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Circuit Analysis II
with MATLAB® Computing and
Simulink®/SimPowerSystems® Modeling
Steven T. Karris
Orchard Publications
www.orchardpublications.com
Circuit Analysis II
with MATLAB® Computing and
Simulink® / SimPowerSystems®
Modeling
Steven T. Karris
Orchard Publications, Fremont, California
www.orchardpublications.com
Circuit Analysis II with MATLAB® Computing and Simulink® / SimPowerSystems® Modeling
Copyright 2009 Orchard Publications. All rights reserved. Printed in USA. No part of this publication may be
reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior
written permission of the publisher.
Direct all inquiries to Orchard Publications, 39510 Paseo Padre Parkway, Fremont, California 94538, U.S.A.
URL: http://www.orchardpublications.com
Product and corporate names are trademarks or registered trademarks of the MathWorks, Inc., and Microsoft
Corporation. They are used only for identification and explanation, without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Library of Congress Control Number: 2009930247
ISBN10: 1934404201
ISBN13: 9781934404209
TX 5745064
Disclaimer
The author has made every effort to make this text as complete and accurate as possible, but no warranty is implied.
The author and publisher shall have neither liability nor responsibility to any person or entity with respect to any loss
or damages arising from the information contained in this text.
This book was created electronically using Adobe Framemaker.
Preface
This text is written for use in a second course in circuit analysis. It encompasses a spectrum of
subjects ranging from the most abstract to the most practical, and the material can be covered in
one semester or two quarters.The reader of this book should have the traditional undergraduate
knowledge of an introductory circuit analysis material such as Circuit Analysis I with
MATLAB®Computing and Simulink®/ SimPowerSystems®Modeling, ISBN 978-1-934404-17-1.
Another prerequisite would be a basic knowledge of differential equations, and in most cases,
engineering students at this level have taken all required mathematics courses. Appendix H serves
as a review of differential equations with emphasis on engineering related topics and it is
recommended for readers who may need a review of this subject.
There are several textbooks on the subject that have been used for years. The material of this
book is not new, and this author claims no originality of its content. This book was written to fit
the needs of the average student. Moreover, it is not restricted to computer oriented circuit
analysis. While it is true that there is a great demand for electrical and computer engineers,
especially in the internet field, the demand also exists for power engineers to work in electric
utility companies, and facility engineers to work in the industrial areas.
Chapter 1 is an introduction to second order circuits and it is essentially a sequel to first order
circuits discussed in the last chapter of Circuit Analysis I with MATLAB®Computing and
Simulink®/ SimPowerSystems®Modeling, ISBN 978-1-934404-17-1. Chapter 2 is devoted to
resonance, and Chapter 3 presents practical methods of expressing signals in terms of the
elementary functions, i.e., unit step, unit ramp, and unit impulse functions. Accordingly, any
signal can be represented in the complex frequency domain using the Laplace transformation.
Chapters 4 and 5 are introductions to the unilateral Laplace transform and Inverse Laplace
transform respectively, while Chapter 6 presents several examples of analyzing electric circuits
using Laplace transformation methods. Chapter 7 is an introduction to state space and state
equations. Chapter 8 begins with the frequency response concept and Bode magnitude and
frequency plots. Chapter 9 is devoted to transformers with an introduction to self and mutual
inductances. Chapter 10 is an introduction to one- and two-terminal devices and presents several
practical examples. Chapters 11 and 12 are introductions to three-phase circuits.
It is not necessary that the reader has previous knowledge of MATLAB®. The material of this
text can be learned without MATLAB. However, this author highly recommends that the reader
studies this material in conjunction with the inexpensive MATLAB Student Version package that
is available at most college and university bookstores. Appendix A of this text provides a practical
introduction to MATLAB, Appendix B is an introduction to Simulink, and Appendix C
introduces SimPowerSystems. The pages where MATLAB scripts, Simulink / SimPowerSystems
models appear are indicated in the Table of Contents.
The author highly recommends that the reader studies this material in conjunction with the
inexpensive Student Versions of The MathWorks™ Inc., the developers of these outstanding
products, available from:
The MathWorks, Inc.
3 Apple Hill Drive
Natick, MA, 01760
Phone: 508-647-7000,
www.mathworks.com
info@mathworks.com.
Appendix D is a review of complex numbers, Appendix E is an introduction to matrices,
Appendix F discusses scaling methods, Appendix G introduces the per unit system used
extensively in power systems and in SimPwerSystems examples and demos. As stated above,
Appendix H is a review of differential equations. Appendix I provides instructions for
constructing semilog templates to be used with Bode plots.
In addition to numerous examples, this text contains several exercises at the end of each
chapter. Detailed solutions of all exercises are provided at the end of each chapter. The
rationale is to encourage the reader to solve all exercises and check his effort for correct
solutions and appropriate steps in obtaining the correct solution. And since this text was
written to serve as a self-study or supplementary textbook, it provides the reader with a
resource to test his knowledge.
The author is indebted to several readers who have brought some errors to our attention.
Additional feedback with other errors, advice, and comments will be most welcomed and
greatly appreciated.
Orchard Publications
39510 Paseo Padre Parkway
Suite 315
Fremont, California 94538
www.orchardpublications.com
info@orchardpublications.com
Table of Contents
1 Second Order Circuits 11
1.1 Response of a Second Order Circuit ....................................................................11
1.2 Series RLC Circuit with DC Excitation ...............................................................12
1.2.1 Response of Series RLC Circuits with DC Excitation ...............................13
1.2.2 Response of Series RLC Circuits with AC Excitation .............................111
1.3 Parallel RLC Circuit ...........................................................................................115
1.3.1 Response of Parallel RLC Circuits with DC Excitation ..........................117
1.3.2 Response of Parallel RLC Circuits with AC Excitation..........................126
1.4 Other Second Order Circuits .............................................................................130
1.5 Summary .............................................................................................................136
1.6 Exercises..............................................................................................................138
1.7 Solutions to EndofChapter Exercises .............................................................140
MATLAB Computing: Pages 16, 17, 19, 113, 119, 1through 123,
125, 126, 128, 129, 132 through 134, 142,
144, 145
Simulink/SimPowerSystems Models: Pages 110, 114, 129, 153
2 Resonance 21
2.1 Series Resonance.................................................................................................. 21
2.2 Quality Factor Q0s in Series Resonance .............................................................. 24
2.3 Parallel Resonance ............................................................................................... 26
2.4 Quality Factor Q0P in Parallel Resonance........................................................... 29
2.5 General Definition of Q ....................................................................................... 29
2.6 Energy in L and C at Resonance........................................................................ 210
2.7 Half-Power Frequencies Bandwidth ............................................................... 211
2.8 A Practical Parallel Resonant Circuit................................................................ 216
2.9 Radio and Television Receivers ......................................................................... 218
2.10 Summary ............................................................................................................ 221
2.11 Exercises ............................................................................................................. 223
2.12 Solutions to EndofChapter Exercises............................................................. 225
MATLAB Computing: Pages 25, 26, 225, 227, 230, 231
Simulink / SimPowerSystems models: Pages 215, 216
3 Elementary Signals 31
3.1 Signals Described in Math Form ...........................................................................31
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling i
Copyright © Orchard Publications
3.2 The Unit Step Function........................................................................................ 32
3.3 The Unit Ramp Function ..................................................................................... 39
3.4 The Delta Function ............................................................................................ 311
3.4.1 The Sampling Property of the Delta Function.......................................... 311
3.4.2 The Sifting Property of the Delta Function .............................................. 312
3.5 Higher Order Delta Functions............................................................................ 313
3.6 Summary ............................................................................................................. 319
3.7 Exercises .............................................................................................................. 320
3.8 Solutions to EndofChapter Exercises.............................................................. 321
Simulink model: Pages 37, 38
4 The Laplace Transformation 41
4.1 Definition of the Laplace Transformation .............................................................. 41
4.2 Properties and Theorems of the Laplace Transform............................................... 42
4.2.1 Linearity Property........................................................................................ 42
4.2.2 Time Shifting Property................................................................................. 43
4.2.3 Frequency Shifting Property........................................................................ 43
4.2.4 Scaling Property........................................................................................... 44
4.2.5 Differentiation in Time Domain Property .................................................. 44
4.2.6 Differentiation in Complex Frequency Domain Property........................... 45
4.2.7 Integration in Time Domain Property ........................................................ 46
4.2.8 Integration in Complex Frequency Domain Property ................................ 47
4.2.9 Time Periodicity Property ........................................................................... 48
4.2.10 Initial Value Theorem................................................................................. 49
4.2.11 Final Value Theorem ................................................................................ 410
4.2.12 Convolution in Time Domain Property .................................................... 411
4.2.13 Convolution in Complex Frequency Domain Property ............................ 411
4.3 Laplace Transform of Common Functions of Time.............................................. 412
4.3.1 Laplace Transform of the Unit Step Function u 0 t ................................. 412
4.3.2 Laplace Transform of the Ramp Function u 1 t ....................................... 412
4.3.3 Laplace Transform of t n u 0 t .................................................................... 414
4.3.4 Laplace Transform of the Delta Function t ......................................... 417
4.3.5 Laplace Transform of the Delayed Delta Function t – a ...................... 417
4.3.6 Laplace Transform of e –at u 0 t .................................................................. 418
– at
4.3.7 Laplace Transform of t n e u0 t ............................................................... 418
4.3.8 Laplace Transform of sin t u 0 t ................................................................. 419
4.3.9 Laplace Transform of cos t u 0 t ................................................................ 419
4.3.10 Laplace Transform of e –at sin t u 0 t ......................................................... 420
4.3.11 Laplace Transform of e –at cos t u 0 t ........................................................ 420
4.4 Laplace Transform of Common Waveforms......................................................... 421
ii Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
4.4.1 Laplace Transform of a Pulse .......................................................................422
4.4.2 Laplace Transform of a Linear Segment ......................................................422
4.4.3 Laplace Transform of a Triangular Waveform.............................................423
4.4.4 Laplace Transform of a Rectangular Periodic Waveform............................424
4.4.5 Laplace Transform of a HalfRectified Sine Waveform..............................425
4.5 Using MATLAB for Finding the Laplace Transforms of Time Functions.............426
4.6 Summary .................................................................................................................427
4.7 Exercises .................................................................................................................430
Laplace Transform of a Sawtooth Periodic Waveform .......................................431
Laplace Transform of a FullRectified Sine Waveform ......................................431
4.8 Solutions to EndofChapter Exercises .................................................................432
MATLAB Computing: Page 4-37
Simulink Model: Page 4-38
5 The Inverse Laplace Transformation 51
5.1 The Inverse Laplace Transform Integral................................................................51
5.2 Partial Fraction Expansion .....................................................................................51
5.2.1 Distinct Poles ...............................................................................................52
5.2.2 Complex Poles..............................................................................................55
5.2.3 Multiple (Repeated) Poles............................................................................58
5.3 Case where F(s) is Improper Rational Function...................................................513
5.4 Alternate Method of Partial Fraction Expansion.................................................514
5.5 Summary ...............................................................................................................518
5.6 Exercises ...............................................................................................................519
5.7 Solutions to EndofChapter Exercises ...............................................................520
MATLAB Computing: Pages 53 through 56, 58, 510
512 through 514, 520
6 Circuit Analysis with Laplace Transforms 61
6.1 Circuit Transformation from Time to Complex Frequency .................................. 61
6.1.1 Resistive Network Transformation............................................................. 61
6.1.2 Inductive Network Transformation............................................................ 61
6.1.3 Capacitive Network Transformation .......................................................... 62
6.2 Complex Impedance Z(s)..................................................................................... 611
6.3 Complex Admittance Y(s)................................................................................... 613
6.4 Transfer Functions ............................................................................................... 616
6.5 Using the Simulink Transfer Fcn Block............................................................... 620
6.6 Summary .............................................................................................................. 623
6.7 Exercises ............................................................................................................... 624
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling iii
Copyright © Orchard Publications
6.8 Solutions to EndofChapter Exercises............................................................... 627
MATLAB Computing: Pages 66, 68, 615, 619 through 621,
629 through 6-32, 637
Simulink / SimPowerSystems models: Pages 68 through 611, 620 through 622
7 State Variables and State Equations 71
7.1 Expressing Differential Equations in State Equation Form................................... 71
7.2 Solution of Single State Equations ........................................................................ 76
7.3 The State Transition Matrix ................................................................................. 78
7.4 Computation of the State Transition Matrix ...................................................... 710
7.4.1 Distinct Eigenvalues (Real of Complex)................................................... 711
7.4.2 Multiple (Repeated) Eigenvalues.............................................................. 715
7.5 Eigenvectors......................................................................................................... 718
7.6 Circuit Analysis with State Variables.................................................................. 722
7.7 Relationship between State Equations and Laplace Transform.......................... 729
7.8 Summary .............................................................................................................. 737
7.9 Exercises .............................................................................................................. 740
7.10 Solutions to EndofChapter Exercises .............................................................. 742
MATLAB Computing: Pages 74, 76, 78, 712, 713, 715, 717, 721
730, 744, 745, 746, 748, 750
Simulink models: Pages 79, 710
8 Frequency Response and Bode Plots 81
8.1 Decibel Defined .................................................................................................... 81
8.2 Bandwidth and Frequency Response..................................................................... 83
8.3 Octave and Decade ............................................................................................... 84
8.4 Bode Plot Scales and Asymptotic Approximations............................................... 85
8.5 Construction of Bode Plots when the Zeros and Poles are Real ........................... 86
8.6 Construction of Bode Plots when the Zeros and Poles are Complex.................. 812
8.7 Corrected Amplitude Plots.................................................................................. 824
8.8 Summary .............................................................................................................. 835
8.9 Exercises .............................................................................................................. 837
8.10 Solutions to EndofChapter Exercises .............................................................. 838
MATLAB Computing: Pages 819, 820, 822, 823, 833, 840, 843, 845
9 Self and Mutual Inductances Transformers 91
9.1 SelfInductance .......................................................................................................91
iv Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
9.2 The Nature of Inductance..................................................................................... 91
9.3 Lenz’s Law.............................................................................................................. 93
9.4 Mutually Coupled Coils......................................................................................... 93
9.5 Establishing Polarity Markings ............................................................................ 911
9.6 Energy Stored in a Pair of Mutually Coupled Inductors .....................................914
9.7 Circuits with Linear Transformers....................................................................... 919
9.8 Reflected Impedance in Transformers................................................................. 924
9.9 The Ideal Transformer......................................................................................... 927
9.10 Impedance Matching ........................................................................................... 930
9.11 Simplified Transformer Equivalent Circuit ......................................................... 931
9.12 Thevenin Equivalent Circuit............................................................................... 932
9.13 Autotransformer .................................................................................................. 936
9.14 Transformers with Multiple Secondary Windings............................................... 937
9.15 Transformer Tests................................................................................................ 937
9.16 Efficiency..............................................................................................................942
9.17 Voltage Regulation .............................................................................................. 946
9.18 Transformer Modeling with Simulink / SimPowerSystems ................................. 949
9.19 Summary ..............................................................................................................957
9.20 Exercises............................................................................................................... 962
9.21 Solutions to EndofChapter Exercises .............................................................. 965
MATLAB Computing: Page 913, 914, 922, 944
Simulink / SimPowerSystems model: Page 949 through 956
10 One and TwoPort Networks 101
10.1 Introduction and Definitions...............................................................................101
10.2 One-Port Driving-Point and Transfer Admittances........................................... 102
10.3 One-Port Driving-Point and Transfer Impedances .............................................107
10.4 Two-Port Networks ...........................................................................................1011
10.4.1 The y Parameters...................................................................................1011
10.4.2 The z parameters ...................................................................................1017
10.4.3 The h Parameters ..................................................................................1022
10.4.4 The g Parameters...................................................................................1026
10.5 Reciprocal Two-Port Networks .........................................................................1031
10.6 Summary ............................................................................................................1035
10.7 Exercises.............................................................................................................1040
10.8 Solutions to EndofChapter Exercises ............................................................1042
MATLAB Computing: Page 1049
Simulink / SimPowerSystems model: Page 1050
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling v
Copyright © Orchard Publications
11 Balanced ThreePhase Systems 111
11.1 Advantages of ThreePhase Systems ................................................................ 111
11.2 ThreePhase Connections................................................................................. 111
11.3 Transformer Connections in ThreePhase Systems ......................................... 114
11.4 LinetoLine and LinetoNeutral Voltages and Currents............................. 115
11.5 Equivalent Y and Loads.................................................................................. 119
11.6 Computation by Reduction to Single Phase.................................................... 1119
11.7 Three-Phase Power .......................................................................................... 1120
11.8 Instantaneous Power in Three-Phase Systems ................................................ 1122
11.9 Measuring ThreePhase Power ....................................................................... 1125
11.10 Practical ThreePhase Transformer Connections .......................................... 1128
11.11 Transformers Operated in Open Configuration .......................................... 1129
11.12 ThreePhase Systems Modeling with Simulink / SimPowerSystems .............. 1131
11.13 Summary .......................................................................................................... 1136
11.14 Exercises........................................................................................................... 1138
11.15 Solutions to EndofChapter Exercises .......................................................... 1141
MATLAB Computing: Pages 1146, 1151
Simulink / SimPowerSystems models: Pages 1132, 1143
12 Unbalanced ThreePhase Systems 121
12.1 Unbalanced Loads.............................................................................................. 121
12.2 Voltage Computations ....................................................................................... 123
12.3 PhaseSequence Indicator ................................................................................. 124
Y Transformation........................................................................................... 127
12.5 Practical and Impractical Connections.............................................................. 128
12.6 Symmetrical Components................................................................................ 1210
12.7 Cases where ZeroSequence Components are Zero........................................ 1216
12.8 Summary .......................................................................................................... 1220
12.9 Exercises ........................................................................................................... 1222
12.10 Solutions to EndofChapter Exercises........................................................... 1223
MATLAB Computing: Page 1227
Simulink / SimPowerSystems models: Page 1228
A Introduction to MATLAB A1
A.1 Command Window .............................................................................................. A1
A.2 Roots of Polynomials ............................................................................................ A3
A.3 Polynomial Construction from Known Roots ...................................................... A4
A.4 Evaluation of a Polynomial at Specified Values .................................................. A5
vi Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
A.5 Rational Polynomials ...........................................................................................A8
A.6 Using MATLAB to Make Plots ..........................................................................A9
A.7 Subplots .............................................................................................................A18
A.8 Multiplication, Division and Exponentiation ...................................................A19
A.9 Script and Function Files ..................................................................................A26
A.10 Display Formats .................................................................................................A31
MATLAB Computations: Entire Appendix A
B Introduction to Simulink B1
B.1 Simulink and its Relation to MATLAB ............................................................... B1
B.2 Simulink Demos ................................................................................................. B20
Simulink Modeling: Entire Appendix B
C Introduction to SimPowerSystems C1
C.1 Simulation of Electric Circuits with SimPowerSystems ...................................... C1
SimPowerSystems Modeling: Entire Appendix C
D Review of Complex Numbers D1
D.1 Definition of a Complex Number ........................................................................ D1
D.2 Addition and Subtraction of Complex Numbers ................................................ D2
D.3 Multiplication of Complex Numbers................................................................... D3
D.4 Division of Complex Numbers ............................................................................ D4
D.5 Exponential and Polar Forms of Complex Numbers ........................................... D4
MATLAB Computing: Pages D6 through D8
Simulink Modeling: Page D7
E Matrices and Determinants E1
E.1 Matrix Definition ................................................................................................ E1
E.2 Matrix Operations............................................................................................... E2
E.3 Special Forms of Matrices ................................................................................... E6
E.4 Determinants .................................................................................................... E10
E.5 Minors and Cofactors........................................................................................ E12
E.6 Cramer’s Rule.................................................................................................... E17
E.7 Gaussian Elimination Method .......................................................................... E19
E.8 The Adjoint of a Matrix ................................................................................... E21
E.9 Singular and NonSingular Matrices ............................................................... E21
E.10 The Inverse of a Matrix .................................................................................... E22
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling vii
Copyright © Orchard Publications
E.11 Solution of Simultaneous Equations with Matrices .......................................... E24
E.12 Exercises ............................................................................................................ E31
MATLAB Computing: Pages E3, E4, E5, E7, E8, E9, E10, E12,
E15, E16, E18, E22, E25, E6, E29
Simulink Modeling: Page E3
Excel Spreadsheet: Page E27
F Scaling F 1
F.1 Magnitude Scaling .................................................................................................. F1
F.2 Frequency Scaling ................................................................................................... F1
F.3 Exercises.................................................................................................................. F8
F.4 Solutions to EndofAppendix Exercises............................................................... F9
MATLAB Computing: Pages F3, F5
G Per Unit System G1
G.1 Per Unit Defined .................................................................................................... G1
G.2 Impedance Transformation from One Base to Another Base ............................... G3
H Review of Differential Equations H1
H.1 Simple Differential Equations................................................................................H1
H.2 Classification..........................................................................................................H3
H.3 Solutions of Ordinary Differential Equations (ODE)............................................H6
H.4 Solution of the Homogeneous ODE......................................................................H8
H.5 Using the Method of Undetermined Coefficients for the Forced Response .......H10
H.6 Using the Method of Variation of Parameters for the Forced Response.............H20
H.7 Exercises...............................................................................................................H24
MATLAB Computing: Pages H11, H13, H14, H16, H17, H9, H22, H23
I Constructing Semilog Paper with Excel® and with MATLAB® I 1
I.1 Instructions for Constructing Semilog Paper with Excel..........................................I1
I.4 Instructions for Constructing Semilog Paper with MATLAB..................................I4
Excel Spreadsheet: Page I1
MATLAB Computing: Page I4
References R1
Index IN1
viii Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Chapter 1
Second Order Circuits
T
his chapter discusses the natural, forced and total responses in circuits that contain resis-
tors, inductors and capacitors. These circuits are characterized by linear secondorder dif-
ferential equations whose solutions consist of the natural and the forced responses. We will
consider both DC (constant) and AC (sinusoidal) excitations.
1.1 Response of a Second Order Circuit
A circuit that contains n energy storage devices (inductors and capacitors) is said to be an nth
order circuit, and the differential equation describing the circuit is an nthorder differential equa-
tion. For example, if a circuit contains an inductor and a capacitor, or two capacitors or two
inductors, along with other devices such as resistors, it is said to be a secondorder circuit and the
differential equation that describes it will be a second order differential equation. It is possible,
however, to describe a circuit having two energy storage devices with a set of two firstorder dif-
ferential equations, a circuit which has three energy storage devices with a set of three firstorder
differential equations and so on. These are called state equations and are discussed in Chapter 7.
As we know from previous studies,* the response is found from the differential equation describ-
ing the circuit, and its solution is obtained as follows:
1. We write the differential or integrodifferential (nodal or mesh) equation describing the circuit.
We differentiate, if necessary, to eliminate the integral.
2. We obtain the forced (steadystate) response. Since the excitation in our work here will be
either a constant (DC) or sinusoidal (AC) in nature, we expect the forced response to have
the same form as the excitation. We evaluate the constants of the forced response by substitu-
tion of the assumed forced response into the differential equation and equate terms of the left
side with the right side. The form of the forced response (particular solution), is described in
Appendix H.
3. We obtain the general form of the natural response by setting the right side of the differential
equation equal to zero, in other words, solve the homogeneous differential equation using the
characteristic equation.
4. We add the forced and natural responses to form the complete response.
5. Using the initial conditions, we evaluate the constants from the complete response.
* The natural and forced responses for firstorder circuits are discussed in Circuit Analysis I with MATLAB®
Computing and Simulink®/ SimPowerSystems® Modeling, ISBN 9781934404171.
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 11
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
1.2 Series RLC Circuit with DC Excitation
Consider the circuit of Figure 1.1 where the initial conditions are i L 0 = I 0 , v C 0 = V 0 , and
u 0 t is the unit step function.* We want to find an expression for the current i t for t 0 .
R L
+
C
vS u0 t it
Figure 1.1. Series RLC Circuit
For this circuit
t
di 1
Ri + L ----- + ----
dt C 0
i dt + V 0 = v S t0 (1.1)
and by differentiation 2
di d i i dv
R ----- + L ------2- + ---- = -------S- t 0
dt dt C dt
To find the forced response, we must first specify the nature of the excitation v S , that is DC or
AC.
If v S is DC ( v S = cons tan t ), the right side of (1.1) will be zero and thus the forced response com-
ponent i f = 0 . If v S is AC ( v S = V cos t + , the right side of (1.1) will be another sinusoid
and therefore i f = I cos t + . Since in this section we are concerned with DC excitations, the
right side will be zero and thus the total response will be just the natural response.
The natural response is found from the homogeneous equation of (1.1), that is,
2
di d i i
R ----- + L ------2- + ---- = 0 (1.2)
dt dt C
whose characteristic equation is
2 1
Ls + Rs + ---- = 0
C
or
2 R 1
s + ---- s + -------- = 0
L LC
from which
* The unit step function and other elementary functions used in science and engineering are discussed in Chapter
3.
12 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
2
R R 1
s 1 s 2 = – ------- ---------2 – -------- (1.3)
2L 4L LC
We will use the following notations:
R 1
S = ------- 0 = -----------
- S = S – 0
2 2
nS =
2
0 – S
2
2L LC
(1.4)
or Damping Resonant Beta Damped Natural
Coefficient Frequency Coefficient Frequency
where the subscript s stands for series circuit. Then, we can express (1.3) as
2 2 2 2
s 1 s 2 = – S S – 0 = – S S if S 0 (1.5)
or
2 2 2 2
s 1 s 2 = – S 0 – S = – S n S if 0 S (1.6)
Case I: If 2S 20 , the roots s 1 and s 2 are real, negative, and unequal. This results in the over-
damped natural response and has the form
s1 t s2 t
in t = k1 e + k2 e (1.7)
Case II: If 2S = 20 , the roots s 1 and s 2 are real, negative, and equal. This results in the critically
damped natural response and has the form
–S t
i n t = Ae k1 + k2 t (1.8)
Case III: If 20 2S , the roots s 1 and s 2 are complex conjugates. This is known as the under-
damped or oscillatory natural response and has the form
–S t –S t
in t = e k 1 cos n S t + k 2 sin n S t = k 3 e cos n S t + (1.9)
Typical overdamped, critically damped and underdamped responses are shown in Figure 1.2, 1.3,
and 1.4 respectively where it is assumed that i n 0 = 0 .
1.2.1 Response of Series RLC Circuits with DC Excitation
Depending on the circuit constants R , L , and C , the total response of a series RLC circuit which
is excited by a DC source, may be overdamped, critically damped or underdamped. In this section
we will derive the total response of series RLC circuits that are excited by DC sources.
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 13
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
Typical Overdamped Response
Voltage
Time
Figure 1.2. Typical overdamped response
Typical Critically Damped Response
Voltage
Time
Figure 1.3. Typical critically damped response
Typical Underdamped Response
Voltage
Time
Figure 1.4. Typical underdamped (oscillatory) response
Example 1.1
For the circuit of Figure 1.5, i L 0 = 5 A , v C 0 = 2.5 V , and the 0.5 resistor represents the
resistance of the inductor. Compute and sketch i t for t 0 .
Solution:
This circuit can be represented by the integrodifferential equation
t
di 1
Ri + L ----- + ----
dt C
0
i dt + v C 0 = 15 t 0 (1.10)
14 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
0.5 1 mH
+ 100 6 mF
i t
15u 0 t V
Figure 1.5. Circuit for Example 1.1
Differentiating and noting that the derivatives of the constants v C 0 and 15 are zero, we obtain
the homogeneous differential equation
2
di d i i
R ----- + L -------2 + ---- = 0
dt dt C
or 2
d R di
-------2i + ---- ----- + -------
i- = 0
dt L dt LC
and by substitution of the known values R , L , and C
2
d di
-------2i + 500 ----- + 60000i = 0 (1.11)
dt dt
The roots of the characteristic equation of (1.11) are s 1 = – 200 and s 2 = – 300 . The total
response is just the natural response and for this example it is overdamped. Therefore, from (1.7),
s1 t s2 t – 200 t – 300 t
i t = in t = k1 e + k2 e = k1 e + k2 e (1.12)
The constants k 1 and k 2 can be evaluated from the initial conditions. Thus from the first initial
condition i L 0 = i 0 = 5 A and (1.12) we obtain
0 0
i 0 = k1 e + k2 e = 5
or
k1 + k2 = 5 (1.13)
We need another equation in order to compute the values of k 1 and k 2 . This equation will make
dv
use of the second initial condition, that is, v C 0 = 2.5 V . Since i C t = i t = C --------C- , we differ-
dt
entiate (1.12), we evaluate it at t = 0 + , and we equate it with this initial condition. Then,
di di
----- = – 200k 1 e –200 t – 300k 2 e –300 t and ----- = – 200k 1 – 300 k 2 (1.14)
dt dt +
t=0
+
Also, at t = 0 ,
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 15
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
+ di +
Ri 0 + L ----- + v c 0 = 15
dt +
t=0
and solving for di
----- we obtain
dt +
t=0
di
----- = 15 – 0.5 5 – 2.5 = 10000
--------------------------------------- (1.15)
dt + 10
–3
t=0
Next, equating (1.14) with (1.15) we obtain:
– 200k 1 – 300 k 2 = 10000
– k 1 – 1.5 k 2 = 50 (1.16)
Simultaneous solution of (1.13) and (1.16) yields k 1 = 115 and k 2 = – 110 . By substitution into
(1.12) we find the total response as
– 200 t – 300 t
i t = i n t = 115e – 110 e (1.17)
Check with MATLAB*:
syms t; % Define symbolic variable t
% Must have Symbolic Math Toolbox installed
R=0.5; L=10^(3); C=100*10^(3)/6; % Circuit constants
y0=115*exp(200*t)110*exp(300*t); % Let solution i(t)=y0
y1=diff(y0); % Compute the first derivative of y0, i.e., di/dt
y2=diff(y0,2); % Compute the second derivative of y0, i.e, di2/dt2
% Substitute the solution i(t), i.e., equ (1.17)
% into differential equation of (1.11) to verify that
% correct solution was obtained. We must also
% verify that the initial conditions are satisfied.
y=y2+500*y1+60000*y0;
i0=115*exp(200*0)110*exp(300*0);
vC0=R*i0L*(23000*exp(200*0)+33000*exp(300*0))+15;
fprintf(' \n');...
disp('Solution was entered as y0 = '); disp(y0);...
disp('1st derivative of solution is y1 = '); disp(y1);...
disp('2nd derivative of solution is y2 = '); disp(y2);...
disp('Differential equation is satisfied since y = y2+y1+y0 = '); disp(y);...
disp('1st initial condition is satisfied since at t = 0, i0 = '); disp(i0);...
disp('2nd initial condition is also satisfied since vC+vL+vR=15 and vC0 = ');...
disp(vC0);...
fprintf(' \n')
* An introduction to MATLAB is presented in Appendix A.
16 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
Solution was entered as y0 =
115*exp(-200*t)-110*exp(-300*t)
1st derivative of solution is y1 =
-23000*exp(-200*t)+33000*exp(-300*t)
2nd derivative of solution is y2 =
4600000*exp(-200*t)-9900000*exp(-300*t)
Differential equation is satisfied since y = y2+y1+y0 = 0
1st initial condition is satisfied since at t = 0, i0 = 5
2nd initial condition is also satisfied since vC+vL+vR=15 and vC0
= 2.5000
We denote the first term as i 1 t = 115e –200t , the second term as i 2 t = 110e –300t , and the total
current i t as the difference of these two terms. The response is shown in Figure 1.6.
– 200 t – 300 t
i t = 115e – 110 e
– 300 t
i 2 t = 110e
Current (A)
– 200 t
i 1 t = 115e
Time (sec)
Figure 1.6. Plot for i t of Example 1.1
In the above example, differentiation eliminated (set equal to zero) the right side of the differen-
tial equation and thus the total response was just the natural response. A different approach how-
ever, may not set the right side equal to zero, and therefore the total response will contain both
the natural and forced components. To illustrate, we will use the following approach.
t
1
The capacitor voltage, for all time t, may be expressed as v C t = ---- i dt and as before, the cir-
C –
cuit can be represented by the integrodifferential equation
t
di 1
Ri + L ----- + ----
dt C
–
i dt = 15 u 0 t (1.18)
and since
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 17
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Chapter 1 Second Order Circuits
dv
i = i C = C --------C-
dt
we rewrite (1.18) as 2
dv dv
RC --------C- + LC --------2C- + v C = 15 u 0 t (1.19)
dt dt
We observe that this is a nonhomogeneous differential equation whose solution will have both
the natural and the forced response components. Of course, the solution of (1.19) will give us the
capacitor voltage v C t . This presents no problem since we can obtain the current by differentia-
tion of the expression for v C t .
Substitution of the given values into (1.19) yields
2
50 dv dv
------ 10 –3 --------C- + 1 10 –3 100
--------- 10 –3 --------2C- + v C = 15 u 0 t
6 dt 6 dt
or 2
dv C dv 5
--------2- + 500 --------C- + 60000v C = 9 10 u 0 t (1.20)
dt dt
The characteristic equation of (1.20) is the same as of that of (1.11) and thus the natural response
is
s1 t s2 t – 200 t – 300 t
v Cn t = k 1 e + k2 e = k1 e + k2 e (1.21)
Since the right side of (1.20) is a constant, the forced response will also be a constant and we
denote it as v Cf = k 3 . By substitution into (1.20) we obtain
0 + 0 + 60000k 3 = 900000
or
v Cf = k 3 = 15 (1.22)
The total solution then is the summation of (1.21) and (1.22), that is,
– 200 t – 300 t
v C t = v Cn t + v Cf = k 1 e + k2 e + 15 (1.23)
As before, the constants k 1 and k 2 will be evaluated from the initial conditions. First, using
v C 0 = 2.5 V and evaluating (1.23) at t = 0 , we obtain
0 0
v C 0 = k 1 e + k 2 e + 15 = 2.5
or
k 1 + k 2 = – 12.5 (1.24)
Also,
dv dv i dv iL 0 5
i L = i C = C --------C- --------C- = ---L- and --------C- = -----------
- = -------------------------------
- = 300 (1.25)
dt dt C dt t=0
C 100 6 10
–3
18 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
Next, we differentiate (1.23), we evaluate it at t = 0 and equate it with (1.25). Then,
dv C – 200 t – 300 t dv
--------- = – 200k 1 e – 300k 2 e and --------C- = – 200k 1 – 300k 2 (1.26)
dt dt t=0
Equating the right sides of (1.25) and (1.26) we obtain
– 200k 1 – 300k 2 = 300
or
– k 1 – 1.5k 2 = 1.5 (1.27)
From (1.24) and (1.27), we obtain k 1 = – 34.5 and k 2 = 22 . By substitution into (1.23), we obtain
the total solution as
– 300 t – 200 t
v C t = 22e – 34.5 e + 15 u 0 t (1.28)
Check with MATLAB:
syms t % Define symbolic variable t. Must have Symbolic Math Toolbox installed
y0=22*exp(300*t)34.5*exp(200*t)+15; % The total solution y(t)
y1=diff(y0) % The first derivative of y(t)
y1 = -6600*exp(-300*t)+6900*exp(-200*t)
y2=diff(y0,2) % The second derivative of y(t)
y2 = 1980000*exp(-300*t)-1380000*exp(-200*t)
y=y2+500*y1+60000*y0 % Summation of y and its derivatives
y = 900000
Using the expression for v C t we can find the current as
dv 100 –3 – 200t – 300t – 200t – 300t
i = i L = i C = C --------C- = --------- 10 6900e – 6600 e = 115e – 110 e A (1.29)
dt 6
We observe that (1.29) is the same as (1.17). The plot for (1.28) is shown in Figure 1.7.
The same results are obtained with the Simulink/SimPowerSystems* model shown in Figure 1.8.
The waveforms for the current and the voltage across the capacitor are shown in Figure 1.9.
* For an introduction to Simulink SimPowerSystems please refer to Appendices B and C respectively.
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 19
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
Voltage (V)
– 300 t – 200 t
v C t = 22 e – 34.5 e + 15 u 0 t
Time (sec)
Figure 1.7. Plot for v C t of Example 1.1
Figure 1.8. Simulink/SimPowerSystems model for the circuit in Figure 1.5
Figure 1.9. Waveforms produced by the Simulink/SimPowerSystems model in Figure 1.8
110 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
1.2.2 Response of Series RLC Circuits with AC Excitation
The total response of a series RLC circuit, which is excited by a sinusoidal source, will also consist
of the natural and forced response components. As we found in the previous section, the natural
response can be overdamped, or critically damped, or underdamped. The forced component will
be a sinusoid of the same frequency as that of the excitation, and since it represents the AC
steadystate condition, we can use phasor analysis to find it. The following example illustrates the
procedure.
Example 1.2
For the circuit in Figure 1.10, i L 0 = 5 A , v C 0 = 2.5 V , and the 0.5 resistor represents the
resistance of the inductor. Compute and sketch i t for t 0 .
0.5 1 mH
vS
100 6 mF
it
v S = 200 cos 10000t u 0 t V
Figure 1.10. Circuit for Example 1.2
Solution:
This circuit is the same as that in Example 1.1 except that the circuit is excited by a sinusoidal
source; therefore it can be represented by the integrodifferential equation
t
di 1
Ri + L ----- + ----
dt C
0
i dt + v C 0 = 200 cos 10000t t0 (1.30)
whose solution consists of the summation of the natural and forced responses. We know its natu-
ral response from the previous example. We begin with
– 200 t – 300 t
i t = in t + if t = k1 e + k2 e + if t (1.31)
where the constants k 1 and k 2 will be evaluated from the initial conditions after i f t has been
found. The steady state (or forced) response will have the form i f t = k 3 cos 10 000t + in the
time domain ( t – domain ) and the form k 3 in the frequency domain ( j – domain ).
To find i f t we will use the phasor analysis relation I = V Z where I is the phasor current, V is
the phasor voltage, and Z is the impedance of the phasor circuit which, as we know, is
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 111
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Chapter 1 Second Order Circuits
–1
1 1 2 1
Z = R + j L – -------- = R + L – -------- tan L – -------- R
2
(1.32)
C C C
The inductive and capacitive reactances are
4 –3
X L = L = 10 10 = 10
and
1 1 –3
X C = -------- = --------------------------------------------- = 6 10
C 4
10 100 6 10
– 3
Then,
1 2
= 0.5 = 0.25 and L – -------- = 10 – 6 10 = 99.88
2 2 –3 2
R
C
Also, –1 –3 –1
–1
1 10 – 6 10 9.994
tan L – -------- R = tan ------------------------------------ = tan -------------
C 0.5 0.5
and this yields = 1.52 rads = 87.15 . Then, by substitution into (1.32),
o o
Z = 0.25 + 99.88 = 10 87.15
and thus o
V 200 0 o o
I = ---- = ---------------------------o = 20 –87.15 20 cos 10000t – 87.15 = i f t
Z 10 87.15
The total solution is
– 200 t – 300 t o
i t = in t + if t = k1 e + k2 e + 20 cos 10000t – 87.15 (1.33)
As before, the constants k 1 and k 2 are evaluated from the initial conditions. From (1.33) and the
first initial condition i L 0 = 5 A we obtain
0 0 o
i 0 = k 1 e + k 2 e + 20 cos – 87.15 = 5
or
i 0 = k 1 + k 2 + 20 0.05 = 5
or
k1 + k2 = 4 (1.34)
We need another equation in order to compute the values of k 1 and k 2 . This equation will make
dv
use of the second initial condition, that is, v C 0 = 2.5 V . Since i C t = i t = C --------C- , we differ-
dt
entiate (1.33), we evaluate it at t = 0 , and we equate it with this initial condition. Then,
di
----- = – 200k 1 e –200 t – 300k 2 e –300 t – 2 10 5 sin 10000t – 87.15 o (1.35)
dt
112 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Series RLC Circuit with DC Excitation
and at t = 0 ,
di 6 o 5
----- = – 200k 1 – 300k 2 – 2 10 sin – 87.15 = – 200k 1 – 300k 2 + 2 10 (1.36)
dt t=0
Also, at t = 0 +
+ di +
Ri 0 + L ----- + v c 0 = 200 cos 0 = 200
dt +
t=0
and solving for di
----- we obtain
dt +
t=0
di
----- = 200 – 0.5 5 – 2.5 = 195000
------------------------------------------ (1.37)
dt + 10
–3
t=0
Next, equating (1.36) with (1.37) we obtain
– 200k 1 – 300 k 2 = – 5000
or
k 1 + 1.5k 2 = 25 (1.38)
Simultaneous solution of (1.34) and (1.38) yields k 1 = – 38 and k 2 = 42 . Then, by substitution
into (1.31), the total response is
– 200 t – 300 t o
i t = – 38 e + 42e + 20 cos 10000t – 87.15 A (1.39)
The plot is shown in Figure 1.11 and it was created with the following MATLAB script:
t=0:0.005:0.25; t1=38.*exp(200.*t); t2=42.*exp(300.*t); t3=20.*cos(10000.*t87.5*pi/180);
x=t1+t2+t3; plot(t,t1,t,t2,t,t3,t,x); grid
– 300t
i 2 t = 42 e
i t
Current (A)
– 200t
i 1 t = – 38e
Time (sec)
Figure 1.11. Plot for i t of Example 1.2
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 113
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Chapter 1 Second Order Circuits
The same results are obtained with the Simulink/SimPowerSystems model shown in Figure 1.12.
Figure 1.12. Simulink/SimPowerSystems model for the circuit in Figure 1.10
The waveforms for the current and the voltage across the capacitor are shown in Figures 1.13 and
1.14 respectively. We observe that the steady-state current is consistent with the waveform shown
in Figure 1.11, and the steady state voltage across the capacitor is small since the magnitude of
the capacitive reactance is X C = 6 10 –3 .
Figure 1.13. Waveform displayed in Scope 1 for the Simulink/SimPowerSystems model in Figure 1.12
114 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
Figure 1.14. Waveform displayed in Scope 2 for the Simulink/SimPowerSystems model in Figure 1.12
1.3 Parallel RLC Circuit
Consider the circuit of Figure 1.10 where the initial conditions are i L 0 = I 0 , v C 0 = V 0 , and
u 0 t is the unit step function. We want to find an expression for the voltage v t for t 0 .
iG iL iC
vt G L C
iS u0 t
Figure 1.15. Parallel RLC circuit
For this circuit
iG t + iL t + iC t = iS t
or t
1 dv
Gv + ---
L 0
v dt + I 0 + C ------ = i S
dt
t0
By differentiation, 2
dv dv di
C -------2- + G ------ + --v- = ------S- t0 (1.40)
dt dt L dt
To find the forced response, we must first specify the nature of the excitation i S , that is DC or AC.
If i S is DC ( v S = cons tan t ), the right side of (1.40) will be zero and thus the forced response com-
ponent v f = 0 . If i S is AC ( i S = I cos t + , the right side of (1.40) will be another sinusoid and
therefore v f = V cos t + . Since in this section we are concerned with DC excitations, the
right side will be zero and thus the total response will be just the natural response.
The natural response is found from the homogeneous equation of (1.40), that is,
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 115
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Chapter 1 Second Order Circuits
2
dv dv v
C -------2- + G ------ + --- = 0 (1.41)
dt dt L
whose characteristic equation is
Cs + Gs + --1- = 0
2
L
or
2 G i- = 0
s + ---- s + -------
C LC
from which
2
G G 1
s 1 s 2 = – ------- ---------2 – -------- (1.42)
2C 4C LC
and with the following notations,
G 1
P = ------- 0 = ------------ P =
2
P – 0
2
nP =
2
0 – P
2
2C LC
(1.43)
or Damping Resonant Beta Damped Natural
Coefficient Frequency Coefficient Frequency
where the subscript p stands for parallel circuit, we can express (1.42) as
2 2 2 2
s 1 s 2 = – P P – 0 = – P P if P 0 (1.44)
or
2 2 2 2
s 1 s 2 = – P 0 – P = – P nP if 0 P (1.45)
Note: From (1.4), Page 13, and (1.43), Page 114, we observe that S P
As in the series circuit, the natural response v n t can be overdamped, critically damped, or
underdamped.
Case I: If 2P 20 , the roots s 1 and s 2 are real, negative, and unequal. This results in the over-
damped natural response and has the form
s1 t s2 t
vn t = k1 e + k2 e (1.46)
Case II: If 2P = 20 , the roots s 1 and s 2 are real, negative, and equal. This results in the criti-
cally damped natural response and has the form
–P t
vn t = e k1 + k2 t (1.47)
Case III: If 20 2P , the roots s 1 and s 2 are complex conjugates. This results in the under-
damped or oscillatory natural response and has the form
116 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
–P t –P t
vn t = e k 1 cos nP t + k 2 sin nP t = k 3 e cos nP t + (1.48)
1.3.1 Response of Parallel RLC Circuits with DC Excitation
Depending on the circuit constants G (or R), L, and C, the natural response of a parallel RLC cir-
cuit may be overdamped, critically damped or underdamped. In this section we will derive the
total response of a parallel RLC circuit which is excited by a DC source for the example which fol-
lows.
Example 1.3
For the circuit of Figure 1.16, i L 0 = 2 A and v C 0 = 5 V . Compute and sketch v t for t 0 .
iR iL iC
vt 32 10 H 1 640 F
10u 0 t A
Figure 1.16. Circuit for Example 1.3
Solution:
We could write the integrodifferential equation that describes the given circuit, differentiate, and
find the roots of the characteristic equation from the homogeneous differential equation as we did
in the previous section. However, we will skip these steps and begin with
v t = vf t + vn t (1.49)
di
and when steadystate conditions have been reached, we will have v = v L = L ----- = 0 , v f = 0
dt
and v t = v n t .
To find out whether the natural response is overdamped, critically damped, or oscillatory, we need
to compute the values of P and 0 using (1.43) and the values of s 1 and s 2 using (1.44) or
(1.45). Then we will use (1.46), or (1.47), or (1.48) as appropriate. For this example,
G- = ----------
P = ------ 1 - = ------------------------------------
1 - = 10
2C 2RC 2 32 1 640
or 2
P = 100
and
2 1 - = ---------------------------
0 = ------- 1 - = 64
LC 10 1 640
Then
2 2
s 1 s 2 = – P P – 0 = – 10 6
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 117
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Chapter 1 Second Order Circuits
or s 1 = – 4 and s 2 = – 16 . Therefore, the natural response is overdamped and from (1.46) we
obtain
s1 t s2 t –4 t – 16 t
v t = vn t = k1 e + k2 e = k1 e + k2 e (1.50)
and the constants k 1 and k 2 will be evaluated from the initial conditions.
With the initial condition v C 0 = v 0 = 5 V and (1.50) we obtain
0 0
v 0 = k1 e + k2 e = 5
or
k1 + k2 = 5 (1.51)
The second equation that is needed for the computation of the values of k 1 and k 2 is found from
dv dv
the other initial condition, that is, i L 0 = 2 A . Since i C t = C --------C- = C ------ , we differentiate
dt dt
(1.50), we evaluate it at t = 0 + , and we equate it with this initial condition.Then,
dv dv
------ = – 4k 1 e –4 t – 16k 2 e –16 t and ------ = – 4k 1 – 16 k 2 (1.52)
dt dt +
t=0
+
Also, at t = 0
1- + + dv
--- v 0 + i L 0 + C ------ = 10
R dt +
t=0
and solving for dv
------ we obtain
dt +
t=0
dv 10 – 5 32 – 2
------ = ------------------------------- = 502 (1.53)
dt +
1 640
t=0
Next, equating (1.52) with (1.53) we obtain
– 4k 1 – 16 k 2 = 502
or
– 2k 1 – 8 k 2 = 251 (1.54)
Simultaneous solution of (1.51) and (1.54) yields k 1 = 291 6 , k 2 = – 261 6 , and by substitution
into (1.50) we obtain the total response as
291 –4 t 261 –16 t –4 t – 16 t
v t = v n t = --------- e – --------- e = 48.5e – 43.5 e V (1.55)
6 6
Check with MATLAB:
syms t % Define symbolic variable t. Must have Symbolic Math Toolbox installed
y0=291*exp(4*t)/6261*exp(16*t)/6; % Let solution v(t) = y0
118 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
y1=diff(y0) % Compute and display first derivative
y1 = -194*exp(-4*t)+696*exp(-16*t)
y2=diff(y0,2) % Compute and display second derivative
y2 = 776*exp(-4*t)-11136*exp(-16*t)
y=y2/640+y1/32+y0/10 % Verify that (1.40) is satisfied
y = 0
The plot is shown in Figure 1.17.
– 4t
v 1 t = 48.5 e
Voltage (V)
vt
– 16t
v 2 t = – 43.5 e
Time (sec)
Figure 1.17. Plot for v t of Example 1.3
From the plot of Figure 1.17, we observe that v t attains its maximum value somewhere in the
interval 0.10 and 0.12 sec., and the maximum voltage is approximately 24 V . If we desire to com-
pute precisely the maximum voltage and the exact time it occurs, we can compute the derivative
of (1.55), set it equal to zero, and solve for t . Thus,
dv –4 t – 16 t
------ = – 1164e + 4176e = 0 (1.56)
dt t=0
Division of (1.56) by e –16t yields
12t
– 1164e + 4176 = 0
or
12t 348
e = ---------
97
or
348
12t = ln --------- = 1.2775
97
and
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 119
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Chapter 1 Second Order Circuits
1.2775
t = t max = ---------------- = 0.106 s
12
By substitution into (1.55)
– 4 x0.106 – 16 x0.106
v max = 48.5e – 43.5 e = 23.76 V (1.57)
A useful quantity, especially in electronic circuit analysis, is the settling time, denoted as t S , and it
is defined as the time required for the voltage to drop to 1% of its maximum value. Therefore, t S
is an indication of the time it takes for v t to dampout, meaning to decrease the amplitude of
v t to approximately zero. For this example, 0.01 23.76 = 0.2376 V , and we can find t S by sub-
stitution into (1.55). Then,
– 4t – 16t
0.01v max = 0.2376 = 48.5e – 43.5e (1.58)
and we need to solve for the time t . To simplify the computation, we neglect the second term on
the right side of (1.58) since this component of the voltage damps out much faster than the other
component. This expression then simplifies to
–4 ts
0.2376 = 48.5e
or
– 4 t S = ln 0.005 = – 5.32
or
t S = 1.33 s (1.59)
Example 1.4
For the circuit of Figure 1.18, i L 0 = 2 A and v C 0 = 5 V , and the resistor is to be adjusted so
that the natural response will be critically damped.Compute and sketch v t for t 0 .
iR iL iC
vt 10 H 1 640 F
10u 0 t A
Figure 1.18. Circuit for Example 1.4
Solution:
Since the natural response is to be critically damped, we must have 20 = 64 because the L and C
values are the same as in the previous example. Please refer to (1.43), Page 116. We must also
have
G 1 1
P = ------- = ----------- = 0 = -------- = 8
2C 2RC LC
or
120 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
2-
1- = 8 -------- 1-
--- = -----
R 640 40
or R = 40 and thus s 1 = s 2 = – P = – 8 . The natural response will have the form
–P t – 8t
v t = vn t = e k 1 + k 2 t or v t = v n t = e k 1 + k 2 t (1.60)
Using the initial condition v C 0 = 5 V , and evaluating (1.60) at t = 0 , we obtain
0
v 0 = e k1 + k2 0 = 5
or
k1 = 5 (1.61)
and (1.60) simplifies to – 8t
v t = e 5 + k2 t (1.62)
As before, we need to compute the derivative dv dt in order to apply the second initial condition
and find the value of the constant k 2 .
We obtain the derivative using MATLAB as follows:
syms t k2; v0=exp(8*t)*(5+k2*t); v1=diff(v0); % v1 is 1st derivative of v0
% Must have Symbolic Math Toolbox installed
v1 = -8*exp(-8*t)*(5+k2*t)+exp(-8*t)*k2
Thus,
dv
------ = – 8e –8t 5 + k 2 t + k 2 e –8t
dt
and
dv
------ = – 40 + k 2 (1.63)
dt t=0
dv i
Also, i C = C ------ or dv
------ = ---C- and
dt dt C
+ + +
dv iC 0 IS –iR 0 – iL 0
------ = --------------
- = ------------------------------------------- (1.64)
dt +
C C
t=0
or
dv IS – vC 0 R – iL 0 10 – 5 40 – 2 7.875
------ = -------------------------------------------------- = ------------------------------- = ---------------- = 5040 (1.65)
dt t=0
C 1 640 1 640
Equating (1.63) with (1.65) and solving for k 2 we obtain
– 40 + k 2 = 5040
or
k 2 = 5080 (1.66)
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 121
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Chapter 1 Second Order Circuits
and by substitution into (1.62), we obtain the total solution as
– 8t
v t = e 5 + 5080t V (1.67)
Check with MATLAB:
syms t; y0=exp(8*t)*(5+5080*t); y1=diff(y0) % Compute 1st derivative
% Must have Symbolic Math Toolbox installed
y1 = -8*exp(-8*t)*(5+5080*t)+5080*exp(-8*t)
y2=diff(y0,2) % Compute 2nd derivative
y2 = 64*exp(-8*t)*(5+5080*t)-81280*exp(-8*t)
y=y2/640+y1/40+y0/10 % Verify differential equation, see (1.40), Pg 1-15
y = 0
The plot is shown in Figure 1.19.
Voltage (V)
Time (sec)
Figure 1.19. Plot for v t of Example 1.4
By inspection of (1.67), we see that at t = 0 , v t = 5 V and thus the second initial condition is
satisfied. We can verify that the first initial condition is also satisfied by differentiation of (1.67).
We can also show that v t approaches zero as t approaches infinity with L’Hôpital’s rule, i.e.,
d-
---- 5 + 5080t
– 8t 5 + 5080t dt 5080
lim v t = lim e 5 + 5080t = lim ---------------------------
- = lim --------------------------------- = lim -----------
- = 0 (1.68)
t t t e
8t t d
----- e 8t t 8e
8t
dt
Example 1.5
For the circuit of Figure 1.20, i L 0 = 2 A and v C 0 = 5 V . Compute and sketch v t for t 0 .
122 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
iR iL iC
vt 50 10 H 1 640 F
10u 0 t A
Figure 1.20. Circuit for Example 1.5
Solution:
This is the same circuit as the that of the two previous examples except that the resistance has
been increased to 50 . For this example,
G- = ----------
P = ------ 1 - = ------------------------------------
1 - = 6.4
2C 2RC 2 50 1 640
or 2
P = 40.96
and as before,
2 1 1
0 = -------- = ---------------------------- = 64
LC 10 1 640
Also, 20 2P . Therefore, the natural response is underdamped with natural frequency
2 2
nP = 0 – P = 64 – 40.96 = 23.04 = 4.8
Since v f = 0 , the total response is just the natural response. Then, from (1.48),
–P t – 6.4t
v t = v n t = ke cos nP t + = ke cos 4.8t + (1.69)
and the constants k and will be evaluated from the initial conditions.
From the initial condition v C 0 = v 0 = 5 V and (1.69) we obtain
0
v 0 = ke cos 0 + = 5
or
k cos = 5 (1.70)
To evaluate the constants k and we differentiate (1.69), we evaluate it at t = 0 , we write the
equation which describes the circuit at t = 0 + , and we equate these two expressions. Using MAT-
LAB we obtain:
syms t k phi; y0=k*exp(6.4*t)*cos(4.8*t+phi); y1=diff(y0)
% Must have Symbolic Math Toolbox installed
y1 = -32/5*k*exp(-32/5*t)*cos(24/5*t+phi)
-24/5*k*exp(-32/5*t)*sin(24/5*t+phi)
pretty(y1)
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 123
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
- 32/5 k exp(- 32/5 t) cos(24/5 t + phi)
- 24/5 k exp(- 32/5 t) sin(24/5 t + phi)
Thus,
dv – 6.4t – 6.4t
------ = – 6.4ke cos 4.8t + – 4.8ke sin 4.8t + (1.71)
dt
and
dv
------ = – 6.4k cos – 4.8k sin
dt t=0
By substitution of (1.70), the above expression simplifies to
dv
------ = – 32 – 4.8k sin (1.72)
dt t=0
dv i
Also, i C = C ------ or dv
------ = ---C- and
dt dt C
+ + +
dv iC 0 IS –iR 0 – iL 0
------ = --------------
- = ------------------------------------------
-
dt +
C C
t=0
or
dv IS – vC 0 R – iL 0 – 5 50 – 2- = 7.9 640 = 5056
------ = -------------------------------------------------- = 10
------------------------------ (1.73)
dt t=0
C 1 640
Equating (1.72) with (1.73) we obtain
– 32 – 4.8k sin = 5056
or
k sin = – 1060 (1.74)
The phase angle can be found by dividing (1.74) by (1.70). Then,
k sin = tan = –
--------------- 1060- = – 212
--------------
k cos 5
or –1
= tan – 212 = – 1.566 rads = – 89.73 deg
The value of the constant k is found from (1.70) as
k cos – 1.566 = 5
or
5
k = ------------------------------ = 1042
cos – 1.566
and by substitution into (1.69), the total solution is
– 6.4t
v t = 1042e cos 4.8t – 89.73 (1.75)
The plot is shown in Figure 1.21.
124 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
Voltage (V)
Time (sec)
Figure 1.21. Plot for v t of Example 1.5
From the plot of Figure 1.21 we observe that the maximum value occurs somewhere between
t = 0.10 sec and t = 0.20 sec , while the minimum value occurs somewhere between t = 0.73 sec
and t = 0.83 sec . Values for the maximum and minimum accurate to 3 decimal places are deter-
mined with the MATLAB script below.
fprintf(' \n');
disp(' t Vc');
disp('-----------------');
t=0.10:0.01:0.20; Vc=zeros(11,2); Vc(:,1)=t';
Vc(:,2)=1042.*exp(6.4.*t).*cos(4.8.*t87.5*pi./180);
fprintf('%0.2f\t %8.3f\n',Vc')
t Vc
-----------------
0.10 274.736
0.11 278.822
0.12 280.743
0.13 280.748
0.14 279.066
0.15 275.911
0.16 271.478
0.17 265.948
0.18 259.486
0.19 252.242
0.20 244.354
fprintf(' \n');
disp(' t Vc');
disp('-----------------');
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 125
Copyright © Orchard Publications
Chapter 1 Second Order Circuits
t=0.73:0.01:0.83; Vc=zeros(11,2); Vc(:,1)=t';
Vc(:,2)=1042.*exp(6.4.*t).*cos(4.8.*t87.5*pi./180);
fprintf('%0.2f\t %8.3f\n',Vc')
t Vc
-----------------
0.73 -3.850
0.74 -4.010
0.75 -4.127
0.76 -4.205
0.77 -4.248
0.78 -4.261
0.79 -4.246
0.80 -4.208
0.81 -4.149
0.82 -4.073
0.83 -3.981
The maximum and minimum values and the times at which they occur are listed in the table
below.
t (sec) v (V)
Maximum 0.13 280.748
Minimum 0.78 4.261
Alternately, we can find the maxima and minima by differentiating the response of (1.75) and set-
ting it equal to zero.
1.3.2 Response of Parallel RLC Circuits with AC Excitation
The total response of a parallel RLC circuit that is excited by a sinusoidal source also consists of
the natural and forced response components. The natural response will be overdamped, critically
damped or underdamped. The forced component will be a sinusoid of the same frequency as that
of the excitation, and since it represents the AC steadystate condition, we can use phasor analy-
sis to find the forced response. We will derive the total response of a parallel RLC circuit which is
excited by an AC source with the following example.
Example 1.6
For the circuit of Figure 1.22, i L 0 = 2 A and v C 0 = 5 V . Compute and sketch v t for t 0 .
126 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
Copyright © Orchard Publications
Parallel RLC Circuit
iR iL iC
vt 50 10 H 1 640 F
iS
i S = 20 sin 6400t + 90 u 0 t A
Figure 1.22. Circuit for Example 1.6
Solution:
This is the same circuit as the previous example where the DC source has been replaced by an AC
source. The total response will consist of the natural response v n t which we already know from
the previous example, and the forced response v f t which is the AC steadystate response, will be
found by phasor analysis.
The t – domain to j – domain j transformation yields
i s t = 20 sin 6400t + 90 = 20 cos 6400t I = 20 0
The admittance Y is
–1
1 1 2 1
Y = G + j C – -------- = G + C – -------- tan C – -------- G
2
L L L
where
1- = ----- 1-
1- , C = 6400 -------- 1 1 - = --------------
1 -
G = --- = 10 and -------- = -----------------------
R 50 640 L 6400 10 64000
and thus
1 2 1 2 –1
1 1
Y = ----- - tan 10 – --------------- ------ = 10 89.72
- + 10 – --------------
50 64000 64000 50
Now, we find the phasor voltage V as
I 20 0
V = ---- = --------------------------- = 2 – 89.72
Y 10 89.72
and j – domain to t – domain transformation yields
V = 2 – 89.72 v f t = 2 cos 6400t – 89.72
The total solution is
– 6.4t
v t = v n t + v f t = ke cos 4.8t + + 2 cos 6400t – 89.72 (1.76)
Now, we need to evaluate the constants k and .
With the initial condition v C 0 = 5 V (1.76) becomes
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 127
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Chapter 1 Second Order Circuits
0
v 0 = v C 0 = ke cos + 2 cos – 89.72 = 5
or
k cos 5 (1.77)
To make use of the second initial condition, we differentiate (1.76) using MATLAB as follows,
and then we evaluate it at t = 0 .
syms t k phi; y0=k*exp(-6.4*t)*cos(4.8*t+phi)+2*cos(6400*t-1.5688); % Must have Sym Math
y1=diff(y0); % Differentiate v(t) of (1.76)
y1 = -32/5*k*exp(-32/5*t)*cos(24/5*t+phi)-24/5*k*exp(-32/
5*t)*sin(24/5*t+phi)-12800*sin(6400*t-1961/1250)
or
dv
------ = – 6.4ke
– 6.4t
cos 4.8t + – 4.8ke
– 6.4t
sin 4.8t + – 12800 sin 6400t – 1.5688
dt
and
dv
------ = – 6.4k cos – 4.8k sin – 12800 sin – 1.5688
dt t=0 (1.78)
= – 6.4k cos – 4.8k sin + 12800
With (1.77) we obtain
dv
------ = – 32 – 4.8k sin + 12800 – 4.8k sin + 12832 (1.79)
dt t=0
dv i
Also, i C = C ------ or dv
------ = ---C- and
dt dt C
+ + + +
dv iC 0 iS 0 –iR 0 – iL 0
------ = --------------
- = -----------------------------------------------------
-
dt +
C C
t=0
or +
dv iS 0 – vC 0 R – iL 0 20 – 5 50 – 2- = 11456
------ = ------------------------------------------------------------
- = ------------------------------ (1.80)
dt t=0
C 1 640
Equating (1.79) with (1.80) and solving for k we obtain
– 4.8k sin + 12832 = 11456
or
k sin = 287
Then with (1.77) and (1.81),
k sin 287
--------------- = tan = --------- = 57.4
k cos 5
or
= 1.53 rad = 89
The value of the constant k is found from (1.77), that is,
128 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
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Parallel RLC Circuit
k = 5 cos 89 = 279.4
By substitution into (1.76), we obtain the total solution as
– 6.4t
v t = 279.4e cos 4.8t + 89 + 2 cos 6400t – 89.72 (1.81)
With MATLAB we obtain the plot shown in Figure 1.23. The plot was created with the MAT-
LAB script below.
t=0: 0.01: 1; vt=279.4.*exp(-6.4.*t).*cos(4.8.*t+89*pi./180)+2.*cos(6400.*t-89.72.*pi./180);
plot(t,vt); grid
Figure 1.23. Plot for v t of Example 1.6
The same results are obtained with the Simulink/SimPowerSystems model shown in Figure 1.24.
Figure 1.24. Simulink/SimPowerSystems model for the circuit in Figure 1.23
The waveform displayed by the Scope block is shown in Figures 1.25, and we observe that it is
consistent with the waveform shown in Figure 1.23.
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 129
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Chapter 1 Second Order Circuits
Figure 1.25. Waveform displayed by the Scope block in Figure 1.24
1.4 Other Second Order Circuits
Second order circuits are not restricted to RLC circuits. They include amplifiers and filter among
others, and since it is beyond the scope of this text to analyze such circuits in detail, we will illus-
trate the transient analysis of a second order active lowpass filter.
Example 1.7
The circuit of Figure 1.26 a known as a Multiple Feed Back (MFB) active lowpass filter. For this
circuit, the initial conditions are v C1 = v C2 = 0 . Compute and sketch v out t for t 0 .
40 k R2 C2 10 nF
R1 50 k
+ v1 R v2
200 k 3 +
vin vout
C1 25 nF
vin(t)= (6.25 cos 6280t)u(t) V
Figure 1.26. Circuit for Example 1.7
Solution:
At node V 1 :
v 1 – v in dv v 1 – v out v 1 – v 2
----------------- + C 1 --------1 + ------------------- + ---------------- = 0 t 0 (1.82)
R1 dt R2 R3
At node V 2 :
v2 – v1 dv out
---------------- = C 2 -----------
- (1.83)
R3 dt
130 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
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Other Second Order Circuits
We observe that v 2 = 0 (virtual ground).
Collecting like terms and rearranging (1.83) and (1.84) we obtain
1
----- 1 1 dv 1 1
- + ------ + ------ v 1 + C 1 --------1 – ------ v out = ------ v in (1.84)
R1 R2 R3 dt R 2 R1
and
dv out
v 1 = – R 3 C 2 -----------
- (1.85)
dt
Differentiation of (1.86) yields 2
dv dv out
--------1 = – R 3 C 2 -------------
2
- (1.86)
dt dt
and by substitution of given numerical values into (1.85) through (1.87), we obtain
1 - + -----------------
----------------- 1 - v + 25 10 –9 dv
1 - + ----------------- 1 -
--------1 – ----------------- 1
v out = ------------------5 v in
2 10 5 4 10 4 5 10 4 1 dt 4 10 4
2 10
or
–3 –9 dv 1
0.05 10 v 1 + 25 10 -------- – 0.25 10 –4 v out = 0.5 10 –5 v in (1.87)
dt
– 4 dv out
v 1 = – 5 10 -----------
- (1.88)
dt
2
dv – 4 d v out
--------1 = – 5 10 -------------
2
- (1.89)
dt dt
Next, substitution of (1.89) and (1.90) into (1.88) yields
2
– 4 dv out d v out
0.05 10 – 5 10 -----------
–3
- + 25 10 –9 – 5 10 –4 -------------
- (1.90)
dt dt
2
–4 –5
– 0.25 10 v out = 0.5 10 v in
or 2
– 13 d v out – 7 dv out
– 125 10 -------------- - – 0.25 10 –4 v out = 10 –4 v in
– 0.25 10 -----------
dt
2 dt
and division by – 125 10 –13 yields
2
d dv out
v out- + 2 10 3 -----------
-------------- - + 2 10 6 v out = – 1.6 10 5 v in
dt
2 dt
or 2
d v out 3 dv out
--------------
- + 2 10 ------------ + 2 10 6 v out = – 10 6 cos 6280t (1.91)
dt
2 dt
Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling 131
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Chapter 1 Second Order Circuits
We use MATLAB to find the roots of the characteristic equation of (1.92).
syms s; y0=solve('s^2+2*10^3*s+2*10^6') % Must have Symbolic Math Toolbox installed
y0 =
[-1000+1000*i]
[-1000-1000*i]
that is,
s 1 ,s 2 = – j = – 1000 j1000 = 1000 – 1 j1
We cannot classify the given circuit as series or parallel and therefore, we should not use the
damping ratio S or P . Instead, for the natural response v n t we will use the general expression
s1 t s2 t – t
v n t = Ae + Be = e k 1 cos t + k 2 sin t (1.92)
where
s 1 ,s 2 = – j = – 1000 j1000
Therefore, the natural response is oscillatory and has the form
– 1000t
vn t = e k 1 cos 1000t + k 2 sin 1000t (1.93)
Since the right side of (1.92) is a sinusoid, the forced response has the form
v f t = k 3 cos 6280t + k 4 sin 6280t (1.94)
Of course, for the derivation of the forced response we could use phasor analysis but we must first
derive an expression for the impedance or admittance, since the expressions we used earlier were
for series and parallel circuits only.
The coefficients k 3 and k 4 will be found by substitution of (1.95) into (1.92) and then by equat-
ing like terms. Using MATLAB we obtain:
syms t k3 k4; y0=k3*cos(6280*t)+k4*sin(6280*t); y1=diff(y0)
y1 =
-6280*k3*sin(6280*t)+6280*k4*cos(6280*t)
y2=diff(y0,2)
y2 =
-39438400*k3*cos(6280*t)-39438400*k4*sin(6280*t)
y=y2+2*10^3*y1+2*10^6*y0
y =
-37438400*k3*cos(6280*t)-37438400*k4*sin(6280*t)-
12560000*k3*sin(6280*t)+12560000*k4*cos(6280*t)
Equating like terms with (1.92) we obtain
132 Circuit Analysis II with MATLAB Computing and Simulink / SimPowerSystems Modeling
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Another Random Document on
Scribd Without Any Related Topics
In proceeding to medication the state of the general system first
demands consideration. If there be increased vascular action and
temperature, with evidences of active congestion of the pelvic
region, manifested by pain, distension, and tenderness of the
hypogastric region, with heat and throbbing of the passages, arterial
sedatives and relaxants will be demanded. Aconite or veratrum viride
may be given until an effect is produced on the pulse, and they may
be combined to advantage with salines, as the liquor ammonii
acetatis. It is in these conditions, of rare occurrence, that nauseants,
such as ipecacuanha, are of service.
Medicines having a more direct action in checking uterine
hemorrhage produce their effect by exciting contraction of the
uterine walls and blood-vessels, moderating congestion, and
modifying the condition of the nervous system. They are ergot,
digitalis, bromide of potassium, quinine, cannabis indica, and
cinnamon.
Ergot stands at the head of the list from its well-known effect in
causing uterine contraction, and although reliable in proportion to
the increased size of the uterus and the distension of its cavity, it is
indicated in almost all cases for its hæmostatic action on the
capillaries, as well as for its specific action on the uterus. Digitalis
slows the action of the heart and excites the contractility of the
arterioles, while experience has proved it to be an efficient remedy
for menorrhagia. Bromide of potassium moderates vascular and
nervous excitement of the pelvic organs, and is especially indicated
in cases having an ovarian origin. Several of the French writers give
very strong testimony in favor of the efficacy of cinnamon as a
remedy, having tested it in a large number of cases without other
medicines. It may always be used as an adjuvant.
All these medicines may be combined in various proportions, and
they should be given in full doses. Infusion is the best form for the
administration of digitalis. Sulphate of quinia in doses of gr. vj-x is
often an efficient remedy, and especially in cases where there have
been malarial influences. Cannabis indica is stated, by very high
authority, to be one of the best remedies, although its mode of
action is not clear. Iron should be administered as an hæmostatic
tonic, and not merely because there is some uterine disease or
derangement.
The action of medicines may be supplemented by local applications.
Cloths wrung out of cold water or vinegar and water may be applied
to the hypogastric region or to the vulva. A bladder or rubber bag
filled with pounded ice may be laid on the abdomen above the
pubes, or applied to the lumbar region for its effect upon the spinal
cord. One of the most efficient means of applying cold is by an
enema of cold water, or, this failing, of ice-water. The rectum and
uterus being contiguous, the cold is applied almost directly. Siredey
speaks highly of the cold douche to the soles of the feet, the water
being projected in jets from a sprinkler. During the application
uterine contractions are felt and the flow stops. This is more
especially adapted to debilitated and anæmic patients with loss of
vascular tone. Patients will often object to the application of cold to
check a flow of blood from the uterus, knowing well the bad effects
of suppression of menstruation which often results from exposure to
this agent. It is believed that evil results never follow the application
of cold when the flow is excessive; perhaps because the system and
the organs concerned have been relieved.
The application of heat is also an efficient remedy—hot-water bags
to the spine on Chapman's plan, or hot vaginal injections may be
administered, as recommended by Trousseau and Emmet, the water
being at a temperature as high as the patient can bear. To be
properly administered the aid of a nurse is required, as the flow
should be kept up for some time, at least a gallon of water being
used.
There is only apparent contradiction in the use of both cold and heat
to check uterine hemorrhage. Various explanations of the action of
both have been given, and much argument presented why one
should act better than, or be preferred to, the other. The truth is,
that both are efficacious, and the value of both is based upon clinical
experience.
The flow in menorrhagia is sometimes, if rarely, so excessive as to
demand mechanical means of restraint. A well-applied tampon gives
absolute control, and should never be omitted when the hemorrhage
is severe and the practitioner is not within easy reach of the patient.
Plugging the cervix with a sponge tent, supported by a vaginal
tampon, is to be preferred as most reliable, and also because upon
its removal the uterus can be explored for diagnosis or is prepared
for direct applications. Should a vaginal tampon alone be trusted, it
must be thoroughly applied to be reliable. This can only be done
through a speculum, preferably with Sims's duckbill. Pledgets or
discs of cotton, the first provided with strings to facilitate removal,
squeezed out of a carbolized saturated solution of alum, should be
packed carefully and firmly around and over the cervix, and the
vagina filled. A folded napkin to the vulva, supported by the usual T
bandage, sustains the whole. Such a tampon may remain, if
necessary, thirty-six hours, the catheter being used to relieve the
bladder.
Direct applications to the interior of the uterus are sometimes
necessary both to check the flow and, in some cases, especially
those dependent upon fungous growths of the endometrium, as a
means of cure. They may be either fluid by application or injection,
or solid. The former may be by swabbing the interior of the uterus
by means of an applicator armed with cotton dipped in the liquid, or
by injection. The drugs used for application are carbolic acid diluted
with glycerin or pure tincture of iodine, or the stronger tincture
known as Churchill's, Monsell's solution, or the liquor ferri perchloridi
diluted or of full strength. The preparations of iron are objectionable
from the hard, gritty, and disagreeable coagula formed, and the
tincture of iodine is generally quite as efficient as a hæmostatic and
more active as an alterative.
For efficient application the cervix should be dilated if not sufficiently
patulous, and a cervical speculum should be used, or the solution
will be squeezed out of the cotton before it reaches the seat of the
disease. For injection the same articles are used, beginning with
weaker solutions and gradually increasing the strength. They should
never be resorted to without the utmost caution. The os should be
patulous as a sine quâ non, and the injection carefully administered.
In case the os is open the instrument may be the common extra
long-pipe rubber syringe bent to a suitable curve by heating. This
having been charged with a drachm or so of the liquid, the end is
served with cotton like an applicator; over this several clove-hitch
turns with a string are taken, so that the cotton may be withdrawn if
pulled off in the uterus. The pipe is then carried to the fundus and
the piston very slowly depressed. Buttle's syringe is a more elegant
and a safer instrument in cases where the os is not thoroughly
opened. The terminal pipe of this instrument is very slender and
perforated with minute openings, and the piston is forced in by
screw-action of the handle, so that the fluid is expelled drop by drop.
Nitrate of silver is sometimes applied in solid form to the interior of
the uterus, both as a means of checking excessive hemorrhage and
to effect a cure by modifying the condition of the endometrium. It
may be done with a probe, the end of which has been coated with
the substance, passed in detail over the inner surface of the organ.
A piece of the solid caustic is also sometimes carried into the uterus
and left there, the application à demeure of the French, some of
whom claim that in their hands this measure has never failed to
check the hemorrhage.
In those cases where positive evidence has been gained that the
disease depends upon fungous growths of the endometrium there is
yet another and a more reliable remedy. It is the curette. By this
instrument the growths which are the origin of the menorrhagia can
be certainly and safely removed, their return prevented by a
thorough application of iodine to the surface from which they spring,
and a cure often effected when all other means have failed.
Intra-uterine applications, injections, and surgical measures affecting
the interior of the uterus have been detailed, as they are advised
and used by authorities. It remains to give an opinion as to their
merits, and to state the precautions which should be taken when
they are resorted to.
First, it must be said that there is a very considerable difference of
opinion as to the safety of these measures. While some do not
hesitate to apply to the interior of the uterus fuming nitric acid, and
introduce pieces of nitrate of silver to dissolve there, others are
extremely careful about making any applications to this part, and
reject intra-uterine injections altogether. Nor can it be denied that
very severe symptoms have frequently, and death sometimes,
followed the application of these remedies. In resorting to them,
therefore, the practitioner cannot be too minute in observing every
precaution, and they should never be resorted to if evidence of peri-
uterine inflammation exists. No intra-uterine injection should be
given unless the os be patulous, and the fluid should be thrown in
with the utmost gentleness. The milder articles should be tried first,
and the severer only as the temper of the uterus is tested. Always
treat the patient afterward as the subject of an operation, keep her
in bed strictly, and combat the first symptoms of trouble with opium.
While the writer would not be just to the reader if he did not state
that some very high authorities are strongly opposed to intra-uterine
injections and applications, he would not be just to himself did he
not state that his own experience has been favorable to them. While
he once saw severe and dangerous symptoms follow syringing the
cervix with water to cleanse it of mucus, he never in a single
instance saw any evil effects from intra-uterine injections properly
administered, nor from nitrate of silver à demeure or the application
of nitric acid. But while these measures have often ameliorated
cases of menorrhagia where the endometrium was affected, they
have seldom cured, as compared with the curette. Indeed, the
general statement may be made that as of late years the value of
the curette has become more and more recognized, resort to severe
intra-uterine applications has proportionally diminished. From his
experience he is fully prepared to believe with Courty, that "there are
cases of uterine hemorrhage which cannot be mastered in any other
way," and with Siredey, that "the operation cures in the great
majority of cases." It should be noted, in this connection, that some
of the warmest advocates of the instrument explain its beneficial
effects otherwise than by the removal of fungosities. Thus, Thomas
attributes them to "the fracture of tortuous and distended blood-
vessels," and Siredey to "the irritation and excitation produced by its
introduction and action during reflex contractions."
INFLAMMATION OF THE PELVIC CELLULAR
TISSUE AND PELVIC PERITONEUM.
BY B. F. BAER, M.D.
The subject of inflammation of the tissues surrounding the uterus
and its appendages would be very much simplified, especially for the
general practitioner, by debarring it of all new and superfluous
names and subdivisions, and by treating it on a broad clinical basis.
It will be my aim in this paper to keep that idea constantly in view,
rather than to follow the history and varying pathological views by
which it has been surrounded and complicated.
The importance of this disease is probably greater in its influence on
the health and future usefulness of the woman than any other; and
its causes and prevention, as well as its early recognition and
treatment, should be fully understood by the physicians who are
most likely to be first consulted in the matter, those engaged in
general practice. I feel safe in making the statement that were this
so, many of the chronic cases of almost incurable displacement of
the uterus, Fallopian tubes, and ovaries, resulting from thickened,
indurated, and contracted ligaments, with their distressing
symptoms, would never reach the gynecologist, because they would
not then exist. In many cases the disease would have been
prevented; in others it would have been arrested in its incipiency.
Whether we understand the primary pathological lesion to be
inflammation of the cellular tissue, the peritoneum, the lymphatics,
or the veins, matters very little, practically, if we recognize the
immediate location of the process; for there can be no doubt that
the disease, once started, soon involves to a greater or less degree
all of the tissues and organs adjacent to it, and the therapeutic
requirements will be much the same in either case.
That inflammation of the cellular tissue can exist without also
involving the peritoneum in its neighborhood is scarcely to be
conceived, and vice versâ; but the one has always a predominating
influence over the other, and differs somewhat in its cause, course,
and consequences. When the inflammatory process has its origin in
the cellular tissue, it is more likely to run through a regular course
and end in abscess than if it had started as a peritonitis, in which
case the course of the disease is often more chronic, resulting in the
formation of false membranes which bind the uterus and other pelvic
organs in permanent displacement. For these reasons, and for the
more systematic study of the subject, I think it best to follow the
plan of those authors who describe the disease separately under the
two general heads, Parametritis and Perimetritis.
Parametritis.1
1 Virchow, Duncan.
DEFINITION AND SYNONYMS.—By parametritis is understood an
inflammation of the cellular or connective tissue near the uterus and
beneath the pelvic peritoneum, including principally the locality close
to the lateral margin of the uterus between the layers of the broad
ligaments, although embracing also all of the various spaces where
connective tissue abounds—viz. between the peritoneal folds which
form the utero-sacral and utero-vesical ligaments. I think it a better
name than pelvic cellulitis or peri-uterine inflammation, because it
more correctly expresses the primary location of the disease than
any other. The disease has been described under many other
appellations, among which have been pelvic abscess and peri-uterine
phlegmon.
ETIOLOGY.—Parametritis does not occur before puberty, and rarely
before the great predisposing causes, abortion and injury at
parturition, have prepared the parts—opened up the channel—for
the more ready advance of the inflammatory process. This is easily
understood when we remember how compactly bound together are
these ligamentous folds, and how small the cellular-tissue spaces are
before impregnation when compared with the condition of the parts
after the function of gestation has been performed. Even were no
accident to occur to interfere with the perfect involution of the parts
which enter into the process of the expulsion of the product of
conception, the tissues would probably always remain more
vulnerable than before the gestation had occurred. But when the
retrograde change which is necessary to perfect involution is
retarded, a condition of relaxation and looseness of the parts results
which increases many fold the liability to the affection. The blood-
vessels and lymphatics remain large, and the connective-tissue cells
are not only larger in size, but a cell-proliferation is probably induced
as a result of the increased amount of blood-supply. Then a certain
low condition of the general nutrition, a diathesis or an inflammatory
tendency, no doubt act as predisposing causes of this disease. Now,
add to the predisposing causes the injury which probably always
attends abortion, and that which so often results from parturition
proper, and a condition results which I believe to be the cause of
parametritis in the majority of the cases.
Abortion the result of accident or design is a most prolific cause of
parametritis, because abortion is so often followed by endometritis,
which is frequently the starting-point of the former. Abortion results
in a wounding of almost the entire surface of the uterine cavity, from
which the placenta is torn, and often also in direct injury to the
tissues of the neck of the womb. This almost necessarily interferes
with involution; and if nothing worse follows immediately, there is
left a strong tendency to a low grade of inflammation or hyper-
nutrition, which may practically result in the same condition of
induration and thickening of ligaments. It is seldom that the subject
of an abortion of this character escapes from a certain degree of
parametritis. If it does not manifest itself at the time in violent
symptoms, the results are found afterward, when the patient is
forced to consult her physician for the relief of suffering the
consequence of the thickening and induration mentioned above.
Parturition without injury or accident is a predisposing cause, as
before mentioned, of parametritis, and renders the patient more
susceptible to the disease from cold, fatigue, etc., and from septic
influences; but when the labor has resulted in injury to the soft
parts, as laceration of the cervix, endometritis, injury to the vessels
outside of the uterus, in the broad ligaments from pressure, the
disease is far more liable to follow.
Parametritis may result from the various operations on the perineum,
vagina, and uterus; from the application of medicines to the uterine
cavity; and it is even said that the disease has been excited by the
introduction of the uterine sound. I cannot believe that the simple
introduction of the sound, when properly done, can be the means of
so much harm. If harm follows, it must result from carelessness or
want of skill. Of course there are contraindications to the use of the
sound, and if these are violated evil will often follow. The use of the
instrument ought not to be thought of if a suspicion of pregnancy
exists, or when there is marked tenderness of the uterus or of the
parts around it, or just before, during, or immediately after
menstruation, and certainly not when active inflammation is present.
Then the awkward manipulation of the sound when the uterus is
fixed as a result of a former inflammation is very apt to relight anew
the process.
If the same restrictions are applied and care used in the medication
of the uterine cavity, the cases in which parametritis will follow as a
result will be almost nil. The same will apply to operations. The
danger lies in proceeding with the treatment of cases as they
present themselves, by a hurried method and without fully
investigating the condition of the tissues and organs outside of the
uterus itself.
There is probably no place where experience is of more value than in
the manipulations and instrumental measures necessary for the
diagnosis and treatment of the various diseases of the pelvic organs
—where more depends upon the skill and care of the operator. I
believe, with Duncan, that pelvic inflammation and abscess are
always secondary, and that these tissues are not specially inclined to
idiopathic inflammatory action. But, undoubtedly, certain low
conditions of the system or certain individual peculiarities furnish
such a strong predisposing influence that a mechanical cause
otherwise inactive will be sufficient in some of these cases to
produce the disease. We probably see this expressed most fully in
the low types of puerperal inflammations which develop gradually
and without apparent cause, so far as injury at labor is concerned,
and which often persistently progress to a fatal termination. It will
be said that these are cases of septic origin; and it may be true, but
I believe the poison is developed autogenetically.
COMPLICATIONS.—Parametritis is usually associated with perimetritis,
and it may be complicated by ovaritis, endometritis, and salpingitis.
Uterine displacement also often complicates this disease; and I wish
here to emphasize the statement that no attempt should be made at
restoring the organ to its normal position until all evidence of active
inflammation shall have subsided. I have seen great harm result
from such attempt having been made on the supposition that the
symptoms were due to the displacement rather than to the
parametritis.
ANATOMY, PATHOLOGY, COURSE, AND TERMINATION.—Everywhere in the
pelvis, below the peritoneum, connective tissue is found in sufficient
abundance to serve the purposes for which it exists—viz. first, as a
bond of union between the pelvic viscera and organs, bladder,
uterus, rectum, ovaries, and Fallopian tubes; second, to surround,
support, and protect the numerous blood-vessels, lymphatics, and
nerves from injury during the mechanical disturbances to which the
pelvic tissues are subjected in the performance of their various
functions.
If it were not for the padding of the pelvic connective tissue, which
allows a free range of movement to the pelvic contents, the ordinary
sudden jars from walking, coughing, etc. could not be sustained
without pain, nor could the functions of the rectum and bladder be
fulfilled properly; much less could the functions of coition and
gestation be performed. This cellular tissue most abounds where it is
most needed—in the locality or spaces where the vessels and nerves
are found in greatest number; viz. at the sides of the uterus and
upper portion of the vagina, extending outward between the folds of
the broad ligaments toward the pelvic wall and the under surface of
the Fallopian tubes and ovaries; next, within the folds of the utero-
sacral ligaments and the vesico-uterine space beneath the
peritoneum. There is little between the peritoneum and posterior
vaginal wall, between the bladder and its peritoneal investment, as
well as between the rectum and peritoneum; and there is none
between the latter membrane and the posterior, superior, and
anterior surfaces of the body of the uterus.
This areolar tissue is the seat of the disease under consideration,
and from a priori reasoning it would be inferred that the
inflammatory process would be found most frequently and in
greatest severity in the locality where this tissue and the vessels
most abound; and this is true, for parametritis almost always has its
starting-point immediately at the sides of the uterus, in the lower
inner edge of the broad ligaments.
But there is another reason why the disease so often begins here. It
is the point, which, with the cervix, must bear the brunt of the
pressure and injury during parturition and abortion, as well as from
many of the operations which are performed upon the uterus. That
inflammation of these tissues is secondary to injury is proven by the
fact that we so often find the results of it, induration and thickening
of the broad ligaments, in the cases of laceration of the cervix which
come under our care. I have constantly observed that the
inflammatory indurations were greatest on the side on which the
laceration was most extensive, and that were the laceration
unilateral the evidences of inflammatory action would be unilateral
also. I have so frequently met with this condition in connection with
laceration of the cervix that I have come to regard its entire absence
as quite exceptional. I refer now to the deeper lacerations. Of course
these inflammatory products are met with when the cervix is entire
and apparently healthy, but this does not disprove the statement
that they are probably invariably secondary, and very often
secondary to injury at labor; for while the cervix may have escaped
laceration, the tissues and vessels may have been so contused from
pressure and instrumental measures as to result in the disease. But,
however originated, the inflammation and infiltration advance in the
direction of least resistance—i.e. along the course of the connective-
tissue spaces between the various ligaments. The product of the
inflammation, the pus, would therefore most likely follow these
channels in making its exit. If the primary inflammation arise at the
base of the broad ligament, it may travel within the folds of the
ligament outward to the lateral wall of the pelvis and upward to the
iliac fossa. This is probably the course which is most commonly
taken by the process in puerperal parametritis, and to which is due
the induration and tumor which so often exist in that region during
the course of the disease. Tumor in the iliac fossa, however, is not at
all uncommonly met with in the course of a severe parametritis in
the non-puerperal state, and it is doubtless of the same pathological
character. Or the infiltration may propagate in the folds or under
surfaces of the utero-sacral ligaments, resulting in the formation of a
tumor which may eventually surround the rectum. In rare cases, and
probably only in the puerperal, the process may develop higher up
and more anteriorly, finally taking the direction and following the
course of the round ligaments; but I have never met with an
instance of it. And it would be impossible to tell correctly in a case
opening in the groin—without a post-mortem demonstration, the
opportunity for which, fortunately, does not often occur—whether
the pus had not descended subperitoneally along the pelvic brim
toward the inguinal region. Of course the inflammation and
infiltration may be general, so that the uterus may be surrounded by
exudation tumors, but this is the exception. Inferiorly, the
parametritic process is limited by the pelvic fascia which covers the
levator ani muscle.
Parametritis, as phlegmonous inflammations elsewhere, has three
stages: 1st, that of active congestion; 2d, that of effusion of serum;
3d, that of suppuration. But the disease does not reach the third
stage in all cases. It may be arrested in the first stage or end by
resolution in the second. I believe, however, that resolution in the
second stage is the exception and not the rule. First, because to end
in suppuration is the natural course of the disease; and secondly,
because in many of those cases which are carefully observed the
ordinary symptoms of the formation of pus, as chill, etc., are usually
manifested, and followed by its evacuation. The fact that pus is not
discovered should not be accepted as proof that the disease has not
advanced to the suppurative stage; for it may be so small in quantity
as to escape observation, or it may be discharged into the bowel so
high up as to mix with the fecal matter, so that its character is lost
by the time it is expelled from the anus, or the point of exit may be
so small as to allow it to escape guttatim, and thus elude detection.
Further, pus is sometimes formed and reabsorbed harmlessly, or it
may remain deeply seated in a cavity—usually, under these
circumstances, a number of small cavities—where it may undergo
decomposition and result in the absorption of septic material and
destruction of the patient before it finds exit. Then, again, it may
become encysted and be retained indefinitely, when it is a source of
constant and sometimes obscure suffering, as well as an abiding
cause of a renewed attack of the disease.
It is probable also that the process is sometimes arrested in the
second stage, neither resolution nor suppuration taking place, the
serous portion of the liquor sanguinis being absorbed, the remainder
undergoing a change to plastic lymph, so called, which proceeds to
organization, resulting in persistent induration of the affected parts;
or, instead of being absorbed, the serum may remain encysted
within cavities formed for it by the lymph. This likewise subjects the
patient to the constant menace of a renewal of the inflammation.
The late D. Warren Brickell of New Orleans has called special
attention to what he named the serous form of pelvic inflammation,
and which he thought had been too much neglected.2 I have met
with at least one well-marked case which supports Brickell's views.
2 "The Treatment of Pelvic Effusions," Amer. Journ. of the Med. Sciences, Philada.,
April, 1877.
The usual course, however, of an acute parametritis which has
advanced to suppuration is evacuation of the pus by the most
favorable channel—i.e. through the rectum or vagina. If through the
latter organ, the point of perforation is either directly posterior to, or
a little to the side of, the cervix. But if the inflammation be located in
the vesico-uterine space—which is rare, however—the point of
rupture may be anterior to the cervix. Less frequently the bladder is
perforated and the pus discharged with the urine. More rarely the
abscess is discharged through the abdominal wall, groin, or
saphenous opening, and still more rarely through the sacro-ischiatic
and obturator foramina. It may also find exit through the floor of the
pelvis near the anus, and it may rupture into the peritoneal cavity,
but the latter termination is fortunately the least common. This is
probably due to the fact that the slightest irritation and pressure,
under these circumstances especially, result in adhesive
inflammation between the peritoneal surface of the abscess and that
of the intestine with which it may be in contact, thus favoring
rupture into the intestinal tract. Then, rupture into the intestine is
conservative and protective, and the other is not, for should the pus
be discharged into the peritoneal cavity the patient would most likely
perish.
When the abscess opens at its most dependent portion, which is the
rule, it is kept thoroughly drained of the pus, and if a single cavity
exists it gradually contracts, and under favorable circumstances soon
disappears, the trouble ending by absorption of the wall of the
abscess. This is the most favorable termination of a parametritis,
and belongs only to the acute form.
When the pus has not been evacuated from the bottom of the sac,
or when there is more than a single cavity and only one is drained,
or where the pus has taken one of the circuitous routes mentioned
above, the disease merges into the chronic form, and may then be
indefinitely prolonged by the formation and evacuation of abscess
after abscess, until the pelvic cellular tissue becomes involved
throughout and riddled by fistulous tracts connecting them.
SYMPTOMATOLOGY.—Pain is probably the first symptom to attract the
attention of the patient, and if the attack is sudden or acute the pain
is usually attended by a chill of more or less severity. The pain may
be so sharp and lancinating as to cause the patient to cry out in
agony, or it may be of a throbbing, aching character. If the former, it
indicates either intense congestion of the vessels and tissues
involved, or that the peritoneum is largely implicated, probably both.
Where the pain is of this character the attack is usually of shorter
duration, since it is soon followed by the second stage, exudation,
when the symptom is at once modified, becoming less acute and
resembling now the pain attending an attack of less severity. Of
course the location of the pain corresponds to the seat of the
inflammatory process. If it is in one or the other broad ligament, the
pain is greater in the right or left iliac regions, most frequently in the
left. Pain is often experienced in the hypogastric and sacral regions
in the beginning of, or preceding, an attack of parametritis, and it is
due to congestion of the endometrium and uterus, from which the
disease is spreading to the looser cellular-tissue spaces in the
ligaments. If, however, sacral pain persists throughout the course of
the disease, or exists in that region chiefly, it indicates that the
inflammation has become general or has invaded the utero-sacral
ligaments. But it would not be correct to estimate the extent of the
disease by the amount of pain complained of, for that symptom
depends so largely upon the temperament of the patient and her
station in life that it is not trustworthy. Some women suffer so much
that they become inured to it or acquire the habit of suffering in
silence; others, from temperament, do not actually experience pain;
whilst others, again, from a love of hardihood, do not complain,
although they may be enduring constant and severe pain. To one of
these classes those cases must belong which are said to pass
through an attack of parametritis without suffering. That cases do
rarely present themselves, on account of mild but persistent
symptoms, which are found on examination to contain a large pelvic
exudation, I can attest; but I have so constantly found on careful
questioning that the usual symptoms of pelvic inflammation were
present at some time during the course of the existing illness that I
cannot agree with the statement made by some authors that this
disease may develop "without causing any particular disturbance"
(Emmet).
As a rule, the bladder and rectum are reflexly affected, the former
sometimes becoming very irritable, so that there often exists a
constant desire to micturate. Constipation is the rule, though I have
known a severe diarrhoea to accompany the disease, the result, I
thought, of reflex irritation. The stomach also is often
sympathetically affected, nausea, and sometimes vomiting of an
aggravated form, being present.
With a subsidence of the chill the temperature begins to rise, and
continues to increase, with evening exacerbations, until it reaches
102° to 103°, usually its highest point. It may, however, rise
suddenly and reach as high as 104° or even 105°—rarely above the
latter point. The pulse is usually full, and beats from 112 to 120 per
minute, sometimes oftener.
In severe cases tympanites exists, with great tenderness in the
hypogastric region; the thighs are also flexed upon the abdomen to
protect the parts from pressure and to relieve the abdominal
muscles from tension. But when these symptoms are marked it may
be confidently concluded that the peritoneum is extensively involved.
Within a few days to a week from the initial symptoms the stage of
effusion is probably completed or well advanced, when the
symptoms are usually ameliorated. Pain is diminished and the
temperature decreased, and if, happily, resolution begins, the patient
may gradually recover during the succeeding two or three weeks.
But, unfortunately, this very favorable course is not the usual one.
Instead of it, the disease often advances to the third stage, that of
suppuration. This stage is very commonly ushered in and manifested
by rigors or chill, followed by a rise in temperature and an increase
in the pulse-rate. There may now be daily afternoon exacerbations
of temperature, followed by sweating, until the pus is disposed of,
usually by evacuation.
PHYSICAL SIGNS.—If an opportunity is afforded for making a vaginal
examination during the first stage, it will be found that the local
temperature is markedly increased, that great tenderness exists, and
that the parts involved are rigid from congestion. A little later this
rigidity or erection subsides, and a bogginess may be discovered at
the point or points where effusion is now taking place. Still later, a
rather firm and, it may be, irregular swelling of variable size and
location can be detected, usually in one of the broad ligaments, and
from the size of a hen's to that of a goose's egg. If the inflammation
has existed on both sides of the uterus, the pelvic roof, so called,
may be found as hard and firm as a board. If pus has formed,
fluctuation may be felt, and later a softening process may be
detected, indicating the point where Nature is attempting to rid
herself of the product of the inflammation.
The uterus is usually displaced by the exudation to an extent
depending upon the size of the swelling, to which it is fixed more or
less firmly. If the effusion has taken place in one of the broad
ligaments, the organ will be displaced to the opposite side, but if the
inflammatory process has extended to the cellular tissue in the
posterior region of the cervix and in the utero-sacral ligaments, the
organ may be displaced forward as well as laterally. If the cellular
space between the bladder and cervix alone be involved in the
inflammation, the resulting effusion may displace the uterus
backward, but the disease is rarely met with in this location.
Retroversion of the uterus frequently complicates parametritis, but in
that case the abnormal position is not necessarily due to
displacement by the exudation. It may have existed previous to the
attack.
It must not be forgotten, however, that the symptoms and physical
signs, as described above, apply only to the acute form of the
disease, and that they do not exist in the same degree nor in the
same regular order when the inflammatory process has been
subacute, as it often is, from its commencement. When the disease
is subacute from the start, the patient may be enabled to go about,
and even to pursue a laborious occupation, but not without
suffering. There will always be more or less pain experienced in the
affected region, and the temperature and pulse will be slightly
increased. In rare cases the manifestations of the disease may be so
slight or so little complained of that the physician is surprised to find,
on examination, a large exudation in one or both broad ligaments.
DIFFERENTIAL DIAGNOSIS.—It is of the greatest importance that this
disease should be recognized early, so that prompt measures may be
taken to arrest it if possible, or at least to modify the severity of its
course. Fortunately, as a rule, the subjective symptoms of pelvic
inflammation are so marked that the attention is at once directed
toward seeking for their confirmation by eliciting the physical signs;
and for diagnosis these local manifestations of the inflammatory
process are to be relied upon entirely, as the subjective symptoms of
inflammation of the other tissues and organs of the pelvis somewhat
resemble those of parametritis.
The diseases the local signs of which approach more nearly those of
parametritis are—pelvic hæmatocele, fibrous tumor, the early stage
of extra-uterine pregnancy, the early stage of parovarian and ovarian
cystic degeneration, and perityphlitis.
In pelvic hæmatocele the symptoms occur suddenly, and often with
hemorrhage; there are also constitutional signs of loss of blood, as
pallor and coldness of the surface of the body, and if the
hemorrhage is great failure of the pulse and syncope. The tumor
caused by the escape of blood into the pelvic cavity is generally
post-uterine, distending Douglas's cul-de-sac and crowding the
uterus forward toward the symphysis pubis, while that formed by
parametritis is oftenest located at the side of the uterus. The
hæmatocele at first is soft and compressible, becoming hard within a
short time—a few days—as a result principally of the surrounding
wall of lymph which nature throws out as a protection. The
symptoms of parametritis, on the other hand, are more likely to
come on gradually, and to present the pulse- and temperature-signs
of inflammation, while the resulting swelling or tumor is rigid at first
from congestion of the tissues, then hard, becoming soft later as the
process advances to suppuration. Mere location of the tumor,
however, cannot be depended upon; we must be guided by the
history of the case and the special character of the tumor.
Fibroid tumor is not attended with the usual acute symptoms of
parametritis, such as pain, increase of temperature, and accelerated
pulse; the tumor is hard from the beginning, or at least never soft; it
is circumscribed, usually smooth, and not sensitive to the touch. Its
attachment to the uterus is also different from that of the tumor
caused by parametritis. The former shows a tendency to
pedunculation, while the latter has always a broad surface
attachment.
The tumor resulting from the arrest and development of a
fecundated ovum in the Fallopian tube or ovary resembles very
much in its locality, and somewhat in its characteristics, a
parametritic tumor; for usually more or less inflammatory exudation
is present in connection with extra-uterine pregnancy, giving at
times a fixity and hardness to the gestation-sac not unlike that
sometimes observed in a tumor parametritic in origin; besides, there
may also be constitutional signs of an inflammatory action. But the
presence of some of the ordinary signs of pregnancy and a little time
will clear up the difficulty; for as the case progresses the tumor will
increase in size and change in character, while the mammary and
other signs of gestation will develop. In addition, the pain attending
tubal pregnancy is never like that of parametritis: it is more
persistent, lancinating, and cramp-like in character, and is
unattended by rise in temperature. Soon also the placental bruit may
be detected, which of course never exists in parametritis.
The early stage of normal pregnancy is said to have been mistaken
for this disease. I can hardly conceive how this mistake in diagnosis
could be made, although I have met with several cases where the
congestion consequent upon fecundation was so violent as to result
in actual pelvic inflammatory symptoms with subsequent exudation.
The following case, which I saw with H. A. M. Smith of Gloucester,
N. J., markedly illustrates and confirms this opinion: Mrs. B——, æt.
21, had been married five years, but had never conceived. Her
catamenia had always been regular in time, but the flow had been
slight in quantity. In the latter part of November, 1884, or about
three months before I first saw her, she was attacked with severe
pain in the pelvis, accompanied by rise in temperature and
accelerated pulse. She was compelled to go to bed, where she had
remained up to the time of coming under my care. During this time
she suffered from great tenderness over the hypogastrium, some
tympanites, and considerable nausea and vomiting. She did not
menstruate in November—the period was due when she was first
attacked with pain—but in December she had severe uterine
tenesmus and a profuse metrorrhagia—symptoms of abortion.
Pregnancy had not been suspected, however, as she had been so
long sterile, and the inflammatory symptoms had been so violent
that the signs of gestation had been masked by them. At the time of
my first visit (March, 1885), there was great tenderness of the
hypogastrium with slight tympanites; nausea and at times vomiting;
great nervous prostration; loss of flesh; menses absent since
November, except the uterine tenesmus and hemorrhage in
December, as above stated; and at each menstrual cycle afterward
she had the symptoms of uterine contraction with a profuse
leucorrhoeal discharge, but no hemorrhage. The mammary glands
showed the usual signs of gestation at about the fourth month; the
vagina was purplish; the cervix uteri low down on the floor of the
pelvis, and the mucous membrane around the os hypertrophied,
soft, and abraded. The body of the uterus was anteverted and
symmetrically enlarged to about the size of the organ at the third
month of gestation. The uterus seemed to be fixed—incarcerated
within the pelvic cavity—by an indurated exudation in the lower
portion of the right broad ligament. I diagnosticated pregnancy, and
accompanying parametritis as a result. The treatment consisted in
painting the right side of the fundus of the vagina opposite the base
of the broad ligament with iodine; the application of iodized glycerin
on pledgets of cotton, together with the use of the hot-water
douche; internally, opium enough to relieve pain and an alterative
tonic in the form of the four chlorides, the formula for which will be
given at another place. She began to improve at once, but as she
was still threatened with abortion and the uterus was still
incarcerated within the pelvis, ether was administered for the
purpose of attempting to release it. With two fingers of the left hand
in the vagina and the right hand upon the hypogastrium to exert
counter-pressure, gentle manipulation was made with the view of
stretching the adhesions. This resulted in a slight elevation of the
womb, and from this time pregnancy went on to full term without
further trouble.
This case is introduced chiefly to show the possibility of the
existence of parametritis with normal gestation. It is true that the
inflammation, which developed simultaneously with fecundation,
may have had a latent existence before the occurrence of that
event, and that the stimulus of pregnancy served simply to bring
about an attack of an active character, but nothing in the previous
history of the case indicated such a condition.
Perityphlitis may somewhat resemble in its subjective symptoms, as
pain and rise of temperature, an attack of parametritis. A careful
study of the physical signs, and also of the exact position of the
tumor in each case, however, ought to be sufficient to differentiate
between the two diseases. The tumor of perityphlitis is always on
the right side, and situated high up in the false pelvis; that of
parametritis may be on either side—it is oftenest on the left—and is
usually located low down in the true pelvis. The latter is easily
reached per vaginam, while the former is almost or quite out of
reach from this direction.
Parovarian cystic disease in the early stage, before the tumor has
developed sufficiently to rise above the pelvic brim, resembles in its
location parametritic exudation; but the history of development and
the physical characteristics of each are different. There is an absence
of hardness and tenderness to the touch in the former, which always
exist in the latter. Parovarian tumor develops without the
constitutional phenomena of inflammation; parametritis, I believe,
never.
It must not be forgotten, however, that either one or more of these
various diseases may exist in connection with, and as complications
of, parametritis, rendering the diagnosis at times exceedingly
difficult, requiring time and patience to clear the way. A case in point
may be stated in brief as follows: Mrs. H—— was sent to me some
months ago. She complained of great pain in both iliac regions—
more in the right—extending into the pelvis and sacrum and down
the limbs. There were also menorrhagia, and profuse leucorrhoea
during the intermenstrual periods. She dated the trouble from an
abortion which had occurred nine years before, and which was
followed by symptoms of acute parametritis, from which she never
fully recovered. Physical examination showed the uterus to be
considerably hypertrophied and fixed, as in a vise, by an indurated
mass on either side of it, which seemed to occupy both broad
ligaments or to be closely adherent to them. The cervix uteri was
also badly lacerated; its mucous membrane presented a surface so
hypertrophied, abraded, and jagged that I was at first strongly
impressed with the fear that epitheliomatous degeneration had
begun to develop. I pursued a plan of treatment designed to reduce
the congestion and hypertrophy of the diseased neck, and at the
same time to induce an absorption of the plastic and indurated
lymph around the uterus, to render the organ mobile, so that an
operation might be made safe. I only partially succeeded, for while
the uterus became much more mobile, there still remained a
swelling or tumor on either side of it. These tumors had ill-defined
borders—were not circumscribed, but elongated and rather
cylindrical in form, and fixed to the lateral pelvic walls as well as to
the uterus, though not very firmly to either. I now suspected disease
of the Fallopian tubes, and probably also of the ovaries. The patient
entered my private hospital in February, 1885, when I operated upon
the cervix, dissecting away a large quantity of tissue for the purpose
of making proper adjustment of the labia and to get rid of the
cicatricial tissue; it was not epitheliomatous. I had hoped by this
operation to not only restore the cervix to health, but at the same
time to induce, by a derivative action, a retrograde metamorphosis
in the diseased tissues and organs appended to the uterus. I
succeeded in the former, and also in modifying all of the symptoms
except the pain in the ovarian regions. This seemed to be made
worse, or at least to become more prominent, as the other
symptoms were improved. The patient was sent to her home, and
advised to rest in the recumbent position for at least a part of every
day. Later, when she did not improve, a local treatment, consisting of
an application of the tincture of iodine to the fundus of the vagina at
intervals of a week, with boro-glyceride tampons almost daily, was
renewed. At the same time, counter-irritation, applied to the
hypogastrium by means of blistering, was faithfully pursued. But
nothing proved of more than temporary avail. She began to lose
flesh and to fail in strength. The old fulness at the sides of the
uterus, instead of diminishing, had increased. She again entered my
private hospital. Under the influence of ether I now determined that
the Fallopian tubes were distended to the size of a small sausage,
that the ovaries were also enlarged, and that the tubes, ovaries, and
ligaments were all adherent to one another by plastic lymph. I now
advised laparotomy for the removal of the diseased uterine
appendages. The patient very readily assented; indeed, she urged
the operation.
A week later I made an incision three inches in length through an
abdominal wall fully two inches in thickness, and came upon the
omentum, which was very fat. This was adherent by its lower border
to the pelvic tissues and organs, so that I was compelled to dissect it
off on the right side before I could reach the uterus with my fingers.
All the parts—Fallopian tubes, ovaries, broad ligaments, uterus,
omentum, and intestines—were so adherent and matted together
that it was difficult to differentiate between them. The tubes were
greatly distended and contained—the right pus, and the left serum.
The fimbriated extremities were glued to the lateral pelvic walls. The
ovaries were as large as a good-sized hen's egg, and closely
adherent to the posterior surface of the broad ligaments. I dissected
with my fingers—two being introduced—until the right tube and
ovary were released, when they were drawn to the incision, ligated,
and removed. The left ovary and tube were released with still
greater difficulty, but I finally succeeded in ligating and removing
them.
It will be sufficient to say here that the patient recovered without an
untoward symptom, and that she has been entirely free from pain—
since her recovery—for the first time within the last nine years.
PROGNOSIS.—A very guarded prognosis should always be given as to
the course and termination of a case of pelvic inflammation. The
disease may run a very acute course, and result in recovery by
resolution or suppuration, or it may become chronic and be
indefinitely prolonged. An acute parametritis without complications
usually runs its course and ends in recovery in from four to six
weeks. But the cases which are acute and uncomplicated are vastly
in the minority; certainly this is my experience. The course of the
disease, as has been stated above, is often chronic, and requires all
the patience and fortitude which can be mustered, both by the
patient and physician, to bring about a cure. Generally, the prognosis
is good where a rational treatment can be pursued. The tendency of
the disease is toward recovery, and comparatively few cases die. It is
less favorable in cases occurring just after parturition, and which are
probably of septic origin. Where the disease is complicated by
peritonitis the prognosis, as to life, becomes less favorable.
TREATMENT.—In the acute form, if the patient is seen during the first
stage—i.e. before exudation has begun—she must immediately be
placed in a warm bed. All sources of excitement must be at once
removed, the nervous system quieted, and pain relieved by a full
dose of morphia administered hypodermatically. I never give less
than a quarter of a grain of the sulphate, and seldom more, but I
repeat it within an hour if pain is still severe. If reaction from chill
has not yet occurred, it should be hastened by the application of dry
heat to the lower extremities in the form of vessels filled with hot
water, preferably, while moist heat, in the form of a hot flaxseed
poultice or some other convenient vehicle, should be applied to the
hypogastrium. Great care must be taken that the moisture from the
poultice does not escape and wet the clothing of the patient, for that
would not only be a source of great discomfort, but it might also be
the means of inducing another chill. The heat and moisture are best
retained in the poultice by a covering of waxed paper or oiled silk. At
the same time, a hot lemonade, to which may be added a
teaspoonful of the sweet spirit of nitre, will often be found useful.
According to Emmet, hot water per vaginal injection is a sine quâ
non in the treatment of this disease. He says: "It is the only means
we possess for aborting an attack of cellulitis, which it will do, if
thoroughly employed at the beginning."3 This is strong language,
and doubtless the eminent author feels warranted in its use from his
experience with the remedy; but I am sure that I have seen reaction
brought about and the disease arrested in the first stage by the plan
recommended above, and without the use of hot water by injection.
There can be no doubt that the first principle to be carried out in the
treatment of this disease is rest—absolute and persistent physical
and mental rest. This can be obtained by the use of morphia
hypodermically or by opium—administered best by the rectum—and
probably by nothing else; certainly by nothing else so well. Hot-
water injections are objectionable during the first stage of the
disease, because of the fuss and movement of the patient
necessarily connected with their administration. Further, I think it is
impossible to say of any remedy that it aborted an attack of pelvic
inflammation, for the disease cannot be said to be unquestionably
established until the stage of exudation has been reached. Indeed,
intense pelvic congestion may occur, giving rise to symptoms of the
first stage of inflammation, and subside spontaneously.
3 Prin. and Prac. of Gynæcology, 3d ed., p. 261.
When it is found that the disease cannot be arrested in the
congestive stage, or when it has already passed into the stage of
effusion before the patient is seen—which is often the case—
exudation should be facilitated by the exhibition of the proper
remedies. Happily, the principle to be followed in the treatment of
this stage of the disease is the same as that of the first stage—viz.
rest, relief of pain, and the local application of heat and moisture,
with the addition now of counter-irritation. The first and second are
to be obtained by the use of opium. The patient must not be allowed
to suffer pain, and immunity can only be secured by the free use of
the remedy. This drug is of more value in controlling the heart's
action and quieting reflex irritability than all the others combined.
The patient should be kept under its influence as long as pain lasts. I
usually order twelve suppositories, as follows:
Rx. Ext. opii aq., gr. xij;
Ol. theobromæ, q. s.;
M. et ft. supposit., No. xij.
Sig. One to be placed in the rectum every two hours if necessary to
quiet pain.
But we should not wait for the rather slow action of the opium
administered in this way. It is best to begin with the administration
of morphia hypodermically, as stated above, repeating it until the
desired result is secured. It is then not difficult to keep up its
influence by the use of the suppositories. If the suppositories cannot
be obtained, the tincture of opium may be administered by injection
into the rectum. The opium should not be given by the mouth where
it can be avoided, as it is more apt to interfere with the appetite and
digestion when thus administered. The proper action of the skin and
kidneys should be maintained by the administration of the liquor
ammoniæ acetatis in dessertspoonful doses. Irritability of the
bladder is often a troublesome symptom during the progress of the
disease, and is best relieved, in my experience, by the following
formula, which combines a diaphoretic and diuretic as well as an
antispasmodic:
Rx. Tr. belladonnæ, fluidrachm j;
Sodii bicarbonatis, drachm iij;
Spts. etheris nitrosi, fluidounce j;
Mist. potass. citratis, q. s. ad fluidounce vj.
M.—Sig. Dessertspoonful three or four times a day, or half the
quantity oftener. I have also known this combination to relieve the
persistent nausea which often accompanies this disease.
As soon as the skin becomes moist the remedy should be given at
longer intervals, and if sweating is induced it should be discontinued
entirely for the time, as that only serves to weaken the patient.
If the pulse does not beat oftener than 112, and the temperature
does not rise above 102°, nothing more in the way of medication will
be required. The patient will recover best if not treated too much.
On the other hand, should the pulse be strong and rapid and the
temperature high, quinine becomes a valuable remedy. It is more
efficient when given in large doses at long intervals than when given
in small doses at short intervals. If the temperature rises above
102°, it is my rule to administer ten grains and wait six hours, when,
if it has not decreased, the quinine is repeated. If, however, the
temperature has increased instead of diminishing, twenty grains are
given at the second dose, and the effect carefully noted. Should
marked cinchonism result, the remedy must be withheld, even
though it has had no influence on the temperature. Quinine is said
to have the power of so contracting the capillaries as to prevent the
migration of the white blood-corpuscles. If this is true, the remedy
ought to have great value in modifying or limiting the third or
suppurative stage of the disease.
The tincture of aconite-root is also of value in controlling the pulse
and lowering the temperature in certain cases. But its use should be
limited to those cases of marked sthenic character, for, as a rule, the
tendency of the disease is toward depression. It may be given in
doses of two to five drops, repeated every two hours until three or
four doses are taken, when, sometimes, the pulse will be found to
have decreased ten to twenty beats per minute. The remedy should
then be withheld until the effect is shown to have passed off by an
increase of pulse-rate, when it may be again exhibited; provided
always that the heart continues strong and vigorous and that it has
shown no sign of weakness. In the latter circumstance the continued
use of the medicine would be extremely dangerous. Under any
circumstances its use should be limited to the first and early part of
the second stage of the disease.
The diet should be carefully attended to, and should be of the most
nutritious character, as milk, eggs, beef-essence, etc.
Locally, in addition to the poulticing, but not to the exclusion of it,
counter-irritation by means of iodine will be found useful. The whole
surface of the hypogastrium should be painted each time the
poultice is changed until the skin shows signs of irritation, when it
should be discontinued and the poulticing alone kept up. The
abdomen must not be exposed longer than is just necessary to
remove one and place another poultice, which should be at hand
and not in another room. The poultice must never be permitted to
become cool on the patient. Turpentine may be used instead of
iodine, and if tympanites is a troublesome symptom it will be found
valuable. A few drops should be sprinkled over the poultice, or its
action may be more quickly obtained by the use of the remedy in
the form of the stupe until marked redness of the surface is
produced, when the poultice can be resumed. Tympanites is most
troublesome when the disease occurs during the puerperal state,
and in these cases I regard the turpentine as a most valuable
remedy, not only as a counter-irritant, but also when administered
internally. It should be given by enema in teaspoonful doses,
repeated every six hours until the desired effect is produced. It
improves the secretions and allays pain by relieving distension. If the
bowels should move as a result of the enemata, it is all the better. If
fecal matter occupies the lower bowel, it should be removed under
any circumstances.
Blistering, by means of cantharidal collodion or by the pure
cantharides spread in the form of a plaster, I regard as the most
efficacious counter-irritant; and if the beneficial effects of the
remedy could be obtained without the discomforts, and often
positive suffering, attending its action, I would probably employ it to
the exclusion of all others. But these cannot be obtained. During the
acute stage of the disease, when the pulse and temperature are high
and the skin hot, the blister should not be used. It is then more
likely to produce strangury; if not that, the other sufferings of the
patient are at least increased in the pain and burning produced on
the surface of the abdomen. This is not compensated for by relief of
pelvic pain, for we have relieved this long since by opium. I think
blistering should be confined to the chronic stage or form of the
disease.
Resolution by reabsorption of the effused product may now
terminate the disease; but that is not the rule when the process has
once advanced beyond the first or congestive stage. If it is found
that suppuration is likely to take place, that the disease is following
its natural course, the third stage must be facilitated. The
therapeutic plan laid down above will serve to limit the amount of
pus-formation and tend to concentrate it to one point for evacuation.
The hot fomentations should be continued, as well as the counter-
irritation by the iodine. It will probably be observed that the patient
has rigors of more or less severity, followed by rise in temperature.
These symptoms should be looked upon as an indication of pus-
formation. The patient should be examined from time to time by the
digital touch per vaginam and by the combined vagino-hypogastric
palpation for the purpose of determining the presence of an abscess
and its location, so that the proper treatment may be applied and at
the proper time.
These examinations must be conducted with the greatest care and
gentleness, and the patient protected from undue exposure. When
the disease has advanced to the third stage means for the
disposition of the pus should be kept constantly in view, and the
case treated as one of pelvic abscess.
Treatment of Pelvic Abscess.—Authorities differ widely as to the
proper method of disposing of the contents of a pelvic abscess.
Some favor a let-alone plan, believing that Nature is competent to
relieve herself more effectually and better than art can do; others,
equally eminent, believe that the pus should be evacuated when
pointing has positively occurred and made the evacuation easy and
safe; while others, again, more radical in their views, believe that
much can be gained by liberating the pus as soon as it is known to
exist, although it may be deep-seated and as yet have shown no
tendency toward pointing.
The same therapeutic principle should guide us in the management
of a pelvic abscess that we would unhesitatingly apply in the
treatment of an abscess in any other portion of the body. It is a
settled law in surgery that if a pus-cavity is evacuated and not
allowed to burrow, much tissue may be saved, the duration of the
disease shortened, and the prognosis rendered more favorable. I
believe that the pus should be liberated promptly as soon as it is
certain that an abscess has been formed and can be reached
without danger to important structures—emphatically so when the
way is being pointed out. True, Nature is competent in some
instances to discharge the accumulation, and usually by the least
dangerous channel. But it is also true that in many other cases she is
not. Instead of taking the shortest, most direct, and safest course to
the surface, the pus frequently takes the most indirect route, riddling
and destroying the tissues in its track; or it may rupture into the
bladder or peritoneal cavity, in the latter case to be followed by
death from peritonitis. Evacuation of the pus by artificial means
when the way has been shown, if done carefully by aspiration, is
attended with almost no danger. Where, on the other hand, the
abscess is deeply seated and there is no tendency toward pointing,
the question of evacuation becomes one requiring great deliberation;
for the dangers of puncture increase as the thickness of the tissues
to be traversed in reaching the abscess is greater. But, even though
the pus be deeply located, when a positive diagnosis of its presence
can be made I still favor early evacuation. Mere exploratory puncture
in the hope of finding pus is a most dangerous practice, and should
not be thought of in connection with pelvic abscess. Delay, even at
the risk of spontaneous rupture, is the proper course until the
diagnosis can be rendered positive; for when the abscess is deep-
seated the progress of the disease is often slow. Of course the
condition of the patient should always be taken into account in
deciding the question whether or not to interfere. If signs of septic
absorption appear, or evidences of constitutional failure become
prominent in spite of the means used for staying the progress of the
disease, prompt measures must be taken to get rid of the product of
the inflammation. The strongest argument in favor of early operative
evacuation of the abscess is the danger that the disease may
become chronic when the pus is not promptly discharged. Many
cases have occurred in which abscess after abscess had been
formed and discharged, until the patient became a mere wreck of
her former self, and finally died from septicæmia or exhaustion. This
is the result of non-interference. I am so fully convinced of the value
and necessity of operative measures in the treatment of pelvic
abscess that the following questions at once present themselves to
me when called upon to decide in a case where spontaneous
evacuation has not already taken place: 1st. When shall the abscess
be opened? 2d. Where shall the opening be made? and 3d. How
shall the operation be done?
The first of these questions has been answered in a general way by
the preceding remarks, and it is only necessary to add here, by way
of recapitulation, that the time for opening the abscess will depend
upon its location and the condition of the patient. If the pus is near
the surface and can be easily and safely reached, whether pointing
has occurred or not, it is ripe for evacuation and should be liberated
at once, even though the patient be in the best possible condition
and show no evidence of deleterious effect from its presence.
Nothing whatever can be gained by permitting it to open
spontaneously, but much may be lost. If, however, the situation of
the abscess be such that it would be necessary to traverse healthy
tissues to a considerable extent in order to reach it, and the patient
shows no evidence of septic absorption, it would be highly
injudicious to attempt to open the abscess: first, because under the
circumstances you could not be positively certain that a collection of
pus existed; and, secondly, because it is doing no harm. Delay, with
careful observation, is now the proper course. Within a few days the
apparent abscess tumor may either show decided signs that it is
diminishing in size and undergoing resolution, or it may approach
the surface, so that evacuation will become safe. On the other hand,
should symptoms of blood-poisoning develop and the patient show
signs of rapid exhaustion, our attitude must be one of action instead
of delay. The pus must then be liberated even at some risk. I still
insist, however, that a positive diagnosis must be established, and
that the operative measure shall be in no sense exploratory.
2d. Where shall the opening be made? This question is often
decided for us by Nature. The puncture, as a rule, should be made
where pointing has occurred. If pointing has not occurred, a position
from which the abscess can be most easily reached through the
vagina or abdominal wall should be selected. The vagina should be
given the preference, because the opening would then be at the
most dependent portion. The rectum should not be selected as the
channel through which to evacuate the pus artificially, although
spontaneous discharge into that tube occurs almost as frequently as
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