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Measles During Pregnancy.
Editor MEDICAL WORLD:-The Subject of measles in utero was brought up in the July WORLD, page 273, and again in the August number, page 322. I have had a case lately that may be of some interest in this connection. The family has been an afflicted one for several months. The folks are poor, hard workers, and generally pretty healthy. But last winter the grip got hold of them, and affected all of them more or less, the wife with the rest. Early in March whooping cough made its appearance, and the four children had it simultaneously, thus adding to the usual burdens of the pregnant wife. On April 23, before they were thru with the whooping cough, Mr. P., the head of the family, came down with smallpox, and had it hard, too; many confluent patches, and plenty of pits left. (He had always made fun of the mild form of smallpox which has been prevalent here. Perhaps this accounts for his having such a hard time of it himself!) None of the rest of the family took it, as all were vaccinated in time.
During Mr. P's illness, his wife workt like a Trojan. She had to; for they could get no help for love nor money; neighbors all scared nearly to death. Besides doing all the housework that was absolutely nec essary, she hauled corn-fodder and water for the cattle, milkt several cows, and
cared for her four children and her sick husband, even tho he was delirious for about 24 hours. The family was in quarantine till May 18. By this time Mrs. P. was pretty well played out.
She had just begun to regain her usual health and spirits when she was taken sick with measles, on June 12. At this time she was about six months pregnant. It would seem that if ever a woman was in good condition to abort, she was. However, I gave her no medicin especially to prevent abortion. At first gave her aconite, lx; this was followed by belladonna 2x, and this by bryonia 2x. She broke out well, and recovered in about the usual time without abortion. On September 25 I delivered her of a 94 lb. girl. No effect of the measles can be noticed on either mother or child. Labor was perfectly normal, and at the time of writing, mother and babe are both doing nicely. Owatonna, Minn., W. C. ROBERTS, M.D.
Prolonged Inter-Menstrual Period and Prolonged Gestation.
Editor MEDICAL WORLD.-Dr. W. A. L.'s case of prolonged menstrual interval in a healthy young lady of twenty-four years (page 446), should receive no treatment whatever, as there is no indication for treatment. The molimen occurring about every 8 weeks is as natural to her as it is with others who menstruate every 28 days. Should this young lady marry and conceive, her period of gestation will be prolonged possibly to 11 months.
I have a healthy patient who menstruates about every 8 weeks, and has had 5 healthy children, but each gestation covered a period of 11 months.
This case of Dr. L.'s might have been benefitted in her early puberty had she then been given some uterin tonic. But at no time in her life has any form of local treatment, as dilating or curetting, been indicated. At this late period of her life, uterin tonics are of little value, and mechanical interference is uncalled for, as her health is good.
Dr. L.'s married lady of 28 years (same page) calls for both mechanical and constitutional treatment. But note "menstruates quite regularly." Give strychnin, arsenic, macrotys and laxativs. dometritis and ulcerations indicate local treatment. E. N. RITTER, M.D. Williamsport, Pa.
Mode of Diminishing Danger of Rupture of theory covers the field, or the Schmorl
theory is accepted, or whether it is due to the presence of a bacterium, or a microbic intoxication from the decidua, remains to be proven. Kundrat and Huyfeld incline to the belief that compression of the ureters is responsible for the eclamptic condition in the puerperal state. Whether the fetus causes the intoxication, or it is due to the mother's improper assimilation and elimination remains mutable, and we must await further developments from microscopical, bacteriological and pathological experts.
We are familiar with the clinical picture of puerperal eclampsia. All text-books on midwifery give a clear exposition of the clinical history of eclampsia.
In 1897 I had three cases of puerperal eclampsia; in 1898, two cases; and in 1900, one case. The mothers recovered, excepting in my first case, and she was the victim of a "consultation." The children were saved, excepting in the one case of twins, one being asphyxiated from prolapse funis.
Editor MEDICAL WORLD. How does nature accomplish the dilatation of the vulva? On account of the bony surrounding, this can take place to any appreciable extent, only in one direction: backward; and this by relaxing instead of stretching the perineum. To accomplish this I accommodate myself to the position of the patient; if she is lying on her side I hook my finger over the edge and make traction directly toward the coccyx; if she turns on her back, with my index finger in the vagina I press downward and backward. If she complains of the pressure, I diminish, and after a little while again increase. With care, but little discomfort will be felt. As my index finger tires, I add my middle finger; and if I need still more, as is often the case, I withdraw my middle finger and place my thumb firmly as a buttress against my index finger and soon tire out the muscular obstruction. Sometimes when delivery is delayed and the perineum has been relaxt too early, it will regain its tone, and this maneuver must be repeated; but it is much more easily accomplisht the second time than the first.
Sometimes when I have not commenced the procedure soon enuf, and the head is pressing down with considerable force, I do not attempt to control the head, but rather welcome the pressure against my finger, as it greatly assists in relaxing the perineum.
Some doubtless will say "It's all wrong; there's nothing in it;" while some too enthusiastic will say, "Here's the disappearance of ruptured perineum." Both will be wrong; there will still be cases of laceration; but if this idea is faithfully carried out, the cases will grow beautifully less. Let me impress this axiom : annihilate the distance between the coccyx and fourchet and you annihilate ruptured perineum. A. V. SNOW, M.D.
Puerperal Convulsions; Its Treatment and
Editor MEDICAL WORLD: -Pages 361, 362, 363 of the September WORLD are replete with puerperal convulsions and treatment. Puerperal eclampsia is quite frequent, and occurs during and after the period of gestation. It is a difficult matter to attribute a cause for the existence of this dreaded hydra. Whether Bouchard's
The treatment: Veratrum viride in ten drop doses hypodermically every ten minutes until patient became absolutely quiescent and pulse numbering from 60 to 90 in the minute; normal saline solutions injected per rectum between the paroxysms.
These women were carefully watcht during their gestation; urin examined at intervals of thirty days; albumin invariably present, specific gravity usually high. The "pre-eclamptic treatment" consisted in keeping the bowels open, no restriction in diet, the liberal use of water both internally and externally. Flint's chaly beate tonic tablets were prescribed two t. i. d. With all these precautionary measures, the convulsions were severe in each case and unavoidable.
I have confined four of these women since, and the fifth is due December 30, 1901. Three out of the four gave evidences of uremic conditions, albumin present in the urin, spe. gr. high, edematous extremities and puft appearance of the face. The accouchement in each case was uneventful, and I expect the same good fortune in the fifth.
The treatment outlined consisted in the free usage of water internally and externally, a a strictly vegetable diet (all meats interdicted), and R methylene blue in onehalf grain doses night and morning. I will leave the scientific explanation of the therapeutic phenomena to the gentlemen
engaged in pathological and physiological research. LIONEL C. CHARBONNEAU. 332 Ninth Street, Brooklyn, N. Y.
Quinin in Labor, Etc.
Editor MEDICAL WORLD:-I have been a constant reader of THE WORLD about fifteen years, and I think it as much of a jewel to the general practitioner of medicin as the Columbia is to the American yachtsman. I frequently notice articles. on puerperal eclampsia, which prompts me to give briefly to the readers a peculiar case that occurred in my practise about ten years ago. The first stage of labor appeared to be progressing in a normal manner in all respects, except a slight pain in the head; and as the least pain in the head at such a time excites suspicion, I got instruments all in shape for business if necessary. About the termination of the first stage I noticed some twitching of the muscles, and the lady complained of feeling very queer, etc., when I quickly applied the instruments and assisted her in her efforts to bring the babe into the world. To my surprise it was in a convulsiv fit, and so remained until next a. m., when it died. The mother was quite nervous a few days, but without any more trouble than usually occurs in child birth, she gradually returned to her normal condition in about the usual time. I am a firm believer in the old idea that the pressure of the child in the womb is at least a factor in the cause of puerperal convulsions.
I believe in the use of quinin in inertia of the womb, but when I use it I always give ergot about the end of the first stage. If hemorrhage should occur quinin is not the cause; it's the weakness of the muscular fibers.
I am of the opinion that if possible anesthetics should not be used when the instruments are being applied. The woman should remain perfectly conscious, so that she may prompt you in the placing
of the blades.
I like to see the columns of THE WORLD open to physicians of all schools. Surely we can learn from each other.
C. W. MUSGROVE, M.D. Trevorton, Pa.
Have a definit purpose in view before you incorporate any drug in a prescription. Never be guilty of "shot gun" work; it is worse than unscientific.
Editor MEDICAL WORLD:-I am pleased that the pages of THE WORLD give space to the writings of our homeopathic brothers. I live near the city of Ogdensburg in this county, and of its physicians whom I often meet in counsel, one whom I most highly respect as a physician and a gentleman, is a homeopath. Of course we do not agree as to treatment.`
About ten years ago I was called on a beautiful summer evening to attend a woman in her eighth confinement. As near as I could ascertain she had then had sharp propulsiv pains for nearly two hours. The waters were pretty nearly drained away. On vaginal examination I found an arm and hand down, the fingers protruding from the vulva. The thumb was toward her left thigh, the back of the hand facing anteriorly. The pains at this time were truly terrific. The mother was a strong, large and well built woman. I had been with her in five previous confinements.
I administered chloroform and attempted, under complete anesthesia, to replace the hand and arm in the uterin cavity, but I could not succeed, tho I workt faithfully, the perspiration in beads on my face, my heart beating like a trip hammer. I was nine miles from any other doctor, and no 'phone, no 'graph. Lower and still lower the shoulder sank in the pelvis until, with the entire arm protruding from the vulva, it was beneath the pubis. Brothers I had never known this mother to give birth to a child weighing less than eight pounds, and she was "at term." My office was but a short distance away, and I stept into an adjoining room to send a messenger with instructions to my wife, for more instruments, expecting to, for the first time in my obstetrical career, have to do a dissection on the child. As I returned to the bedside the mother said to me, "Doctor, there is something coming." On examination I found the presenting shoulder being expelled from the vulva. I will say here, having no assistant, the mother had regained consciousness in part or entirely during my absence from the room. The head and thorax were soon expelled, followed by the breech and legs. Immediately after the partial expulsion of the shoulder I made two lateral incisions of the perineum, that no doubt facilitated the birth of the head and thorax and perhaps saved this body a more serious wound, The child gaspt several times after birth
and died. It weighed a trifle over eight to date. pounds. The mother did well.
Here then was a variety of spontaneous evolution that I understand is very rare. "Evolutio conduplicato corpore." I administered chloroform once more on my return to the room and the mother was completely anesthetized at the birth of the child. I never met a case like this before nor since, not where the head and thorax were given birth simultaneously. Bear in mind also an eight pound babe and at term, and the fact of life after birth.
to date. The progressiv doctor never gets too old to be a student.-ED.]
Tick Found in Ear of Child.
Editor MEDICAL WORLD:-I send you today, under separate cover, a tick which was taken from the ear of a little child about 9 months old, believing that it would be of interest to the Medical profession. This is not an infrequent occurrence in this country, and is peculiar to the high plains, or northwest part of Texas. In this instance the tick was im
trance, or about the middle portion of the anditory canal. This is a peculiar insect, and entirely different from the ordinary tick found on the cattle in this country. Silverton, Tex. E. C. PUCKETT, M.D.
Long live THE WORLD say I. I never felt like writing much for a medical journal till I took this paper. And altho the space I may use may be better occupied by those who have more to say, I greatly enjoy bedded in the ear about one-half to threethese monthly chats with you all gentle-fourths of an inch from the outer enmen, thru its pages. God guide its Editor. O. C. HAMMOND, M.D. Heuvelton, St. Lawrence Co., N. Y. [It is just these familiar monthly chats that endear THE WORLD to so many thousands of doctors in all parts of the country, and cause us all to feel that the medical profession is really a brotherhood; regardless of the distance separating its members. Here, in the pages of THE WORLD, there are no "brilliant lights" to dazzle and blind the modest worker, and no dominating authorities to overawe. Here we are brothers working together, each for the help of all, and all for the aid of each, in the daily round of the general practitioners duties. "May God guide its Editor" is a prayer that touches his heart. He does not wish to dominate, but like the chairman of a meeting, he only seeks to guide the discussions into the most useful channels, and secure fairness and justice to all. So speak up freely, particularly you heroes of many wintry storms and perilous rides. thru darkness over dangerous roads. Heroic devotion to humanity makes the light of science burn more brightly in your minds and hearts. Join in the monthly chats for the aid that you can give, as well as for the aid which you wish to receive. None can receive unless some give; let us all both give and receive. Yes, take other medical periodicals, too; plenty of them, for all, or nearly all, are worth much more than their price. But if you should take all of them, you will still want THE WORLD, for its monthly chats. And don't neglect to buy and carefully read the latest books. Your work and your contributions to the "chats" should be thoroly up
A Doctor's Union.
Editor MEDICAL WORLD:-It is with a great deal of pleasure that I read Dr. Thornton's notice (page 423, October WORLD), of the formation of a society of physicians for mutual protection against dead beats in his vicinity. I desire to state that at a gathering of six physicians from as many states last month, at my house, was formed the "Physicians' Protective Union of America," duly chartered and incorporated under the laws of Maine, and the title copyrighted and secured. The object is to form local and state unions and a National union, exactly on the same plan of the various labor unions now in existence. The professional side of the doctor's life may or may not be considered; but the business and financial part will be most thoroly looked after. Such an undertaking, we all recognize, will be slow and must be carefully considered; but among the objects already agreed upon between the founders were the mutual protection from dead beats, within as well as without the profession; the correction of the patent medicin nuisance within the pale; mutual help in malpractice suits; old age and accident pension, and the opposing of harmful and helping beneficial law making, both state and National. Several other objects will be added later. To become a member a person,
male or female, must be a regular graduate from some recognized school, a legally qualified practitioner where he lives, and in active practise.
We are at present engaged upon collecting facts and data, and having literature bearing upon the various objects printed. A temporary National Committee was formed. Sometimes next year we hope to organize in due form, and to elect regular officers. The undersigned was appointed, without salary, temporary National Executive Officer, to whom various communications should be addrest, always, however, inclosing a stamp if reply is desired.
Now let us see if the medical profession at large. takes interest enuf in its own welfare to awake, unite, and shake off the shackles that greed and ignorance from time to time have tried to fasten around us. F. A. HANSON, A. B., M,D. Trial Judge for Aroostook County. New Sweden, Maine.
[In publishing the above the Editor assumes no responsibility beyond presenting the same as information. Send to the ad
dress given for further information, and ask for evidences of responsibility, etc.ED.]
Tissue Remedies for Neuralgia, Etc. Editor MEDICAL WORLD:-I am an eclectic, and have practised in accordance with the teachings of that school for over forty years with a fair measure of success. For the last three years I have, with Dr. R. L. Moore, been using the tissue remedies in many cases with almost marvelous success. Take, for instance, facial neuralgia: put one dram of mag. phos. 3x (Schuessler) in a tumbler and add twenty teaspoonfuls of hot water; give a teaspoonful every fifteen minutes; if necessary repeat. When the pain begins to abate, give less frequently-say every half hour. I have more than once been astonisht at the results. In my hands painful menstruation has yielded in the same manner with the same treatment, but may have to be repeated a second or third time to complete the cure. I was called to see a young lady, age 19, full habit. She was lying on She was lying on the bed crying in great agony. I prepared the mag. phos. as stated, giving her a tea. spoonful every ten minutes till pain began to abate, then less often. In one hour she was out in the yard playing croquet.
When the tongue is corrugated, no matter what the disease, give a few doses of calc. fluor, 3x and see how soon it will
The Doctor's Daughter" has not given a full description of her case. Biochemists do not treat disease by name, but according to symptoms or indications. If the discharge be thick, yellow and offensiv, take three grain powders of kali sulf. 6x three times a day. Tissue remedies in powder form are taken dry on the tongue, and followed by a swallow of water. J. H. THOMAS, M.D. Wyoming, Del.
Final Echoes of Dr. Chapman's Test Case.
Dr. Chapman Says That His Test Case was not a Hypothetical One.
Editor MEDICAL WORLD:-Since sending
you my test case I have changed my location to 3838 Vincennes Avenue, Chicago, Ill., and have had but little time to devote to literary work, medical or otherwise. I shall be as concise as possible in making a few necessary explanations.
First:-My case was not a hypothetical one. I did not see it until morning of seventh day. I gave phosphorus 200th, (cc.) a powder every two hours until symptoms of improvement were apparent. Then a placebo so long as improvement continued. To complete the cure I gave a dose of sulphur 100,000th (cm.). His recovery was rapid and complete.
Second:-I have verified the curative power of the high potencies of phosphorus many times when indicated by the symptoms, as in this instance. Thousands of homeopathic physicians can corroborate this testimony.
Third:-In my anxiety to be perfectly fair with the old school, I had hardly been so with the members of my own school. If I had been stating the case to homeopaths alone I would have dwelt more particularly upon the mental condition, the modalities, etc. I believed, however, that I had given three good and substantial legs for our prescription to rest upon: (1). Extensiv hepatization of right lung. (2) Great sense of tightness of chest. (3) The characteristic sputum.
In Gentry's Concordance Repertory the