A manual of midwifery : including the pregnancy and the puerperal state / by Karl Schroeder ; translated into English from the third German edition by Charles H. Carter.

  • Karl Schroeder
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A manual of midwifery : including the pregnancy and the puerperal state / by Karl Schroeder ; translated into English from the third German edition by Charles H. Carter. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    tinned and the vomiting stopped by pieces of ice or champagne. The more intense pains require subcutaneous injections of morphia. Turpentine enemata renderthe greatest service against the distressing meteorismus. Tarnoffsky and Dohrn saw very good results from painting the anterior abdominal wall with collodion, whilst other observers have not been successful with it. A future time will have to decide to what extent the removal of the fluid exudation by puncture will find a place in the treatment of general peritonitis. Spencer Wells removed the fluid which accu- mulated in Douglas's pouch after ovariotomy by means of the trocar, and made use subsequently of drainage tubes. Thompson and Storer have even washed out the abdominal cavity with greatly diluted carbolic acid. In all cases in which a retro-uterine tumour is attended by grave symptoms of peritonitis, or by those of blood- poisoning, Douglas's pouch may be punctured through the vagina, and the exudation thus removed. Puncture through the abdominal walls must remain limited to ext reme cases, in which the exudation is evidently very considerable and Douglas's pouch not very prominent. When collapse comes on the fatal end may sometimes be pre- vented by the copious use of strong wine. We have seen four cases in which with such treatment death did not occur at least at the height of the peritonitis, but only after it had begun to subside, and in four other cases the patients recovered. In one case the patient was already moribund and comatose, but by the free use of wine she was kept alive until she finally and completely recovered. On the whole, good food and an abundant supply of wine should be given, even when the fever is considerable. Of the treatment of metastatic inflammations we cannot speak in detail. This must be varied according to the principles of medicine and surgery. Appendix.—Tetanus Puerperalis Happily it is only in very rare cases (at least, in Europe) that tetanus occurs after labour at terai; it occurs, however, somewhat more frequently after premature deliveries. Its etiology is still quite obscure. We mention it in the Appendix to Infectious Dis- eases because it is very probably due to infection, or at least to a peculiar irritation proceeding from a puerperal wound. The causes also which favour the occurrence of tetanus are not yet distinctly known, and the influence of cold is the most uncertain of all of them ; relatively speaking, tetanus occurs more frequently after profuse haemorrhage, especially if this has rendered plugging of the vagina necessary. The symptoms do not differ from those whieh are found in tetanus following any other injury. The prognosis is very unfavorable. Of twenty-seven cases collated by Simpson, five only terminated in recovery. The treatment, there- fore, can show very little BUCCeS8. In accordance with the views of Sim]»son, we recommend the use of chloroform BO as to produce absolute anaesthesia.