After some business had been dispatched, to which we shall allude
in another place, Mr. Jewel related the particulars of a case of
"supposed extra-uterine fœtation." The case, which is one of much
interest, is as follows:--
Mrs. F. a robust, healthy woman, ætatis 27, had been married one
year, and aborted once; when, in the month of September 1827,
she quitted her husband in London, and accepted a situation in
the country. After the expiration of a few weeks she received
permission to come to London for a day; and, naturally enough,
passed that night, (November 8th), with her husband, returning
again to the country next morning. Soon afterwards, the
morning-sickness, heart-burn, and other sympathetic affections
of pregnancy, appeared; but the catamenia still returned at the
regular periods, though scanty and paler in colour than natural.
She now quitted her situation, returned to her husband, and
engaged a midwife to attend her in her expected confinement. The
circumstance of quickening occurred in the latter part of February,
and was accompanied by a severe paroxysm of fainting, whilst the
abdomen gradually enlarged, and the motions of the child (as was
imagined) could not only be easily detected with the hand, but were
visible to the eye. On the 9th of August, making a period of 274
days, she was seized with the usual premonitory symptoms of labour;
the midwife arrived; found her walking her chamber, and concluded
that the process had considerably advanced. Three distinct uterine
contractions took place subsequent to the midwife's arrival, the
last of which was so severe as to compel the patient to grasp
firmly the back of a chair, and induce, after its subsidence,
excessive faintness. From this time no further parturient effort
was made; no examination per vaginam was instituted; neither was
there noticed any sanguineous vaginal discharge. When Mr. Jewel saw
her, examination detected nothing unusual in the os uteri, and the
symptoms she presents are these. The abdomen is about the size of a
woman's in the sixth or seventh month of pregnancy, the enlargement
being general. Her general health is much disturbed: she complains
of pain in the left hypogastric region, particularly when the
abdomen is compressed by the hand or stays--and she also complains
of weight in the abdomen, especially on leaning forwards. The woman
herself has a strong prepossession that "something is to come
away," or that she might be relieved by an operation. The woman
believes that she still feels the motions of the child, though
feebly.
Having read this case, Mr. Jewel concluded by offering some
observations on the subject of extra-uterine fœtation. He
considered this as probably an instance of "graviditus
abdominalis," and remarked that the uterus not having expelled its
dezidua, was no conclusive proof to the contrary, Dr. Blundell and
Mr. Langstaff having examined cases where this was wanting.
Dr. Locock never saw a case where laceration occurred in the
early months of pregnancy. Dr. L. remembered the particulars
of a case where the uterus was lacerated in the fourth month,
and the ovum escaped into the cavity of the abdomen, and the
symptoms of pregnancy were exceedingly strong. Dr. Locock almost
doubted whether Mr. Jewel's was an instance of pregnancy at all,
for frequently women enjoying sexual intercourse have enlarged
abdomens, and many of the other symptoms of pregnancy, which a few
doses of purgative medicine will remove.
Two remarkable instances of extra-uterine fœtation were related
by Mr. Burnett and Mr. Cæsar Hawkins; and towards the conclusion
of the evening the discussion turned on the powers of the ergot
of rye. Dr. Locock had frequently tried it in amenorrhœa, and, on
the whole, without any very good effects. In one remarkable case,
where the lady particularly wished to have children, Dr. Locock
having boiled an ounce of the ergot in a pint of water down to half
a pint, gave an ounce and a half of this decoction three times a
day. After the young lady had taken about half a pint, the most
violent convulsions succeeded, which placed her life in imminent
hazard, and from which it was long before she completely recovered.
She menstruated twice after that, but then the discharge again was
arrested, and has never since returned, nor has she become pregnant.
The practice of "bougieing the uterus" in cases of dysmenorrhœa
was brought upon the tapis, and excited a good deal of laughter,
the members appearing to consider the proposal ridiculous in the
extreme.