
not be fufpended,from fifteen to twenty ounces may be re¬ 
moved by cupping-glaffes applied to the nape of the neck. 
If the patient is able to fwallow, a pill containing 
from five to ten grains of calomel (liould be got down ; 
or the calomel, mixed with mold fugar, may be put 
into the mouth, and it will be fwallowed involuntarily. 
This (hould be followed by a folution of falts, every three 
or four hours, till fufncient dools are procured. 
The life of emetics, on the attack of puerperal convul- 
fions, has been reprobated in very drong terms by Mau- 
riceau, Levret, and others. But, when there is good 
reafon to fufped an overloaded domach, an emetic feems 
to be fo appropriate a remedy, that we need not hefitate 
to employ it. “ I do not recoiled (fays Dr. Merriman) 
to have given medicines exprefsly for the purpofe of ex¬ 
citing vomiting, but have fometimes feen vomiting take 
place in confequence of the dofe of calomel, and fome¬ 
times fpontaneoully; and have always thought it was 
rather beneficial than otherwife. Dr. Bard, of New 
York, in his Compendium of Midwifery (1808), fays, 
8 R. “after 
