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APPENDIX.

MEDICAL REPORTS.

Case of the late Princess Charlotte of Wales.

FROM THE LONDON MEDICAL REPOSITORY.

THE Editors, having been sufficiently apprised that the profession expected from then some account of this case, the lamentable termination of which has spread such a settled gloom over the British Empire ; immediately, on learning that the Physicians who attended it did not mean to publish any statement, (a resolution, in the propriety of which, under the circumstances, they perfectly coincide,) strenuously endeavoured to obtain every information respecting it, from such sources as could be depended on. Their exertions have been successful, and they are now enabled to present a report to their readers, which may be regarded as strictly authentic.

In prefacing their narrative, in this place, it is not for them to attempt to paint the simultaneous and wholly unprecedented expression of unfeigned sorrow, which the death of this excellent person, not less elevated by her virtues than by her rank, visibly imprinted on the countenance of the inha

bitants of this extended realm. It spoke a language

that could not be misconstrued. The profession have participated in this feeling, in common with their fellow subjects; and have borne a part in that extraordinary demonstration of respect for the departed, which, perpetuated in the page of history, will be contemplated by posterity as the most dignified tribute to individual worth, and the sublimest triumph of virtue, which mankind have ever witnessed ; a tribute honourable to the object of it, in a degree fitted to excite the envy of the proudest monarchs, and an eternal memorial of the ardent feelings of an honest-hearted, brave, and generous people. But as they are incapable of doing justice to this part of the subject, they shall leave it to abler commentators; and proceed to detail the facts they have collected, as far as regards the case in a medical point of view.

The Princess Charlotte, previously to her confinement, was in good health, and immediately under the

eye of her accoucheur, Sir Richard Croft, who resided at Claremont for three weeks, up to the moment in which she was taken ill. Dr. Baillie, also, was in attendance, chiefly, we have been informed, on account of a promise exacted from him by the Princess, that he would be near her on this occasion. Her spirits were excellent, and she anticipated only the most favourable issue of the event which was hourly expected.

She was first made sensible of her approaching delivery at seven o'clock on Monday evening, the third of November; but the labour pains were so inefficient, although acute, as scarcely to evacuate the water, which had ruptured the membranes at the commencement of the labour; a circumstance, however, which every accoucheur knows, prognosticates nothing either uncommon or untoward. In this manner the labour proceeded, slowly, for twenty-six hours; the Princess being frequently up and walking about, from finding that the pains almost left her when she was in the recumbent posture. About this time, also, judging from the inefficiency of the pains, and the little progress made in the labour, we understand Sir Richard Croft suspected that there were either twins, or that there existed some irregular action of the uterus; and, as it was probable a consultation might ultimately be required, he wrote to Dr. John Sims, requesting his Immediate attendance. He had, in the mean time, provided whatever could be wanted, should it be found expedient to have recourse to artificial delivery

Dr. Sims arrived at Claremont at two o'clock in the morning of Wednesday, but did not then see the Princess; and, as the cause of this has been grossly mis-stated, we think it proper, in justification of an honourable man, and so highly respected a member of the profession as Sir Richard Croft is well known to be, to state, that we have been informed, from a quarter which we must credit, that it was proposed by Sir Richard to Dr. Sims, that he should then be introduced to the Princess; but both Dr. Sims himself and Dr. Baillie thought his presence, at that time, could not be productive of any benefit, but might agitate the patient. Dr. Sims, therefore, declined entering the lying-in room. No consultation was at this period necessary, as the labour was evidently advancing, although slowly: but on hearing the statement of the situation of the Princess from Sir Richard Croft, Dr. Sims concurred in the opinion that every thing should be left to nature.

About noon, on Wednesday, it was first suspected that the child might be dead, or that it might be born in a state of suspended animation ; and every known means of recovery were immediately prepared. Still, the labour continued to be scarcely progressive; the pains being such as tend

to forward birth rather by moulding the head so as to admit of its easy passage, than by forcible ex. pulsion. When this was completed, the pains became more efficient; and, at the termination of fifty hours from the commencement of the labour, the Princess was delivered, by natural efforts, of a still-born male child. No great discharge followed the birth; but it was soon discovered that the uterus was acting irregularly, and taking on the hour-glass contraction; and an unfavourable sepa ration of the placenta was anticipated. This, likewise, in some degree, accounted for the protracted character of the labour.

At half-past nine o'clock, a discharge of blood occurred. Dr. Sims, who was then employed in an adjoining room, in endeavours to re-animate the infant, was instantly informed of this occurrence; and, in consultation with Sir Richard Croft, agreed that the immediate separation and removal of the after-birth was necessary.

It was effected with little difficulty, and was followed by a very trifling discharge either of fluid or coagulated blood.

The Princess was now as well and composed as ladies usually are immediately after delivery, and continued so until a quarter before twelve o'clock, taking frequently small supplies of nourishment; but at this time she became restless, and rather talkative, and complained of being sick. She vomited, but nothing was ejected, except a little camphor julep, which she had taken; and at this moment her pulse was firm, steady, and under a hundred. She again was composed. About half-past twelve, however, the breathing became impeded; the respiratory organs were evidently under the influence of spasm, and continued in that state until she breathed her last, at balf-past two o'clock; exactly five hours and a half after her delivery.

In this afflicting state of the case, Dr. Baillie and Dr. Sims, who had been called into the room when the breathing first became affected, united their judgment and their skill with that of Sir Richard Croft, but in vain, to avert the impending calamity. Art proved unavailing, although every thing which it could devise, and which experience could suggest, was attempted.

On the seventh of November the body was opened by Sir Everard Home, assisted by Sir David Dundas, Mr. Brande, and the Apothecary Of Prince Leopold's household; and we believe the following is a pretty accurate statement of the appearances these Gentlemen observed:

The membranes of the brain presented their natural aspect. The vessels of the pia mater were less distended with blood than was to be expected after so severe a labour. The ventricles of the brain contained very little fluid. The plexus choroides was of a pale colour, and the substance of the brain had its natural texture.

The pericardium contained two ounces of redcoloured fluid. The heart itself and the lungs were in a natural state. The stomach contained nearly three pints of liquid. The colon was distended with air. The kidneys and other abdominal viscera were in a natural state.

The uterus contained a considerable quantity of blood, and extended as high up in the abdomen as the navel; and the hour-glass contraction was still very apparent.

The foregoing narrative throws very little light upon the immediate cause of the death of the Princess. The fluid found in the pericardium might have obstructed the due action of the heart; but it is not easy to account for its presence there, nor to conceive how so large a quantity could have been effused during the short space of time that supervened to delivery, before the breathing became impeded. The quantity of the blood which

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