Licence: In copyright
Credit: A manual of midwifery / by Alfred Lewis Galabin. 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.
892/982 (page 862)
![sometimes be necessary to open several loculi, eitlier at one or successive operations. Treatment of i^elvic cellulitis and pelvic peritonitis.—In these conditions the treatment has to be directed cliiefly to the local affections and to the consequent pyrexia, not to any general septicnemia. If the disease comes on with higli fever within a week after delivery, quinia should be given in full doses in the manner alread}' described. If it commences insidiously, and is observed only at a later period, quinia may be given in moi’c moderate doses. Opiates should be given in suHicient quantity to kee|) the pain in check. The requirement for them will be mostly in ])roportion to the degree in wliich the peritoneum participates in the inflammation. In mild cases, suppositories containing half a gi-ain of hydrochlorate of morphia may be introduced per rectum from time to time by the nurse, whenever great comi)laint of pain is made. Linseed ])oulticcs sliould be kept constantly applied over the lower ])art of the abdomen, so long as there is pain and high temperature. Olyecrinc of belladonna or tincture of opium may bespread over the skin beneath. If it is desired at this stage to try the effect of an absorbent, the skin under the poultice may be smeared with etjual parts of unguentum hydrargyri and unguentum belladonna). In America the application of cold instead of heat is much used, but it is doubtful whether cold applied to the skin really diminishes the tem))crature in the deep parts of the pelvis, beyond that e.xtent to whicli it may lower the general tcmpex’ature. As a rule, the warm a])plication gives more comfort to the patient. If cold is employed, a coil of Leiter’s temperature regulator over the abdomen is the most convenient mode for applying it. The time for appl}'- ing cold is while it is hoped that suppuration may be averted. If suppuration has commenced, poultices hasten the pointing of the abscess, land do most to relieve pain. An essential part of the treatment is complete and prolonged rest. A late outbreak of acute symptoms is often due to the eai’lier stage having been overlooked, and the patient getting up and returning to work prematurely. The patient should remain in bed until the pain, tenderness, and jxyrexia have subsided for some considerable time, and the exudation is, in great part, absorbed. Caution about any over-exertion or exposure to cold is necessary for weeks or months longer. If there is persistent local pain long after all fever has subsided, counter-irritation to the skin over the painful spot may be employed. Liniment of iodine may be painted over it daily until the skin becomes sore. Irrigation or syringing with hot water at a temperature of from 110° to 115° F. appears to tend to reduce the inllammation and hasten the absoiq^tion of the exudation by stimulating the lympha- tics. This may be commenced as soon as it can bo carried out](https://iiif.wellcomecollection.org/image/b21932645_0892.jp2/full/800%2C/0/default.jpg)
