Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
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Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

    18/50 (page 16)
    artificial delivery in all cases of hemorrhage, and to point out galvanism as a powerful agent in inducing uterine contraction. His recommendation is not merely theoretical, but he has employed it successfully in one instance by ap¬ plying one conductor of an electro-magnetic apparatus to the os, and the other over the fundus uteri; and breaking contact occasionally, but continuing to employ it till the desired effect was produced. Galvanism has since been used with success in a case of uterine hemorrhage by Mr. Cleveland.* * * § [The employment of galvanism to excite uterine action had already been suggested by v. Herder in his Beitrage zur Erweiterung der Geburtshiilfe, Leipsig/1803 ; and Stein had with the same view recommended the use of forceps, the two blades of which should be of different metals,f but Drs Hoeniger and Jacoby, and Dr. Radford are unquestionably the first who have reduced the suggestion to practice.] Dr. Radford cautions against attempts to deliver in cases of un¬ avoidable hemorrhage, before the os uteri is sufficiently dilated. He re¬ commends the rupture of the membranes in cases of partial placenta presen¬ tation, advises when the placenta is seated fully over the os if exhaustion be present, that the liquor amnii be drawn off gradually by perforating the pla¬ centa, (with an instrument like that of Holmes for the induction of premature labour,) and that the placenta be then completely separated. He further ad¬ vocates the detachment of the placenta, coupled when necessary with the use of galvanism as generally applicable to all cases of complete placenta presen¬ tation. Midwifery statistics, reports of hospitals, Spc. The note contains references to papers on these subjects.^ Dr. Ramsbotham’s tables are very valuable, since they embody the results of 35,743 deliveries ; and an account of about half that number forms the subject of Professor Klein’s report. The mortality of the hospital at Vienna as stated by Dr. Klein, amounted to 6 6 per cent.; while that of the Dublin Lying-in Hospital under Dr. Collins, was 1 per cent., and of the patients of the London Maternity Charity *4 per cent. Some expla¬ nation of this occurrence may be thought to be afforded by the fact that Dr. Klein used the forceps once in 32 times, Collins once in 608, and Ramsbotham once in 729. The actual mortality among the forceps cases does not appear from Dr. Klein’s report. THE PUERFERAL STATE. Puerperal fever. The learned work of Dr. Litzmann,§ which contains a historical sketch of the principal epidemics of this disease that have prevailed at any time, supplies a deficiency in medical literature. Dr. Litzmann like¬ wise describes an epidemic which he witnessed at Halle in the years 1840-1. Dr. M'Clintock has detailed[J the particulars, an epidemic which broke out quite unexpectedly at the Dublin Lying-in Hospital, in the early part of 1845. This epidemic was characterized by great depression of the vital powers, and proved speedily fatal. During the time of its prevalence, erysipelas was un¬ usually frequent in other hospitals in the city. Dr. Blackmorell has published a series of papers, the object of which is to establish the identity of the poison * Medical Gazette, June 27, 1845. f Busch und Moser’s Handbuch der Geburtskunde, Band ii, Art. Galvanisraus. I Dr. H. F. Ramsbotham, report of the Maternity Charity, Med. Gazette, May, June, July, 1844, and in the Appendix to his book; Dr. Burwell, report of the Philadelphia Hospital, Amer. Journal of Med. Science, April 1844 ; Dr. Murphy, report of Midwifery Practice at University College, Dublin Journal, Nov. 1844; Dr. W. Campbell, statistics of 5754 cases, in Northern Journ. of Med. June 1845 ; Mr. Watson and Dr. Waddy, Prov. Med. and Surg. Journal, Dec. 4, 1844, and Jan. 15, 1845, cases in private practice; Professor Klein, report of Lying-in Hospital at Vienna, Oesterr. Med. Jahrb. Jan., Feb., Marz 1845. § Das Kindbettfieber, etc.; Halle, 1844, 8vo. || Dublin Journal, May 1845. In the Prov. Med. and Surg. Journal during the early part of 1845.