Influence of fibroid tumors studied in 550 cases of myoma. The prevailing opinion as to the unfavorable influence of these tumors upon pregnancy and labor is not justified. Of the married women, 26.7 per cent. were sterile; hut in very few cases was the sterility due to the myoma. Of the women who had borne children, the average number of pregnancies was 3.6, and only 22 per cent. of the 550 had been pregnant only once. The omission of conception may favor the development of these tumors, the hereditary disposition to which is about the same in all women. Consider ing the benign influence of myomata on the course of pregnancy. operative inter ference during gestation. condemned ex cept in exceptional eases. Hofmeier (Zits. f. Gel). u. Gyn.. B. 412, 3, 1900).
2. Nervous 1?eflexes.—It would be dif ficult to refer to all the possible disorders of this character. The nerve-connections of the uterus with other parts of the body, especially with the abdominal cera, are so numerous that there is a certain degree of reasonableness in attrib uting a great variety of nervous disturb ances to a cause within the uterus. A woman with highly-developed nervous system may be peculiarly sensitive to irritation when the uterus is in an alted state of functional activity, and thus we may explain many of the peculiar phenomena of pregnancy. Perhaps the most common of these phenomena are the nausea and vomiting: the "morning sickness" of pregnancy. Others which are less noteworthy are neuralgias in various parts of the body, peculiar con ditions of the special senses, disturb ances of digestion, secretion, etc. The nexus between these conditions and preg nancy seems to be demonstrated in the fact that with the termination of preg nancy the conditions in question disap pear also.
Forty-nine eases of peripheral neu ritis in pregnancy and the puerperal state collected. The disease is more corn mon in multiparre. One-fourth of the cases occurred during pregnancy, while in one-third there was a history of some form of sepsis. In 11 cases marked and incessant vomiting was present. It was not possible to trace a, connection with alcoholism, and sepsis and continual vomiting are the most potent causes. The disease began in the legs, then ex tended to the arms. The muscles were wasted and there were disturbances of sensation. In 14 eases there was either no recovery or hut partial clue. In eases recovery was complete. while in 13 no mention was made of the termina tion. Ileynolds (Brit.. Med. Jour., Nu. 1920, '97).
Unlike hysteria and epilepsy, chorea constitutes a serious complication of pregnancy; the mortality has been vari ously estimated from 30 to 2S per cent.:
sudden death has been reported among such patients. In vital eases death en sues from asphyxiation, the patients be coming paralyzed and often maniacal. In 20 per cent. abortion happens, or premature labor. Many of these women were rheumatic or chlorotie before preg nancy. Tarnier (La Presse Med., No. 29. '97).
Influence of maternal nervous lesions on the vitality of the foetus studied. through the production in pregnant rab bits of sciatic neuritis and meningo myelitis. Neither of these conditions, produced in rabbits a certain time be fore term, caused the death of the fetus before that of the mother, the latter having been killed a short time before term in order to ascertain the condition of the fetus. L. Butte (Jour. de Med. de Paris, Feb. 22, March 1. 1903).
3. Nutritive changes, especially in the blood, nervous system, digestive appa ratus, and secretions. Pregnancy is cer tainly the expression of a physiological requirement in animal nature. Nor mally it should be attended by no unu sual phenomena; but unfortunately the absolutely normal type of pregnancy is seldom seen. The variations in connec tion with the nutritive functions are espe cially pronounced. In a general way it • may be said that exaltation is the charac teristic in one class of cases and depres sion in another.
With the former the improved condi tion of the tissues shows the comparative gain in volume and nutritive value of the blood; the mind and nervous system, which may have been in a condition of irritation, are now so calm and equable that the change becomes noteworthy to those who are familiar with the state of affairs prior to impregnation. The digestion is improved, the secretions by their abundance show the activity of the entire glandular apparatus; in a word, pregnancy has acted as a stimulant and tonic, and such women frequently de clare that they have never felt better in their lives than when pregnant. This is the exaltation which may be coinci dent with pregnancy. In the other class the very opposite is seen: anwmia be comes more and more marked as preg nancy advances, nervous and mental irri tability and depression are more or less constant, melancholia and mania being not infrequent; digestion is constantly disturbed, nothing seems to be well as similated, nausea and vomiting cause great annoyance, and the secretions arc deficient in quantity and impaired in ef fectiveness. This is the depression which may also be the accompaniment of preg nancy.