sudden, a very rapid amendment was observed. On questioning the lady, I found that she had reason to think herself about six weeks pregnant, which was the fact; from that time, the cure advanced uninterruptedly, so that before the end of her gestation, the arm was perfectly well, and has so continued ever since, she having, in the interval, borne several children.

On the other hand, it is not to be forgotten, that occasionally the natural sympathetic affections may become excessive, and be very injurious, or even destructive of life, as, for instance, when total exhaustion and death have resulted from incessant vomiting, or when the violence of that act has caused the rupture of internal organs, as the uterus or liver; and, moreover, the influence of pregnancy in modifying or preventing other active processes proceeding in the system at the same time, is sometimes detrimental to the female, as when in cases of fractures the formation of callus and the reunion of the bone is prevented, or at least retarded, until after delivery; a consequence, however, which is not to be regarded as constant, but only of occasional occurrence: and probably to the same cause it may be ascribed that the cure of syphilis and of paralytic affections is so often rendered imperfect during that condition.

There is a fact connected with the history of pregnancy, when complicated with disease, which has always appeared to me one of great interest; when a pregnant woman labors under a malady which is to end fatally before the natural completion of her gestation, it almost invariably happens that a short time, generally a day or two before her death, which, in most cases, is delayed until the child has acquired such a degree of development as to be capable of living if born, labor is established, and delivery accomplished. I have so frequently observed this occurrence, that I cannot but regard it as a pre-ordained arrangement to prevent the unborn child from participating in the decease of the mother.

See cases by Mr. Wardrop, Med.-Chir. Trans., vol. v. p. 359; and Mr. Alanson, Med. Obs. and Enq., vol. iv. p. 410. Meckel, after enumerating different other causes, says: "Enfin la concentration de l'activité plastique sur un autre organe; c'est cette dernière circonstance qui fait que les fractures ne guérissent point pendant la grossesse et l'allaitement, quoiqu'il n'en soit cependant pas toujours ainsi."-Manuel d'Anatomie, tom. i. p. 337.

There is a simulation of disease which occasionally accompanies pregnancy and depends apparently on disturbance of the nervous influence, which sometimes very remarkably affects the functions of some of the organs of the external senses, in which no appreciable organic change can be at the time discovered; and that none such does really take place, seems sufficiently evident from the fact, that the affection lasts only during gestation. Thus, instances of temporary amaurosis induced by pregnancy are by no means uncommon.' I saw a lady thus affected; she could see certain objects distinctly, as a line drawn on paper; others appeared confused, and some she could hardly discern at all: occasionally, she imagined she saw objects which were not present, as a person crossing the room, or flower-pots, or bunches of flowers on her table, when nothing of the sort was there. Salmutius relates a case in which a lady became blind every time she was pregnant, and recovered her sight as soon as she lay in. Beer3 saw a young Jewess, who at the very beginning of her first three pregnancies, which followed each other quickly, regularly became amaurotic, and continued blind till after delivery; but on the third occasion she did not recover her sight. Chambon ascribes these affections to plethora, but such an explanation is scarcely consistent with the occurrence of amaurosis from protracted, or undue lactation, when the constitution is in a state of great debility and exhaustion, two well-marked instances of which I saw in two sisters, who quickly recovered their sight, by weaning their children. Dr. Matthews, of Moate, has just informed me of the case of a lady, who, when five months pregnant, for the first time, sustained total loss of voice, which she recovered at the time of her labor. Gardien notices this part of our subject fully, and mentions a variety of affections which I have not met with. Dr. Bennewitz has detailed the particulars of a case, in which a young woman was, in three successive pregnancies, affected with diabetes mellitus; which, each time, completely ceased on delivery, but again returned when she became pregnant.5

1 Vide Mason Good, Study of Med., vol. iv. p. 247; Cooper's Surg. Dict., art. Amaurosis.

Cent., iii..obs. 27.

Traité des accouchemens, vol. i. p. 437, and vol. ii. p. 76.

Osann's Clinical Report for 1823.

3 Lehre von den Augerkrankheiten.

Edinb. Med. Journ., vol. xxx. p. 217.

51 GENERAL OBSERVATIONS; CUSTOMS RELATING TO PREGNANCY.

Since the publication of the former edition of this work, I have seen several instances of hæmoptysis occurring only during preg. nancy, and unconnected with any pulmonary disease; and when we come to the consideration of uterine hydatids, Chap. XI., I shall have occasion to relate a case of this kind, involving details of very great interest.

In conclusion, if we take a review of former times, a conviction will be forced upon us not very flattering to our fancied superiority above our ancestors, in our watchful care of our women when pregnant, or in the legal provisions enacted for their protection and comfort; in both of which respects, the laws and customs of the earliest periods seem to have greatly excelled, both in justice and humanity, those which, even at this day, prevail amongst us. The Jewish law' decreed, that if two men quarrelling injured a pregnant woman so as to make her miscarry, she not suffering in health thereby, they should be liable to punishment, at the discretion of her husband, and to such fine as the judges should determine; if she sustained bodily harm, then, the law of retaliation was to be put in force; but if she lost her life, the punishment of death was awarded: and although the Jews were, in general, strict observers of the ordinances of the Mosaic law, they allowed pregnant women the use of forbidden meats, lest the child might suffer from their longings. A law of Lycurgus required the citizens in public places, to turn aside and make way for them; and at Rome, they were exempt from the necessity of standing aside, or mixing with the crowd to make way for the passage of the consuls or others in authority; but, on the other hand, harsh treatment was by many considered justifiable and proper towards those who were pregnant, but unmarried; religion and the progress of civilization have, long since, produced a more just appreciation of their natural rights in this respect; and while, on the one hand, the prerogatives of pregnant women have been wholesomely restricted, a more reasonable allowance is made by mankind, in general, for the frailty of our nature, and the errors of passion; and its victims obtain more of the sympathy and kindly consideration, of which they often stand so grievously in need.

Exodus, chap. xxi. ver. 22, et seq.

The Athenians spared the life of the murderer who took refuge under the roof of a woman with child, and by the kings of Persia, they were each presented with two pieces of gold. The Roman laws allowed them the same privileges as did those of France; in the code of which country, at the close of the last century, an enactment existed' which forbade that a pregnant woman should be brought to trial; the humanity and propriety of which provision we cannot too much admire. Although not aware of the grounds on which such a prohibition was framed, I can see two excellent reasons for its adoption, first, lest the mental disturbance arising from the state of the nervous system should, in any degree, render the accused less capable of defending herself; and, secondly, lest the agitation and terror excited by her trial might have an injurious effect upon her offspring; and such, I find, is the light in which the matter is viewed by Raige Delorme. By the British law, no such merciful exemption is provided; a pregnant woman may be tried for her life, and if found guilty, executed, and with her, her guiltless offspring, except it can be made appear that she is not only pregnant, but quick with child. When examined as witnesses, and under other circumstances, pregnant women frequently refuse to take an oath, and I believe their objection is generally allowed in unimportant matters, but of the grounds of this usage, I am not aware.

2

CHAPTER II.

INVESTIGATION OF THE SIGNS OF PREGNANCY.-LEGAL AND SOCIAL RELATIONS.DIFFERENT SOURCES OF EVIDENCES OR PROOFS OF THAT STATE.-CLASSIFICATION OF SIGNS.

"NUNQUAM forte magis periclitatur fama medici, quam ubi agitur de graviditate determinanda: undique fraudes, undique sæpe insidiæ, struuntur incautis." "Omnes enim, qui de graviditatis sig. nis scripserunt, quamvis longo artis obstetricia usu celebres fuerint,

I See Foderé, Méd. Lég., tom. i. p. 428, et seq.

2 Dict. de Méd., tom. x. p. 449.

unanimi ore fatentur, primis præcipue mensibus, signa graviditatis satis incerta esse," was the conclusion to which Van Swieten came, more than a hundred years ago; and now, that we have had the experience of more than another century to guide us, I believe there will be found few prepared to refuse their assent to the truth of his assertion, which expresses the opinion, not of its author only, but of all who, before, or since his time, have well considered the subject, and candidly stated the result of their experience. Still, I am convinced that many of the errors which have been committed, both in theory and practice, have arisen, far less from the acknowledged difficulty of the investigation, than from the want of proper information, and the careless way in which examinations are conducted; for, although we shall occasionally meet with cases so complicated that the best exertions of our judgment, assisted by experience and the possession of the requisite dexterity in the different modes of examination, will still leave us unable to do more than arrive at a result so involved in doubt, as to forbid our attempting to hazard anything approaching to a decisive opinion, such cases are infinitely less frequent of occurrence, than one would be led to conclude, who judged from the number of mistakes made on the subject; such extreme difficulty can, in general, only be encountered during the early months, and, even then, an examination conducted with sufficient attention and care will always enable the practitioner to avoid giving an erroneous opinion; and where blunders have been committed at more advanced periods, they have always, in my opinion, been caused by ignorance, want of care, prepossession, or a perverse and short-sighted reluctance to acknowledge, frankly, the inability to decide positively, under circumstances of unusual obscurity: which avowal, exclusive of the imperative necessity of acting honestly, is surely much less humiliating, as well as less likely to detract from our reputation, than to venture, precipitately, on an opinion for which, we must know, we have not sufficient grounds, or through a vain affectation of superior discernment, to pretend to an accuracy of knowledge which the circumstances before us really do not admit of, and which, the event is to belie.

At all events, one thing is certain; few questions in medicine, whether considered in a merely professional point of view, or,