PUERPERAL CONVULSIONS


The most useful homeopathy remedies for Puerperal Convulsion symptoms from the book The diseases peculiar to women and young children by H.N.Guernsey. …


THE two principal variety of convulsions to which women are subject are the hysterical and the epileptic. Our present concern is with those only which appear during gestation or after its termination in parturition. The convulsions which occur during the first eight months of pregnancy are usually hysterical; although is some persons originally predisposed or actually subject to epileptic attacks, convulsion would be still more more liable to appear in pregnancy, even in its earlier stages, and they would of course partake of the same epileptic nature.

But in general only those convulsions which arise during the last month, and especially during he last weeks of gestation, are allied to epilepsy; and hey are properly termed puerperal. because of their precise similarity in character to those which occur during labor and after parturition. Still in common language all convulsions of pregnant women may be termed puerperal, whether they appear in. the earlier or in the elate states of gestation during labor, or subsequently in the puerperal state. And in fact such individual. The hysterial form of convulsions appearing principally in the early months, in persons of a nervous or hysterical constitution may be considered rather as an aggravated kind of the hysterics; and studied in. the preceding article and chapter on this disorder; reference rather an aggravated kind of hysterics and studied in the preceding article and chapter on this disorder; see pages 144 and 148. And in. the present section, we shall have reference rather to the epileptic form of convulsions, to those which more immediately precede, accompany, or succeed labor, and shall consider their causes, symptoms and proper treatment.

Causes. The causes of puerperal convulsions may be most conveniently studied, by first dividing them into two general classes; the Centric, or these which arise from direct irritation of the great nervous centres and Eccentric, or those which arise from more external influence reflected back upon these centres. The Centric causes are either physical, acting as material irritants of the nervous centres; or physical, consisting in mental emotions. The physical causes may be either intra-cranial, such as act primarily upon the brain and medulla oblongata; or they may intra-vertebral, acting upon the membranes of the spinal cord and upon the substance of the spinal centre itself.

The most prominent of the physical intra-cranial causes consists in that derangement of the sanguineous system incidental to many cases of pregnancy, and known by the old term of plethora. “Pregnancy is usually and very justly considered a state of plethora; and it may be readily presumed that the balance of such plethora may determine towards the head in as much as the great vessels of the abdomen must be suppose, during the latter weeks of gestation, to be liable to much impediment to their action, from the pressure of the gravid uterus.’ Davis. Any agent which like a clot of blood, (*Romberg, Diseases of the Nervous System, ii, p. 188 serous effusion, or fulness of the cerebral circulation, causes undue or unusual pressure on any apart of the brain, by causing also a counter-pressure on the medulla oblongata, may occasional convulsions. And the deprivation of the accustomed pressure, both on the brain and on the spinal cord together, must necessarily be attended with similar results. Thus cases of convulsions arise, either in pelthord conditions with red, bloated face and projecting eyes; or in anemic conditions with red, bloated face and projecting eyes; or in anemic conditions characterized by excessive pallor and debility. In case to excessive and fatal uterine haemorrhage, convulsions always appear art before death from this very cause. The physical classes of causes of convulsions consist in sudden and violent emotions of fear, of joy or of grief; or in deeper and more protracted influence, s such as the sense of shame inseparably connected in many instances wish pregnancy in unmarried females.

The intra-vertebral causes of puerperal convulsions have reference either to the quantity of the the quality of the blood. Too large a quantity relatively, extorting an undue pressure upon the spinal cord, either directly or by means of serous effusion, may give rise to puerperal convulsions and a similar result, as already stated, will follow the opposite or anaemic condition. The abnormal character of the blood itself may cause convulsions. This may arise from respiration due to the encroachment of the abdomen upon the thorax; from that state of the blood which corresponds to albuminuria; from a true toxaemia or poisonous state of the blood due to its double function of eliminating the debris of the foetal as well as of the maternal system; and from the fever connected with the first secretion of milk. Generally speaking, :the immediate causes of puerperal confusions are often very obscure. The appear sometimes to depend upon a loaded state of the brain; at other times the brain appears to be influenced by some distant irritate in, in the in. he uterus or digestive organs. and again in some cases puerperal convulsions are induced apparently by a peculiar irritability of the nervous system. It has been remarked, that thee has been a greater disposition to puerperal convulsions in those patients who have been in early lie subject to convulsive attacks, particularly of an epileptic character, and have omitted those measures usually employed as precautions.

The eccentric causes of puerperal convulsions consist in irritation of the extremity so the excited nerves. The greatest, and most frequent and important of all these, are found in direct irritation of the uterus itself, and of the uterine passes. This may be caused by the pressure of the head, or of any other presenting part upon the incident spinal never of these organs. In some excessively nervous or epileptic conditions, the convulsions may be brought on by the changes of position of he foetus in the first states of labor; by the irritation resulting from over-distention of the uterus by excessive quantity of liquor amnii, and by the presence of a dead foetus within the womb. the introduction of the hand into the uterus from the sake of removing an adherent placenta, has sometimes immediately thrown the woman into convulsions. The same result may also follow the irritation caused by indurated feces; by purgative medicines; by irritability of he bladder, the stomach, and even of the mammae.

Symptoms.-The symptoms of puerperal convulsions, may be divided into promontory,, and actual symptoms. And by a careful attention to the former, when they occur some days or even weeks before labor, we may be able to avoid the frightful complication of convulsions in child -bed.

The premonitory, or predisponent symptoms may sometimes consist in a sense of fulness in the head even to vertigo; of intense pain in a part or in the whole of he head; confusion of the understanding,, a sense of ringing and of other noises in the ears;temporary confusion or the loss of power of vision, and temporary abolition of the power of thought, and even of sensation. for much symptoms, which may appear at anytime in the late states of pregnancy, Dr. Davis appear at any time in the later states of pregnancy, Dr. Davis recommends he abstraction o blood; but a no less decided and much more beneficial result may be secured by the exhibition of he appropriate Homoeopathic remedy. For convulsions threatened during labor, the same author gives the following predisponent symptoms an excited state of the circulation a gradual accession of cephalic symptoms, m such as those above enumerated, with rigors, nausea and even vomiting; a great excitement of the heart and arteries; immense irritation and restlessness; great development of heat, unaccompanied by adequate moisture on the surface of the body; usual strength and fulness of the pulse. engorgement of the vascular structure of the face, producing much turgescence and flushing, an approach to or actual delirium; great fulness and wildness of he eyes; often accompanied by an expression of extreme distress, or else of a state approaching to fatuity; perception of scintillations of light, or the fancied presence of divers other bodies; and in may cases, a sudden seizure with violent pains in the abdomen, different in character from those of labor. Severe pain in the stomach, and an intense pain in the forehead have been mentioned as premonitory of the worst kind of cases of convulsions. A tumid state of the hands and face sometimes precedes an attack a dropsical swelling of the face alone, or face and upper extremities, is not uncommonly followed by convulsions, and if the urine is at the same time albuminous, this condition should excite strong apprehension of such catastrophe. Sometimes, have, there are no precursory symptoms; and however similar such attacks may be to epilepsy, they differ from this disorder in seldom or never being preceded by the aura epileptica.

H.N. Guernsey
Henry Newell Guernsey (1817-1885) was born in Rochester, Vermont in 1817. He earned his medical degree from New York University in 1842, and in 1856 moved to Philadelphia and subsequently became professor of Obstetrics at the Homeopathic Medical College of Pennsylvania (which merged with the Hahnemann Medical College in 1869). His writings include The Application of the Principles and Practice of Homoeopathy to Obstetrics, and Keynotes to the Materia Medica.