« ForrigeFortsett »
my good friend, Dr. Collins, to my assistance. me valuable assistance; but nothing we did The Doctor gave me valuable aid, and after a seemed to be of any avail whatever, labor extending over seven hours the patient These are some of the difficulties which I was delivered of twin babies, both of which have encountered in the practise of obstetrics; were dead. We were beginning to congratu- but they were trivial as compared with a case late ourselves that all might be well, but in two which came under my care Feb. 25, 1906. hours after delivery she had a violent convul. The patient was a stout, robust woman, aged sion, and immediately sank into unconscious- 35, in her eighth confinement. I was called ness from which there was no awakening; and to see this patient about 5.30 p.m.; found her she died three hours after delivery, having had having some irregular pains, and she said she three convulsions.
had been having slight pains all day. I made In the two shoulder presentations which oc- an examination and found her in labor, the os curred in my practise, delivery was effected by dilating and a normal vertex presentation. performing podalic version. Both cases were She seemed to be doing all right, and I defatal to the child, but the mothers made un- cided to wait on nature rather than to offer eventful recoveries.
interference. In about an hour I gave her My first case of shoulder presentation was a to grain of strychnin and a drink of hot tea; strong, robust young woman in her first con- and in the course of an hour and a half the os finement; and to put it mildly, I was scared. was fairly well dilated and the pains were beIn this case another noble-minded physician, coming stronger, tho at no time did she have Dr. Lindsey, of Salineville, came to my assist what would be called severe labor pains. At ance, and I shall not forget him for his kind- about 8 p.m. she had a fairly good pain and ness to me and to my patient. The venerable suddenly exclaimed, “Oh! something has Doctor is a prince among men, and a man bursted in me.” I distinctly heard the sound, whose friendship any man might well be proud but supposed it was the rupture of the memof.
branes. I immediately made an examination My case of prolapsus funis occurred in a and was horrified to find all pain had ceast, stout young primipara, and I found it impos- the head had receded, some blood was coming sible to keep the cord in place and a stillborn away, the abdomen was flattened, and patient babe was the result. The accident did not bathed in clammy perspiration, and pulseless affect the mother.
at the wrist. She was in profound collapse, The case of hand and arm presentation re- and it lookt like death was imminent. I realsulted favorably to both mother and child. I ized in a moment that I had encountered a replaced the hand and arm with the mother in case of rupture of the uterus with all its attendthe knee-chest position, and labor terminated ant horrors. I gave strychnin, digitalin and in the natural way.
nitroglycerin with whiskey, and applied warmth All my cases of post-partum hemorrhage re- to the extremities and sent for assistance. In sulted favorably, tho I shall not forget my first about 20 minutes I had succeeded in controlone, a fine, robust young woman in her first ing the shock to the extent that she had a labor, which was normal and not tedious; but pulse, tho weak, and she could speak. At this almost immediately following the birth there point Dr. Minor arrived, and after a hasty came such a fearful gush of blood as to saturate consultation the Doctor made an examination, the bed and run upon the floor. I was greatly and found what I have already described. We alarmed, as this was my first experience with decided to bring down a foot and deliver the such a case. The Credé method was fresh in child, which was accomplisht without much my mind, and I immediately put it into prac- difficulty. With the child came the placenta tise; with one hand firmly grasping the uterus and a gush of blood, together with protruding from above, and the other within the vagina, omentum. At this point Dr. Giesey arrived, I soon succeeded in delivering the placenta, and we consulted in regard to the advisability and the hemorrhage promptly ceased. The of an abdominal section. But as our patient lady was blancht and fainted, but made a was pulseless and in profound collapse, both splendid recovery and is living and well today. consulting gentlemen advised against such pro
The only case of puerperal insanity that I cedure, unless we could rally the patient to have ever witnest occurred in my practise consciousness. Stimulants were given freely, near Carrollton about 12 years ago. A stout but there was no response, and our patient young woman, normally confined, got out of sank into eternal sleep within an hour of the bed on the ninth day, crost a cold hall to the time she exclaimed, “Oh! something has kitchen, and in a few hours was seized with a bursted in me." It was a sad experience; and fit of violent puerperal insanity which termi- altho rupture of the uterus is of exceedingly nated fatally in 48 hours. Dr. Williams, of rare occurrence, I had many times feared it. Carrollton, saw this patient with me and gave Now as to the cause of this most distressing accident. I learned asterwards from the hus- fluid, and joined with their neighbors until band that about 10 days prior to the confine- large areas were exposed which bled freely. This ment this patient sustained a severe fall, strik- process continued for four days, until the skin ing upon her abdomen, and shortly after the over the sacrum, buttocks, posterior and lateral fall she had a pronounced chill, after which sides of both thighs, calves of legs, and knees, she did not feel any movement of her child. both scapulae and posterior surfaces of arms, My theory is that the child died at that time, elbows and forearms were one raw and bleedand that there was degeneration of the muscu- ing surface. lar structures of the uterus, which made it less On other parts of the body the epidermis able to resist pressure; and from that cause it loosened, and exfoliation took place in large gave way. It was certainly not on account of sheets. A piece of skin apparently healthy prolonged labor or severe pains, for she did could be pincht up between the thumb and not have either. The accident came to my fingernails, and the epidermis removed in strips patient without warning of any kind, only that several inches in length. About the face and of a premonition she had had for some weeks neck the scales were fine and branny. that she would not live thru this confinement. Upon entering the hospital his fever was It was a bitter experience for the doctors as well 103.5°, continued so until the process of skinas for the stricken family. I cannot close this ning subsided, when it gradually dropt to norincident without expressing my heartfelt appre- mal. His tongue and palate showed the rash ciation of the valuable counsel and assistance at first; his bronchitis was slight, but he had a of Drs. Giesey and Minor, who came quickly severe laryngitis which reduced his speech to a to my aid and stood mansully by me, sharing whisper. the weighty responsibilities of this most sor- The denuded surfaces are now covered with rowful and unfortunate case.
a new skin except at the elbows, which have not Toronto, Ohio. J. M. WATT, M.D. entirely healed; and the new skin is bright and
[Here is a doctor whose heart seems “ tuned pink, except a few places where the old skin aright" toward his professional co-workers. has not yet been cast off. Notice the way he speaks of them, and the Anders speaks of petechial and hemorrhagic evident pleasure he takes in speaking highly of measles, and Osler mentions these and states their nobility of character and their skill. Of that in epidemics atypical rashes are not uncourse they respond promptly to his call for common. I send this case, as it might be of aid, because his heart is right toward them. interest to some one. We venture that Dr. Watt is universally re- Almola, Wash. DR. VIRGIL MCCOMBS. spected, loved and trusted by his professional brethren. Kindness will beget kindness. We
Insomnia, Etc.-Bright's ? mention this because it is a well-known but Dear DR. TAYLOR:-In the March WORLD I regretable fact that the beautiful spirit breathed noticed two inquiries, one by Dr. A. R. Macall thru this article does not exist among the Kenzie, of Taneytown, Md., and the other by profession of all communities, particularly “S.,” to which I feel like replying. Dr. small communities. It should, and we think MacKenzie (page 98) wishes to know what will the trend is decidedly in the direction of im produce sleep and allay the extreme nervousprovement in this respect.-ED. 7
ness in a case of a man suffering from “nephri
tis, dropsy, and insomnia." The Editor has Hemorrhagic Measles.
recommended veronal, gin, nitroglycerin, oil · Editor MEDICAL WORLD:-I am sending you of erigeron, and elaterium. Might I suggest what I consider an unusual and interesting for the insomnia and motor restlessness a comcomplication of measles. An epidemic of measles bination of sulfonal and conium? Three or broke out in one of the camps on the construc- four grains of each in capsules ; one capsule, tion work here. All ran a typical course of or two for that matter, may be given at 6 p.m., fever. More or less bronchitis and eruption at 8 p.m., and at 10 p.m. The cumulativ followed by desquamation, except this one, action will thus be secured, so that the second which was not so fortunate.
night the dose may be decreased. This comMarch 14 he developt fever and bronchitis bination never occasions any untoward sympand four days later the rash appeared and he toms, and acts in the majority of instances came to the hospital. During this period he very happily. Much of the nervousness could was unable to eat, but drank large quantities of probably be overcome by giving 15 to 30 grains whiskey and kept at work. At the hospital he of sodium bicarb. in a glass of water three or was given a hot bath, which brought out the four times a day, free alkalinization being rash decidedly, and bullae were noticed on the very essential in these cases to prevent uremia. buttocks and backs of the arms. Others rap- Free elimination should be maintained, prefidly developt and filled with muco-purulent erably by saline laxativs; if a stronger cathartic is required, elaterium may be cautiously fied basilicon ointment, and never did medicin administered.
act more like a specific than it did. I think the other inquiry by "S.," of Ohio, This leads me to a few words regarding this entitled “ Bright's?” (page 101) is a case of salve. I had not been long in the practise renal insufficiency from autotoxic strain. In a when I became dissatisfied with vaseline for paper that I read before the Sioux Valley Med general purposes. I had learned of my father ical Association, at Sioux City, Jan. 18, 1906, to make this ointment in a way to be very and which was publisht in the Journal of the much better than the official basilicon ointMinnesota State Medical Association in Feb. ment of resin io, yellow wax 4, lard 16; and ruary, this condition is thoroly discust. The something like twenty years ago I began using treatment is, briefly, first, to avoid undue it as a basis for special ointments, and for very strain on the poison-destroying function of many purposes in general practise. In the the liver ; secondly, to increase its oxidizing light of my experience it is nearly a curepowers; and thirdly, to stimulate removal by all; but it is especially advantageous in the kidneys of other substances than mere the urethra and rectum. I always make it water thru removal of strain by indican and by guess, but use much less resin than the allied products. All this can be accomplisht official directions call for. As officially made, by reducing starchy foods, and also the pro- it is too dark and strong to be a nice ointment. teids; avoidance of intestinal fermentation can I am careful, too, to get a good article of yel. be secured thru the use of intestinal antisep- low wax, to strain carefully, and stir until cool. tics, such as the sulfo-carbolates or other equally I think instead of 10 the resin should be 6 or good intestinal antiseptics. It is also desirable 7. I have seen it do excellent service even in where there is a tendency to excessiv elimina specific gonorrhea, by allaying much of the tion of watery urin to transfer the water elim- irritation and inflammation caused by the gonoination from the kidneys to the intestin and cocci, or the medication, and perhaps by tangliver, and this can be done by a combination ling up the gonococci as to render them less of hepatic stimulants and hydragog cathartics. activ. If there is a chlorohydremic condition needing Some years since I was induced to pay a attention, Basham's mixture will be found very small sum for a receipt to preserve surgical efficient. Oliv oil could be taken with advan instruments free from rust. When I read it I tage. If the urin shows a low degree of acidity was surprised to see this same formula I used or an increased ammonia excretion, sodium for a general purpose ointment. This whole bicarbonate, in 60 grain doses, daily, will ex- story does sound like the old woman's bear hibit the same markedly beneficial effects that grease that was good for everything ; but it has it does in the acidosic states of diabetes. If surely come to my relief in some unexpected dyspnea or asthmatic states make their appear- ways.
Davis R. EMMONS. ance, much benefit will result from the use of North Lewisburg, O. aspidospermine.
Geo. F. BUTLER. 103 State Street, Chicago.
Editor MEDICAL WORLD :-I want to say to Dr. J. A. Francis that if he will give that case
of creaking joints rhus tox. 3x t. i. d. he will A Venereal Case.—Basilicon Ointment.
cure the case. Say, did you know that if a Editor MEDICAL WORLD:-The report of person suffering with cramp of feet and legs venereal case of Dr. Garrison on page 110 SO would sleep with a piece of soít iron at the closely resembles an experience of mine when I feet it would cure? Surely will. Try it. was young, I cannot refrain from making some Angola, Ind.
A. D. SMITH. remarks. My patient, also, was an educated man, and I placed far too much confidence in Hypertrophy of Prostate.-" Creaking in the his judgment. He insisted so very strongly
Joints."-Scarlet Fever.-Eclectic on everything being done both prophylactic
Remedies for Cough. and curativ that I was led, against my better Editor Medical WORLD:-I note on page judgment, into furnishing him with local treat- 99, March issue, some M.D. wants a treatment ment entirely too activ, with the result that a for hypertrophy of the prostate. I have had urethritis was produced that thru further very good success with Lloyd's spec. saw palignorance and activ medication became really metto in 10 to 15 drop doses three times a day. formidable. Finally, becoming convinced of I also note “ creaking in the joints," page the true state of affairs, I hit on a treatment so 102. I have had fine success with kali murisimple and effectiv that you may possibly con- ate 3x, dose 22 to 5 grs. three or four hours sider it worthy of being given to the profes- apart during the day. This is a homeopathic sion. With a Nelaton catheter I had him remedy, but what need he care, so it does the push up the urethra a small portion of modi- work?
On page 89 I note homeopathic treatment Of course, we all know very well that iodin for scarlet fever. Not long since a family is valuable as an absorbent, that it acts as an moved from East Ok. Some 10 years ago alterativ, principally thru its influence upon they had a little daugh:er die of scarlet fever, the lymph-glandular apparatus. This is conand they sealed up some of her hair in a pic- clusivly shown by its resolvent action upon ture frame, so they could see it thru the glass various forms of inflammation, including speas well as see the picture. On moving, it cific cases. The therapeutic properties of lime broke. One of their little boys handled the (calcium) are also well recognized, this being hair, picture, etc., then the mother rolled them one of the most important constituents of sevup and put them away. The rest of the chil- eral standard preparations. dren were not at home-some four or five of In the present instance, however, it seems to them. Some time after, the little boy took me that the estimate placed upon iodized lime sick and I was sent for. I found a pronounced is not sufficienily discriminating, since those case of scarlet fever. I gave aconite, bella- who commend it so highly are disposed to donna and mercury as indicated, also Burgee's regard the iodin content as the more impordouble sulfides, and put the rest of the chil- tant constituent. My object in the present dren on Lloyd's spec. belladonna, gtts, 15 to communication is to develop more fully the 4 oz. of water; dose, a teaspoonful three hours therapeutic value of the lime content, and thus apart. One other child had the fever, but was give the physician a more complete idea of the no: confined to bed; was kept in the house, scope and usefulness of this new combination but would not go to bed.
-starting, of course, with the assumption that I stopt the children from school, had the iodized lime now offered to the profession conhair and picture fumigated, and kept on fumi- tains 10 to 12 percent of iodin and 88 to go gating after all were up, and stopt the disease percent of lime. in that family. The little boy was very sick a The following question, propounded by your few days; his ears both gathered and run, etc. contributor, warrants me in presenting this
A cough remedy in one case might not be of phase of the question relating to the employany value in another. Eclectics study single ment of iodized lime: “ This being the unremedies, their direct indications, and make doubted composition of the drug, what, if any, their mixtures as they go along; so there is no advantages has it over calcium iodid or other “ best.” For instance, if we had a case with preparations of iodin ?" As regards the caloppression across the chest and tight breath- cium iodid, the new preparation contains more ing, lobelia would be the remedy; drop gtts. iodin ; and in addition to this, the calcium 15 to 30 Lloyd's spec. lobelia into 4 oz. of content is more readily available than that water; dose, a teaspoonsul from 15 minutes on contained in the chemical compound. But I up to 1, 2 or 3 hours as required. If a tick- think it is susceptible of proof that the lime in ling cough, mostly in the throat, it would be this mechanical combination is more valuable Lloyd's spec. blood root used the same as the than the iodin, notwithstanding the general lobelia. I advise the doctor to read Elling- impression that the advantages are due to the wood's, Fyfe's or Scudder's works and get an free iodin. understanding of the principles of the school. My contention for the clinical virtues of the Highley, Ok. J. S. LEACHMAN, M.D. lime content is based upon well-establisht sci
entific research, confirmed by extended clin" lodized Lime.”
ical observation. As evidence, I beg to offer Editor MEDICAL WORLD:—The interest the following explanation, and any physician which has been manifested concerning the in general practise can easily verify my claims therapeutic properties of so-called “iodized in properly selected cases within twenty-four lime” is encouraging, because it shows a de- hours after beginning treatment: One of the sire on the part of the medical profession to first clinical indications for icdized lime is the learn why this new candidate for professional treatment of croup; and it will be found that favor should be recognized. Referring to the this combination is especially useiul in the case contribution by Dr. W. A. Hinckle, of Peoria, of children who are debilitated and suffer more Ill., which appears in the April WORLD (page or less from colds, bronchial catarrh and intes140), together with the editorial comments tinal indigestion. In other words, it will be upon the same, I can probably throw some more effectiv in this class of cases than where additional light upon this unsettled question. the patient is robust, free from bronchial irriIn the first place, the name itself, "iodized tation, and does not suffer from intestinal indilime,” indicates its character, just the same as gestion. In the first class of cases we have to iodized oil indicates the nature of this latter deal with more or less acidity from time to product, full directions for the preparation of time, and as a consequence, these patients are iodized oil being given in the Dispensatory. nervous and irritable; they show a capricious appetite and suffer alternately from diarrhea responds to this treatment. For example, the and constipation. This morbid complexus is iodized lime has been highly recommended for traceable to acid excess, and will promptly the treatment of specific infection, because of disappear when the diet is corrected and nor the prompt improvement following its employmal reactions re-establisht. It is a very simple ment, but the clinical facts properly intermatter to determin this condition, especially preted fully explain the modus operandi by when the child suffers from night-sweats or which the results are obtained. I think it was local sweating affecting the head and shoulders. Brunton who first outlined the effect of merAs a result of this acid excess there is an inter- curials upon the bony structures, the lime conruption in the transmission of nerve impulses, tent being diminisht especially in the bones the lime content in the nerve structures being of the lower extremities, and when mercurials depleted or filtered out. In many instances are long continued there follows calcification administration of lime will promptly correct in the kidney structures, leading eventually to this deviation from the normal and convales- edema and ascites. And as it is not unusual cence will be establisht within twenty-four in the treatment of specific infection to adminhours. The iodin, of course, will be helpful ister magnesium sulfate, we can readily underbecause of its alterativ action in connection stand how such patients go from bad to worse with the exhibition of lime, which restores to and suffer constantly from obscure nervous the system the necessary principle.
phenomena. In addition to this there is someAnother thing which should be taken into times coincident acid excess, but even in the abconsideration in this connection is the fact sence of this condition the administration of that in many families, where croup prevails in lime is promptly followed by markt improveall seasons of the year, the children are allowed ment in both the subjectiv and objectiv sympto have cereals ad libitum, which leads to toms.
JOHN AULDE, M.D. acidity, accompanied by various nervous phe Philadelphia, Pa. nomena, including chorea. The employment of Epsom salt (magnesium sulfate) is also a Membranous Croup Without Diphtheria. common practise in these families, and as a Editor MEDICAL WORLD:-Replying to sevconsequence most of them suffer more or less eral comments appearing in the April WORLD from magnesium poisoning, a statement which upon the identity of membranous croup and at first may appear incredulous, but neverthe- diphtheria, I beg to cite a recent experience less a fact which is susceptible of clinical and which, it seems to me, is ample evidence scientific demonstration. Thus, while lime that we may have a non-diphtheritic memỨ2/?2?Â?Â2Ò2Â?Â?2?Â2Ò2ÂòÂ2âÒ\/2Ỉģ2ūtiffimò/?§Âūti2/►ūti22222m222/22ģ2ò ŻÂ2Ò2Â§Â2Ò2Â§Â2Ò2Â§§Ż human organism, it is a fact establisht by sci- moment, however, the accepted belief that entific research that acid excess not only de- they are ( usually identical. pletes the lime content, but also permits the Five children of a family of six spent an aftermagnesium to take its place in the nerve struc- noon recently playing in the snow; and as a tures. No less an authority than Professor result, all had croup that night. One boy, aged Loew, of the University of Munich, makes the 6 years, became worse and a physician was following statement: “The calcium nucleo summoned the next morning. Later in the proteids of the organized structures are trans- day counsel was called, who administered anformed by the presence of soluble magnesium titoxin and advised that all the children be salts into magnesium compounds, while the treated similarly; th's the parents refused to calcium of the former enters into combination allow. Notwithstanding all that could be done, with the acid of the magnesium salt. By the the little patient grew worse and died that transformation of organized nucleo-proteids evening. into magnesium nucleo-proteids the capacity I was called next morning and found three for imbibition will change, which must lead to children in bed; two with moderate fever, a disturbance in the structure that will prove quite hoarse, no sore throat or other alarming tatal. Only the simultaneous presence of dis symptoms. The third, a bright little fellow of solved lime salts can prevent this effect, ac- four and one-half years, presented quite a cording to the law of mass.”
different picture : great distress, entire loss of In this connection I should add that observ- voice, intense dyspnea and beginning cyanosis ing clinicians will especially note the prompt upon a waxy pallor. relief afforded by the administration of lime I believed tracheotomy inevitable, but salts in the case of patients who have been sub thought I would give internal remedies a trial. ject to the magnesium sulfate regime. When I emptied bowels with copicus enemas, and acidity is neutralized and a proper diet insisted internally gave aconite and iodized lime upon, it is remarkable how quickly the nervous (Abbott's), 23 gr. in hot water every fifteen phenomena subside and how promptly nature minutes. In about two hours his color had