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Mauser bullets. This is the age of ad- hear a doctor say that he never has any vancement, and so rapid has been the lacerations or puerperal fever. march that the “ little good ” of the past There were three cases of adherent has fallen far in the rear and is nearly placenta and twelve of retained placenta lost sight of, and I wish to bring up what from lack of contraction or irregular conever" little good” there may be in this past traction. Of postpartum hemorrhage, eight; thirty-five years' experience.
fever lasting three days or more, fifteen ; Persia, Iowa. Dr. F. M. HILL. deaths during puerperal state, one ; sup
posed to be from internal hemorrhage,
during fourth week after delivery. Treatment of Pneumonia.
My rule when engaged to attend a case Editor MEDICAL World: – How can a is to
is to inquire after the general health, doctor who sees his pneumonia patients and insist that the woman take a sufficient once in 24 or 36 hours give veratrum vir amount of mild purgatives, stronger if ide, aconite or atropin, to say nothing of necessary, to keep the bowels free. The nitroglycerin and strychnin? We need liver being active, I usually have but little something better. As you know antimony trouble with the kidneys. If there is a is the great remedy in pneumonia, and with leukorrhea, I depend on injections_of opium, potassium nitrate, calomel, digitalis, warm water and zinc sulfocarbolate. For blistering, counter-irritations with a good the ill-defined pains that many suffer from diet and good nursing, we will have all we during the latter weeks, large quantities need in nine-tenths of the cases we have of tea, made from blackhaw bark, uva to treat. With this treatment we will lose ursi and squaw vine, any one by itself or very few cases, at least such has been my all together but plenty of it, seems to have experience since 1858. I am delighted to given me the best effects. see so many articles on pneumonia.
During labor I find more use for chloral I think The World has done much for than any other drug. It lessens the seus in the treatment of typhoid fever, verity of the suffering in normal labor, and should “never grow less."
and if there are colicky pains, or if there Salem, Va. J. L. STEARNES, M. D. is severe headache as there is sometimes,
it is the thing. I have seen it have the
most happy effect when there was intense Obstetric Experience.
headache with a weak irregular pulse. Editor MEDICAL WORLD:-Following is Combined with potassium bromid it has a something of my experience in obstetrics. better effect in some cases, the potash I have attended about 100 cases. This seeming to hasten the labor. I have never number including abortions and miscar. had a postpartum hemorrhage when the riages of which there was fifteen, three patient had taken as much as a dram and under suspicious circumstances. Rapid a half of fluid extract of jaborandi during labor (two hours or less) ten cases; twins, three or four hours before delivery. I am three ; labor lasting two days or more, 20. convinced that the more aseptically the Breech presentation, one; face, one; second case is managed the less liability there is of occiput, ten; occipito-posterior, and of fever following, but there will be fever rotated with or without assistance, ten ; sometimes anyway. children of viable age dead or died soon I depend on the "classical" ergot to after birth, six; placenta previa, three; get uterine contraction after delivery, not one lateral and two central, mothers all before. Sometimes giving as much as six saved but barely, and children all dead drams within two hours after delivery. when born ; eclampsia, one; os closed by Since I have adopted a routine of giving adhesions necessary to break up before ten grains of sodium salicylate with half a labor would progress, one; cases in which grain of calcium sulfid, four times a day it would probably have been best to use for a week, in addition to other precauforceps, eight; used forceps in none. tions, I have less fever.
There were twenty or more cases of I use chloroform during the propulsive laceration of the perineum, usually not stage, but usually not to complete anesmore than half way thru the perineal body, thesia, and this does wonders. It seems some deeper but none thru the anal in most cases to hasten rather than retard sphincter. No doctor ever took more the progress. Nearly all placentas will pains to prevent lacerations than I. Some
come away with but little trouble if you how doubts come into my mind, when I give them time. See that there is no
hemorrhage and let the patient rest from best comparison I could make would be half an hour to six hours rather than use say it was about the firmness of tender radical measures.
raw beef, Much of this may appear crude to many The illustrations in the books, with the of THE WORLD's readers, but it is the ex- description of peeling the placenta off from perience of a young doctor in a "rooral the interior of the uterus, make the prodeestrick." H. C. SANDERS, M. D. cess seem very plain and easy ; but, from Stantonville, Tenn.
experience, I am sure that it is nothing
like so easy as one might imagine from A Report of Obstetric Cases During 1898. looking at the illustration and reading the
Editor MEDICAL WORLD :-On page 145, description. Brethren, have you ever April, 1898, number of THE WORLD, is a tried it, and if so, don't you agree with report of my obstetric experience for the me? By the sense of touch, when the playear 1897. I will supplement that by giv- cental tissues are as firm as the uterine ing a report of the same experience for tissues and the two are so blended together 1898.
that you cannot tell which is which, the I delivered 49 full-term babies, all liv- peeling process is not only difficult, but ing—27 boys and 23 of the contrary sex sometimes utterly impossible. and 2 premature, both being dead before This was the state of affairs in this case. delivery, if not before labor began. All I removed all I could without doing any of the cases, except two, were vertex pre- harm, washed her inside and out with a sentation, one of these being a breech and bichlorid solution, tested her urine and the other being a face presentation, the found it loaded with albumin, put her on last being one of the premature births. supportive treatment, and washed her out
Instruments were used nine times, five every day with a bichlorid solution, each cases being primiparæ, whose ages were day getting a little more of the placenta ; from 23 to 36 years, and four being multi- but, in spite of this, septic fever set in, pare, the oldest being 42 years and this and she died five days after confinement. being her fourteenth living child, the Could a fatal termination of this case twelfth having been delivered with instru- have been averted had it been possible for ments by myself.
her to have had the advantage of a modern One of the primiparæ, aged 26, had hospital? I think not, when we take in been “bloated she said for several consideration the condition of her kidneys years, but as I had never seen her before, and the placental complications. and there had been no analysis made of Some of your readers may be ready to her urine, I am not able to say to what this say, “Oh, you have used instruments en"bloating” was due.
tirely too often;''-nine times in 51 cases, When I was called, she was in active or once to every 51 cases on an average. labor; her head was aching and face flusht Well, it does look rather often, especially and pulse full and throbbing. Her hands, to the man who has been practising forty face and lower limbs were very consider- years and never used them in his life; still ably swollen. Fearing convulsions, I gave the cases, in my opinion, demanded it and chloral and potassium bromid, in anticipa- I used them. By doing so, I am sure I tion, and they came not, neither did the did no harm and some good, caused no baby. After giving Nature a fair show, more pain than there would have been and finding her inadequate to the task, I without them and saved much suffering, had the patient placed in proper position lost no life on account of their use, but no and delivered her easily and quickly with doubt saved some lives, both to mothers instruments. But now came the difficulty and babies. which resulted in her death-the only Instruments are like chloroform, powerdeath from confinement occurring in my ful—to do good when properly used-to do practice during the year, and the only one harm in the hands of the ignorant. Anythat has ever occurred where I had used thing that is powerful to do good is also instruments. The placenta was adherent powerful to do harm if not properly used. thru its entire extent. Just here, I wish The idea of leaving things to Nature is all to say, I have been unfortunate enuf right when Nature is competent to do the to see three such cases, except that in this work, but when she is not, then brush case the placental tissue was much firmer away the old adage, "avoid meddlesome than I have ever seen placental tissue be- midwifery," and do something-anything fore or since. It seems to me that the that needs doing, and don't fear violating that old precept which could never be times a day, for a number of months, taktwisted into an excuse for "do-nothing- ing it up to the very day of her confineism.''
ment. If Nature should have her course, why The labor was normal, easy, and the have a doctor at all? That simple fact patient was delighted with the result, due shows that we don't propose to always leave to her faithful use of the medicine. things to Nature. Show a sensible woman Two cases in which this medicine proved an easier, quicker and safer or even as of such remarkable benefit mean some. safe a way to pass thru the suffering of an thing, and the reason I report the cases accouchement, and she will take it, tho is, if possible, to induce other practitioners that way leads by forceps and chloroform. to give the remedy a trial in similar cases Chloroform and instruments, with asepsis, -cases that are difficult on account of are saving lives to mothers and babies- some defect in the uterus itself, rather saving suffering and apprehension to than cases that turn out unfavorably on mothers, saving time and anxiety to doc- account of systematic diseases, such as tors in a degree that was little dreamed of kidney troubles. a decade ago. Still we have the old fogies Jasper, Indiana. Dr. E. J. KEMPF. with us who believe in leaving a poor, suffering woman to Nature, denying her the
A Case of Superfetation, relief which it is possible to give by the Editor MEDICAL WORLD:-The followtwo first and disregarding the dangers of ing case seems to me sufficiently extraneglecting the other. Still we have a few ordinary to bring to the attention of your amongst the laity who will prefer good old readers : Doctor
to an up-to-date doctor. I was called in haste recently to attend Possibly, we have a few who would prefer a confinement case, arriving at 9 p. m. to travel in the discarded stage-coach to a The head of the fetus presenting seemed modern palace-car. The difference is as unusually small, and the pains seemed lomarkt, tho not so plain to all.
cated at an unusual height in the abdoG. G. THORNTON, M. D. men. The child was born at 11 o'clock, Gravel Switch, Ky.
and presented the appearance of a six
months' fetus, but was living, however. Painful and Tedious Labors-A Suggestion. Another head was presenting, and this
Editor MEDICAL WORLD:-I deem it my child was delivered in about a half-hour, duty to report my experience in two ob- the second pain pushing it at least six stetric cases which were decidedly out of inches from the vagina. The first thing the ordinary.
attracting my attention was that it was CASE I.-Mrs. S. — had given birth to heavily veiled."
The placenta was nine children ; four of these were still- delivered simultaneously with the last born after very tedious labors. Twice turn- fetus. ing in utero had to be performed before Examination showed the last-born fetus labor could be completed; twice forceps to be no more than a four-months' one. had to be used ; once craniotomy had to Both children were given immediate attenbe resorted to in order to save the woman's tion, but the second lived only a few seclife; and all the labors were tedious and onds, while the first-born survived three prolonged.
hours. During her tenth pregnancy Mrs. S
The mother stated that two months took liquor sedans, a teaspoonful three after the first cessation of her menses times a day, for several months, up to the they again appeared, and she was sick as day of her confinement, and the result was usual, having intercourse very near this remarkable indeed. The labor was in time. Undoubted evidence from the apevery way a normal one, and the woman pearance of the children convince me blesses liquor sedans.
this is a case of superfetation. Can any. CASE II.-Mrs. K— had given birth one give me additional information on this to three children. I attended her in the subject?
0. H. FRANKS, M. D. three labors. The first and second were Seabrook, Kansas. very tedious labors, and the third a most [The best authority upon cases of such difficult one. Forceps were used in the unusual interest to the profession is Curi. three labors.
osities and Anomalies of Medicine," by During the fourth pregnancy, the woman Drs, George M, Gould and Walter M. took liquor sedans, a teaspoonful three Pyle, of this city, who cite a number of
cases of this type, and convey much in- to blow into a long-necked bottle, never teresting information on the subject, at too dreaming that it is the contraction of the great a length for reproduction here, how- abdominal muscles and downward presever. This case seems worthy of perma- sure of the diaphragm that produces its nent record.-Ed.]
expulsion, and that a cough or sneeze
would do as well. Brown lodid of Lime-Asepsis—Practice in Many otherwise good physicians still Obstetrics.
oppose the use of the warm vaginal douche Editor MEDICAL WORLD:-To the in
after labor. In all normal cases I like it quiries of Dr. Bordner and Dr. Gore, for two reasons: It promotes rest and repage 77, February WORLD, I would answer cuperation, relieves the parts of the acthat I have recently used iodid lime cumulated debris, which, being disposed (Nicholls) prepared by Billings, Clapp & of, prevents, in a great measure, the liaCo., in two cases of croup, with the hap- bility of infection by the reabsorption of piest results. While I cannot make any this putrefying animal matter. In normal predictions as what success will attend my
cases I order a half-gallon water given three use of it in the future, or land it as an un
times daily, with fountain syringe, and failing specific, I must admit that I was use no antiseptic whatever. I always inhighly pleased with it in these two cases. struct the nurse to dip the vaginal tube in I gave it according to directions on origi- boiling water just before inserting. nal ounce package, viz, Can
Regarding Dr. Newlon's case, on page B Iodid lime (Nicholls)
of the hairpin might arouse the suspicion
that it was not swallowed” according Water
to the orthodox method. M. Sig. Shake and give teaspoonful
As this is my first contribution to THE every half-hour until relieved.
WORLD, I will close, lest I become tedious; I will say, however, that I gave in each and if this does not land in the wastecase, at intervals of one hour, a tablet basket, I may write again. composed of calomel, 1-5 gr., ipecac, 1-10
W. M. WHEELER, M. D. gr., sodium bicarb., 1 gr. till bowels moved Gray Summit, Mo. freely.
[No danger of such practical notes from Dr. Matchette, page 73, while entirely practice becoming tedious. What is wanted too radical in his views on the use of the in medical journals is not fine writing, clinical thermometer, demonstrates very but the jewels of experience. Obstetriforcibly the urgent need of more care cians are, in many instances, deprecating being exercised for the protection from in- the use of the douche before or after labor, fectious diseases through this medium. I claiming that the vagina is naturally antiusually keep several thermometers, and septic thru its secretions and bacteria, and leave one with the patient having such that the douche is likely to carry infection diseases as typhoid fever, diphtheria, etc., in rather than prevent it. Have you thought and when I visit him I use his thermom. of this point, Doctor?—ED.] eter, not the one in my pocket. Regarding obstretic work, I am con
Brown lodid of Lime. vinced that there is no other line of work Editor MEDICAL WORLD:-I notice in coming within the domain of the physi- February WORLD a call for information cian that is so completely surrounded with regarding the iodid
regarding the iodid of lime and, being in mystery and “hoodoism” as that of ob- possession of a few facts, gladly furnish stetrics, especially in the rural districts, them. and sometimes we are surprised to meet it This salt is a dark brown amorphous in some of the more cultured circles. powder of powerful iodin taste and smell;
I have been criticised for taking a pair it is unofficial and so far as I am able to of scissors and clipping a hole in the cloth determine, is not mentioned in any standfor dressing the cord, the wise old granny ard work on materia medica or chemistry. shaking her head and reminding me that This is not the calcium iodid mentioned in it should be burned thru with a red-hot the secondary list of the United States iron. There are to-day scores of old dispensatory. The latter is a pearlywomen and midwives who think that the white rystalline salt when pure, while only proper method for the expulsion of the brown iodid of lime is a dark-brown the placenta is for the parturient woman preparation. It is made by Billings, Clapp & Co., Boston, who furnish the following
Membranous Croup. information concerning it:
Editor MEDICAL WORLD:- I would sug. "Iodid of lime is a chemical compound gest to Dr. Bordner and Dr. Gore for discovered by James R. Nichols, of Bos. membranous croup a remedy that has ton, in 1855. It is a preparation entirely proved very successful in my practice for distinct from the iodid of lime of com- a number of years, merce. The latter is a stable salt of cal
R cium and iodin, of light color and very
Oil lobelia . .
3i little therapeutic value. Iodid of lime is
3ii an unstable combination of these two ele
. 3iii ments, of a very dark brown color with a
zi large excess of iodin.'' This drug has been heralded abroad as
Dose :-One drop on sugar every 2 or 3 a sovereign remedy for membranous croup
hours, if the case is very bad give drop or croup of any character, for the last year
every hour for 3 or 4 hours. Afterwards or two. The first mention I ever saw of give every 2 hours. Rub a little on the it was in the Medical Council of Philadel. windpipe 2 or 3 times a day. phia, and it was made by Dr. Lawrence of
I. C. HARING, M. D. Kansas, in February, 1897. He quotes a
West Nyack, N. Y. letter from Dr. Beebe, and Dr. Beebe had a letter in the Medical Summary of March,
For Use in Grip. 1894, in which he praises this drug as a
Editor MEDICAL WORLD :-Please say specific in croup. Dr. Beebe in his letter
Dr. Beebe in his letter for me to the readers of THE WORLD, that to Dr. Lawrence says: “I have never lost Gross's neuralgic pills, half strength, every a case of croup under this treatment, altho third hour, come as near a specific in grip, I have used it for 25 years. According to according to my experience, as we may my belief, every death which occurs from hope to find soon. I usually prescribe membranous croup could be averted by the medicine in tablet form. this treatment if employed within a reas
J. I. T. LONG, M. D. onable time. I have never known it to fail when it had a fair chance."
La Grippe-A New Theory. The iodin appears to be the true remedy Editor MEDICAL WORLD:-Little or no in this combination. The drug is used as literature of la grippe was in possession follows: Measure out 10 grains and dis- of the profession when it swept in upon solve it in four ounces of water; let the us, and only the thoughtful investigators superfluous lime fall to the bottom of the could successfully handle it. It was, and container and administer one or two tea- now is, by many classt as a disease of the spoonfuls every 15, 30 or 60 minutes, ac- respiratory organs, but my investigations cording to age or severity, until the dry, have convinced me that this classification hoarse cough is succeeded by the moist is a mistake. I do not mean that the resform, then give less frequently until the piratory organs are not involved, but child is out of danger. Don't shake the that it is a disease of the central nervous mixture. Keep in the dark.
system--of the brain and spinal cord. I Dr. Gore in the February World, asks mean that, as in diphtheria, the influence for the formula of this compound. The of the poison is exerted specifically against manufacturers will probably retain this se- the brain and cord; and we believe the cret; they say it is made by a special pro- cord must be always more or less anemic cess of manufacture, but don't tell what to make an attack of la grippe possible. it is.
The poison exerted against the cord directly I desire to state that my experience is causes a degeneration or waste of the that this remedy is a "dead shot” in this spinal nerve cells, thus impairing the trouble and that I have several clients functions of every organ under control of who keep the remedy in solution at their the nervous system. Hence we find the homes ready for any emergency. This following symptoms: Great soreness of may be done if care is taken not to expose muscles, especially of the lower limbs, one it to the light.
or both sides ; an affection of the muscles The use of this drug in croup does not of the face, causing an annoying squintappear to be in its infancy. Why noting and often preventing the adjustment have a symposium on it?
of vision to different distances; dizziness Mosheim, Tenn.
M. G. PRICE. or vertigo ; irregular, irritable and very