RESPIRATORY APPARATUS.
The changes are either mechanical or chemical.
1st. Mechanical Changes. — Kuchenmeister, Fabius, Wintrich and Dohrn state that during pregnancy the base of the thorax widens, while the vertical and antero-posterior diameters diminish. The reverse occurs after delivery. They say that this diminution and increase compensate one for the other, and that the capacity of the thorax is unchanged. Tarnier and Chantreuil deny this last, and state that, the diaphragm being pushed upward, and not being able to descend as far as usual, there is a diminution in the cavity, as is proved by the kind of respiration, and the dyspncea of pregnant women upon exertion. This dyspno3a is greatest in women with deformed pelvis, or abnormal spine. Again, this dyspncea abates in the last few days of pregnancy, as the foetus engages and the fundus uteri sinks.
2d. Chemical and Gavarret prove that, during all of pregnancy, the amount of carbonic acid exhaled increases daily. A similar phenomenon occurs at the menopause, and at each menstrual epoch.
Urinary troubles arise from compression of the bladder, displacement of the urethra, causing dysuria, sometimes cystitis, and very often, an incessant desire to urinate, which most pregnant women experience even when there is no cystitis.
The kidneys are compressed and congested, and this congestion may lead to albuminuria.
The urine shows increase in water and chlorides, while the phosphates, sulphates, urates, uric acid, creatin and creatinin diminish in propor tion as pregnancy advances. Kyestein, described by Nauche, Eguisier, Tanchon, Stark, Letheby and Kane, has been relegated to obscurity by the experiments of Regnault, Cazeaux, Hcefie and Scanzoni.
It is proven that this pellicle, which forms on the surface of still urine at the end of thirty-six hours, is composed simply of crystals of ammonio maguesian phosphate with vibrios and monads, and that it may even make its appearance in man's urine.
It is quite otherwise concerning the presence of sugar in the urine of preg nant women, of those who are just delivered and in those who are nursing.
This was described by Blot in 1856, and was proven by Leconte and Keisten; but it appears to be less frequent than Blot claimed. Hempl and Gubler have quite recently called attention to this.
Cutaneous we find pigmentary deposits, or the uterine chloasma, pityriasis versicolor, wheals and diminution in the thickness of the nails (Esbach). Beau has described the diminution in growth (in length) of the nails during the diseases of pregnancy. We also find eruptions, acne and prurigo.
Nervous we find neuralgia, toothache, headache, de rangements of the special senses—especially taste, smell and sight—and finally, psychical changes.
The Osseous referring to relaxation of the symphy ses and of intimate changes in the bone, we must mention that some women, who have married very early in life, grow during pregnancy, es pecially after delivery. The bones of the extremities increase in length, and a substance resembling bone tissue is deposited, in the majority of pregnant women, between the internal table of the cranial bones and the external surface of the dura mater, especially around the sinuses:—these are cranial osteophytes.
Rokitansky, in 1838, described these osteophytes, and, in 1844, Ducrest and Moreau were the first in France to find them. The latter has proved that they are not found solely inside of the skull. In 98 cases of women who died at the Maternite during childbirth, 42 showed intra-cranial os teophytes and 12 osseous plates on the exterior of the skull.
In these twelve cases the intra-cranial osteophytes were very well de veloped.
Follin and Claude Bernard found osteophytes, like those of the cranium, in the pelvis of women who had died in childbirth.