CONVULSION'S NOT DUE TO ECLAMPSIA.
Puerperal eclamptic convulsions, we 8nd numer ous cases referred to in literature, as puerperal convulsions. These are convulsions occurring in the puerperal state, and differ essentially from true eclampsia. Thus, .Taoquemier, under the heading convulsions with out determinate form, cites Baudelocque's case of a woman who fell into convulsions whenever her child moved. Deneux saw a woman who, im mediately after conception, was seized with spasms of the whole left side. These spasms lasted without pain or functional derangement until the third month of pregnancy. R,esidence in the country afforded relief in three weeks. Dubois saw a woman, pregnant between five and six months, whose abdominal muscles contracted so violently as to force the uterus completely down into the pelvis. The organ then quickly re turned to its place, rebounding like an elastic ball. Other little promi nences, apparently due to spasmodic contractions of the viscera and of the abdominal walls, appeared in the loins, the epigastrium and the umbilical region. This woman recovered without au abortion. Velpeau cites an analogous case. Delamotte has seen convulsions from retention of the urine. Hysteria, tetanus and catalepsy, may occur during pregnancy.
Neuralgia& • These are common in pregnancy. The most freqUent form is dental neuralgia, upon which Lindner has recently written at length. It is one of the early symptoms of pregnancy, but puerperal tooth-ache is not always purely neuralgic; it is often due, as Pinard says, to gingivitis or even to caries. In these cases the teeth should not be extracted, but local meas ures relied on.
Pregnant women are also often the victims of migraine, head-aches, cramps, pains in the.legs and of intercostal neuralgia. They often have hepatalgia, with or without biliary e,alculi. We have seen hepatalgia with out calculi repeated in the same patient in three consecutive pregnanciea. We have also recently seen,with Dr. Magnin, a case of inflammation of the gall-bladder, which ended in eight days, without inducing premature labor. We have seen six cases of hepatic colic, either duriiig utero-gesta tion or during labor. In neither of them was pregrutncy interrupted. Quinine best relieves these neuralgias, but they are very rebellious, and only stop after a certain stage of pregnancy. Morphine, hypodermically, has rendered us some service. Neuralgias of the legs are most persistent, and sometimes do not disappear until after labor. Duprilot classifies
neuralgias as follows: 1. Nervous Troubles from mechanical Causes.—Abdominal Pains.— These correspOnd nearly to the points of exit of the lumbo-abdominal and sacral plexuses. Pectoral: at the waist or near the insertions of the ab dominal muscles. Lumbar or inguinal: not very serious; sometimes prodromata of abortion. Crural: numbness and cramps. Uterine: uterine rheumatism.
2. Nervous Troubles of central Origin.—They are due to an alteration of the blood, or to a direct action of the blood on the nerve tissue. A. Abnormal distribution of blood due to pregtancy. 1. Whenever there is a determination of blood to one organ the others suffer from lack of blood. Compression of largo abdominal veins by the fcaus. B. Abnormal composition of the blood, during pregnancy. Plethora; aniernia. In the head: ringing in the ears; disturbances of the senses; muscre volitantes; irritability; change of disposition; vertigo; insomnia; headache. In the chest: palpitations; syncope; dyspncea. In the stomach: anorexia; dyspep sia; gastralgia. Various sensory derangements. C. Depreciation of blood by abnormal substances. Albuminuria.
3. Reflex Troubles.—Tetanie, apoplectiform, hysterical, epileptio and eclamptic convulsions; emesis; cough; spasms; reflex vesical irritability; vascular spasms; spasms of the capillaries; hemiillegia; paralysis.
Vertigo, Sparks before the Eyes, Syncope.
Syncope is, certainly, the most frequent of these accidents, is inde pendent of cardiac affections, and occurs from insignificant or from inde terminate causes. It may be produced by emotion, joy, anger, fright, strong odors, repugnance for objects or persons, or movements of the child. Often it occurs at meals, but most often when the horizontal posi tion is exchanged for a vertical one. Ordinarily occurring without precur sory symptoms, syncope may be preceded by yawning, malaise and pros cordial heat, but almost never induces complete loss of sensibility and intelligence. Generally short, syncope may still be protracted, and is then often accompanied, as Cazeaux remarks, by hysterical symptoms, such as oppression, hypogastric pain, constriction of the throat, and, sometimes, true convulsions. The best treatment is to stretch the patient out flat, with the head low, and then to employ tonics and antispasmodics. These purely nervous accidents are, generally, devoid of gravity, and do not dis turb the regular course of pregnancy.