File:A textbook of obstetrics (1899) (14591119879).jpg

Identifier: textbt00hirs (find matches)
Title: A textbook of obstetrics
Year: 1899 (1890s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia : Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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enthol ointment, and other analgesic applications;very hot water, vinegar, and an infusion of tobacco are house-hold remedies of some value. In the worst cases the womanbecomes almost maniacal. She may walk the floor all night,tearing at the vulva with her finger-nails until the labia are rawand her fingersare stained with blood. In such cases the induc-tion of labor must be considered. Hdema of the vulva maybe unilateral or bilateral, and in somepregnant women reaches an extreme degree. It is due to pres-sure upon the pelvic veins, to kidney insufficiency, or, in the uni-lateral form, t labial abscess. There are some women who DISEASES OF THE VULl A. 1 I 9 develop a vulvovaginal abscess regularly in every pregnancy, and not at other times. Treatment.—If the cause can be removed, the edema disap-pears. The treatment of kidney insufficiency removes thedropsy of the labia associated with that condition, as it dotsthe other dropsies of the body. if the edema is due to pressure,
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Varices of the vulva. rest in bed, with the occasional assumption of the knee-chestposture, often gives relief. If the edema does not yield to gen-eral treatment and to hot fomentations locally, the labia may bepunctured. It should be remembered, however, that even thisslight operation may terminate pregnancy. The vitality n\ thepart, moreover, is so lowered that infection and even gangrenemay follow the puncture. In the unilateral edema, associated 2 20 PREGNANCY. with labial abscess, the vulvovaginal gland should be laid openin the last month of pregnancy, curetted, cauterized with car-bolic acid, and packed with gauze. One of the worst cases ofpuerperal sepsis I have ever seen was due to infection from avulvovaginal abscess that ruptured during labor. Periuterine Inflammations and Adhesions.—Old cases of pelvicadhesions may be benefited by massage and tampons. The mostsatisfactory results, however, are secured by appropriate treat-ment during the intervals between pregnancies. Fr

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