irty-eight,
advanced eight months in her ninth pregnancy, who after eating a hearty
meal was seized by a violent pain in the region of the stomach and soon
afterward with convulsions, supposed to have been puerperal. She died
in a few hours, and at the autopsy it was found that labor had not
begun, but that the pregnancy had caused a laceration of the spleen,
from which had escaped four or five pints of blood. Edge speaks of a
case of chorea in pregnancy in a woman of twenty-seven, not
interrupting pregnancy or retarding safe delivery. This had continued
for four pregnancies, but in the fourth abortion took place.

Buzzard had a case of nervous tremor in a woman, following a fall at
her fourth month of pregnancy, who at term gave birth to a male child
that was idiotic. Beatty relates a curious accident to a fetus in
utero. The woman was in her first confinement and was delivered of a
small but healthy and strong boy. There was a small puncture in the
abdominal parietes, through which the whole of the intestines protruded
and were constricted. The opening was so small that he had to enlarge
it with a bistoury to replace the bowel, which was dark and congested;
he sutured the wound with silver wire, but the child subsequently died.

Tiffany of Baltimore has collected excellent statistics of operations
during pregnancy; and Mann of Buffalo has done the same work, limiting
himself to operations on the pelvic organs, where interference is
supposed to have been particularly contraindicated in pregnancy. Mann,
after giving his individual cases, makes the following summary and
conclusions:--

(1) Pregnancy is not a general bar to operations, as has been supposed.

(2) Union of the denuded surfaces is the rule, and the cicatricial
tissue, formed during the earlier months of pregnancy, is strong enough
to resist the shock of labor at term.

(3) Operations on the vulva are of little danger to mother or child.

(4) Operations on the vagina are liable to cause severe hemorrhage, but
otherwise are not dangerous.

(5) Venereal vegetations or warts are best treated by removal.

(6) Applications of silver nitrate or astringents may be safely made to
the vagina. For such application, phenol or iodin should not be used,
pure or in strong solution.

(7) Operations on the bladder or urethra are not dangerous or liable to
be followed by abortion.

(8) Operations for vesicovaginal fistulae should not be done, as they
are dangerous