Page:Clinical Lectures on the Diseases of Women.djvu/21

Rh children, dead abortions, in various stages of decomposition, are quite common; but putrid fœtus or putrid abortion is quite a rarity. Your nose is a sufficient instrument of diagnosis. A decomposed fœtus is very seldom putrid, and it should not be so described. In our case there was no putridity, but there was the peculiar condition of decom- position which I have called "mummification."

In this case I call your attention to what is perhaps a very important element—the disease of the heart. It is only recently that great care has begun to be paid to the bearings of disease of the heart upon pregnancy and parturition; I know of none paid to the bearings of disease of the heart upon abortion. It is a subject well worthy of attention and study. It would be quite easy to erect a theory of this woman's abortion founded upon disease of the heart. Disease of the heart induces miscarriage frequently. This is not a case of miscarriage; it is a case of missed abortion: therefore, the explanation of the dependence of the death of this child upon the disease of the heart (mitral regurgitation) is far from being made out. This is, as I have said, a subject which, like innumerable others, remains for you to investigate.

You will notice in this case that I introduced the probe, and those who were present will remember that I said at the time, "I do this without hesitation, because, if the woman is pregnant, I wish the pregnancy to end." Before you decide to introduce a probe into the uterus you should always consider the question of pregnancy. In this case it was considered, and the probe was deliberately introduced. You see also beautifully illustrated, in this case, the power of what is called uterine catheterism in inducing labour. A single introduction of a uterine probe within six hours set the machinery of uterine pains a-going efficiently.