VI. Quickening, where it can be distinctly recognized, becomes of course a conclusive evidence of pregnancy; but it cannot be thus positively determined except in those whose previous experience leads them to interpret aright the sensations which compose it. The term was originally applied to the supposed period at which the foetus in utero first became possessed of the living principle, or was united to its physical soul, which “quickening” of the foetus was believed to be the cause of the changes and unusual sensations experienced by the mother at that time. It is curious to see how the advance in physical science is equalled by that in psychical knowledge; how physiology and psychology go hand in hand. Thirty years ago Davis wrote, in this connection: It is now well known that the foetus in utero possesses some of the most important attributes of life form the earliest pulsations of the first speck of organization called the punctum saliens. The true doctrine is well state by an eminent Homoeopathic physician in a recent publication. ( The United States Medical and Surgical Journal, Vol. l., p. 387). The true scientific position is this: from the moment of conception, when the spermatozoa coalesces with the cell-wall of the ovule, the ovum is a distinct human being, with a human soul, simply attached to the mother for the obtainment of nutritive materia, but growing, living, organizing, by forces and powers entirely its own, and derived through nature from God.
By Quickening, therefore, we merely understand those sensations which indicate the escape of the gravid uterus from the pelvic into the abdominal cavity. It is not result, as formerly supposed, of movements of the foetus itself; but rather of the intrusion of the uterus itself among the other organs of the abdomen, and perhaps of he removal of the pressure hitherto exerted by the uterus upon the large vessels in the pelvis. “The sudden intrusion of the volume of the uterus among th abdominal viscera, organs of high sensibility, accompanied by a sudden removal of pressure from the iliac vessels, is quite equal to the production of the sensation called quickening. The sensation is felt in the transit at the moment when the uterus, upon quitting its residence in the pelvis, enters the abdominal cavity.”Davis. This sensation, which occurs at various periods in various women, is to be distinguished from those arising from the actual movements of the foetus in utero, which are only subsequently experienced. Quickening may occur as early as the tenth week, or it may not be observed till the sixteenth, the eighteenth or even the twentieth week; the average period is probably about the sixteenth week.
VII.Changes in the Urine. Much valuable time and a great amount of labour have been spent in attempting to render the alternations of the urine useful as a rational sign of pregnancy. And while for reasons subsequently to be stated, we attach even less importance to these changes in the urine, than do the Allopathic writers, we will briefly describe them, following principally the account given by the celebrated Dr. Elisha Kent Kane. (*See American Journal of he Medical Science, New Series, Vol.iv., July, 1842.
These changes consist briefly in the formation of a gelatino- albuminous product in the urine of pregnant females subsequent to the first month of gestation, which is separated from the other elements of that fluid by rest alone, and to which is given the name of Kiesteine. This consists of certain globules held in suspension in the urine when secreted and which rise to the surface and there form a pellicle. which resembles in appearance the thin scum of fatty substance covering sop as it cools. When thick, this pellicle is said to give off a strong cheesy odor. This pellicle usually makes its appearance upon the second day or in the course of the third;; though it is sometimes not observed till the urine has stood longer, even till the eighth day. the experiments of Dr. Kane and others prove that the Kiesteine is by no means peculiar to pregnancy; but that it has more especial relation to lactation, either prospective or actually present. Since it makes its appearance either where the milk is but imperfectly withdrawn from the breasts; or in those cases in which, as in pregnancy, nature is preparing for the future function of lactation. And finally, Kiesteine cannot be regarded as an unerring diagnostic of pregnancy;l since it may occur under of the conditions of the system, and is not always observable where pregnancy actually exists; but its presence in the urine of a n otherwise healthy woman is stated by Cazeaux to be an important rational sign.
It remains now to state why we attach little or no importance to this phenomenon as an indication of pregnancy is the Homoeopathic practice. And this is from the fact that these changes of urine which ultimate in, the formation of this peculiar pellicle, if not purely pathological, are at least but the consequences of the imperfectly performed physiological processes. These imperfections are also manifested in other more positive morbid symptoms, which being cured by appropriate Homoeopathic medication, the pellicle entirely fails to make its appearance. Still in case of supposed pregnancy, the experiment could easily be made as a mater of curiosity.
SENSIBLE SIGNS.-The sensible signs of pregnancy are observe through the medium of the senses of touch and heating. By the touch we examine the condition and position of the uterus and its relations to the adjacent parts, externally, through the vagina, and, if necessary, through the rectum. By auscultation we ascertain the probable existence of pregnancy from hearing the bruit de souffle, or bellow smearier,-and, at a little later period, if positive existence by detecting the pulsations of the foetal heart.
The term “touch signifies the means whereby knowledge is obtained of he condition of the female as to health or disease, or whether she be pregnant or other wise, by vaginal or anal examination with the finger, or by external examination with the hand, called palpation. By vaginal touch we may be able to diagnose the state of gestation, the stage of parturition, or whether the female is in that state; the progress of labor; the presentation and position o he child; in fact all normal and abnormal conditions which have ultimated themselves in malarial products. In order to be able to use the touch with certainty and advantage, the finger must be educated to recognize all the normal conditions then it will be able to readily detect disease or any important change in material or structural manifestations. the vaginal touch may be practised with the female standing, lying upon her back or upon either side.
If she be standing, the physician should place himself towards her left, and upon his right knee;. his left hand upon her abdomen externally, and his right hand, the index finger being well lubricated with oil, should be carried under her clothes and directly between her limbs, great care being taken not to touch her skin, the back of the hand upwards, with all but the index finger closed. The index finger should be slightly flexed, and if carried directly between the limbs, will come directly in contact with the hairy portion of the vulva; now press with a little firmness and straighten the finger and its pass the finger upwards and forwards and it will exactly trace with canal of the vagina; and but rotating he hand on the wrists, the interior cavity of the smaller pelvis can be explored and all the abnormalities and deviations in that vicinity may be noted.
If the female by lying upon her left side, with her thighs flexed upon her abdomen, which is the most usual position for the examination, the physician will sit at her back and use his right hand. In this case also the thumb and all the fingers should be closed except the index, which should be well lubricated and slightly curved, as before direct. The head should be carried between the limbs as already directed, with great care to avoid touching the bare skin. As the back of the finger come sin contact with the hairy portion of the vulva press firmly though carefully, straighten the finger and its point at once enters the vagina. Let the finger now be carried backwards and the canal for the vagina will be traced, and by rotating the hand, as before, all parts of the canal can be well examined. If the patient be lying upon her right side, the physician wills eat himself at her back as before, but will touch with the finger of the let hand.
The physician should accustom himself to examine with both hands; since it may be necessary sometimes to use the left hand, from the peculiar condition f the patient herself, or from experiencing a temporary injury to his right. In like manner it may be desirable to examine both in the erect and in. the horizontal position. In the earlier months the recumbent position, with the extremities flexed and separated, will give a grate degree of relaxation of the abdominal muscles and render the uterus more completely accessible. In the standing position, ballottement may be more readily accomplished. But in all doubtful or difficult cases the female should be examined in both positions. when about to be examined standing, the patient should de placed with her back against the will, a chair should be placed at each side to support her hands and the upper part of her body should be a little bent over the forward.
