On puerperal convulsions / by Thomas More Madden.

Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: On puerperal convulsions / by Thomas More Madden. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    affusion in a small stream from a moderate height on the head and face. This remedy is of considerable antiquity, being recommended by Valcscus, of Tarenta, in a work* originally published in the year 1482. It was re-introduced into practice on the authority of Denman, who derived great benefit in such a case by merely sprinkling his patient’s face with cold water during the paroxysms—a very different practice, I may observe, from the copious cold affusions now recom- mended. In the asthenic form of eclampsia this remedy should be used cautiously. It should not be employed except during the convul- sions, nor persevered in so long as to depress the circulation unduly. In all cases the primce vice should be unloaded, ns soon as the con- vulsions commence, by a bolus of calomel and jftlap, or by a drop of croton oil placed on the tongue. Enemata of assafcctida and turpentine, suspended in thin gruel, may also be resorted to, and repeated if necessary. The head should be shaved if possible, and the back of the scalp freely painted over with liquor epispasticus, whilst, at the same time, a bladder loosely filled with ice may be laid over the front of the head. The feet and calves of the legs should be enveloped in mustard poultices, until a decided rubefacient effect is produced. In cases of sthenic ])uerperal convulsions, venesection is, notwithstand- ing the disysage into which blood-letting has fallen in all other diseases, still the only remedy of uiuloubted etficacy in subduing the convulsive action. If the patient be plethoric, and her pupils be con- tracted, showing cerebral congestion, we may, as a rule, bleed. If, on the contrary, the pupils are dilated, the condition of the brain may be considered as anatmic, and blood-letting would probably be out of the question. This rule is liable to many well-known ctvuses of exception, as the state of the pupil may normally vary widely in different indivi- duaLs, as well as he affected by various toxic agents. The amount of blood that may be taken from a plethoric woman, suffering from eclampsia, should be raeasured by the patient’s condition and the effect produced, rather than by the quantity abstracted. In one case I took nearly forty ounces of blood, and within a few hours twelve ounces more, but without any benefit. Generally, however, a very much smaller bleeding wmU suffice, and, as a rule, not more than from eight to twelve ounces of blood should be taken. Chloroform is still regarded by some authorities as the remedy par excellence for puerperal convulsions: and though, according to my experience, this is an exaggerated estimate of the value of this anajs- thetic, its inhalation is of unquestionable use in many cases. In hysterical convulsions, if sprinkling the face w’ith cold water does not » Valescua de Tarenta, Philon. Phariiiaceut. et Chirurg. Lib. i., c. 27, p. 92. Franca, 1599.