A system of midwifery / by Edward Rigby.

  • Rigby, Edward, 1804-1860.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: A system of midwifery / by Edward Rigby. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    occurrence, even after a single labour, is sufficiently frequent to make them worthy of careful observation. Indeed, on more than one occasion, we have known them occur even after a miscarriage, a circumstance on the strength of which the patient had ventured to deny that she was pregnant. On the other hand, we sometimes meet with the os uteri in a second preg- nancy so little altered by the effects of the previous labour, that it would be extremely difficult to come to a decision. When labour is over, the uterus contracts very considerably, and, in a few days after, its parietes will be found at least an inch in thickness. It now gradually diminishes in size, and continues to do so for some weeks; the blood-vessels contract, and losing the peculiarly loose spongy struc- ture of pregnancy it becomes harder, firmer, and more compact. It never- theless remains softer and larger than in the virgin state, and does not attain its original size and hardness until an advanced period of life. The OS uteri, which in the latter months of pregnancy had formed a circular opening, resumes its former shape, except that its lips, especially the posterior one, which are more or less irregular and uneven, are thicker and longer than in the virgin state. For the first weeks after labour, the OS uteri is high in the pelvis, soft, and easily admits the tip of the finger; at the end of the second week it is much lower in the pelvis, and no longer permits the finger to pass. Immediately after labour, the contracted uterus forms a hard solid ball, the size of a new-born child's head; this state of contraction is not, however, of long continuance: in the course of half an hour, or even less, it begins to increase in size, becoming softer and larger, and continuing to increase slowly for some hours, when it again gradually diminishes, until, as before observed, it approaches its original size in the unimpregnated state. The state of powerful contrac- tion in which the uterus is felt immediately after labour, after a time gradually relaxes; its spongy texture, from which the blood had been forcibly expelled by the violent action of its fibres, becomes again filled with blood; the organ swells, and becomes softer and more bulky, and the orifices of the vessels which open into the cavity of the uterus are again partly pervious, and emit a sanious fluid called the lochia. This state lasts for two or more days after delivery, when the vessels begin to re- cover their former caliber, and lose that degree of dilatation peculiar to the gravid state. The lochia become less and less coloured, and now, and not before the uterus undergoes that gradual diminution of size and bulk which we have just alluded to. The copulative or external organs of generation are the vagina, hy- men, clitoris, nymphcB, and labia, the last three being known by the term vulva. Vagina. The vagina is a canal of about four inches in length and one in breadth, broader above than below; its parietes are thin, and are immediately connected with the uterus. It envelops the portio vaginalis of the uterus at its upper or blind extremity (fundus vaginae,) and is con- tinuous with its substance; inferiorly, where it is narrowest, it passes into the vulva. It is situated between the bladder and rectum, and attached to each by loose cellular tissue. Its direction differs from that of the uterus, for its axis corresponds very nearly with that of the pelvic outlet,