Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel.

  • Hermann Senator
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidneys and of the spleen, hemorrhagic diseases / by H. Senator and M. Litten ; edited, with additions by James B. Herrick ; authorized translation from the German, under the editorial supervison of Alfred Stengel. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    to irritate the kidneys. Mild laxatives, warm baths, and so-called refrigerant diuretics are indicated, as has been mentioned in connection with the treatment of dropsy (see p. 88). To combat the actual attacks of eclampsia, the remedies which diminish the excitability of the y^ervous centers have been found most useful: chloral hydrate in the dose of 2 gm. (30 gr.), given in the form of an enema on account of the inability to swallow, morphin hypodermically^ and chloroform by inhala- tion. These drugs should be given whenever a violent attack comes on, and their administration continued until profound narcosis is achieved, with due regard, of course, to the behavior of the heart, the respiration, and the pupillary reaction. Unfortunately, the administra- tion of narcotics has an unfavorable effect on the life of the fetus. Venesection, which was formerly practised, is not much used now, per- haps too little, as the withdrawal of blood at the same time removes from the body a part of the toxins which cause the disease. It is, of course, admissible only in the case of vigorous, full-blooded individuals with good heart action. Infusion or transfusion of physiologic salt solution, human blood or serum, with or without venesection, may also be employed to wash the poison out of the body and thus exert a favor- able influence on the eclampsia. The congestion in the head, which develops progressively during the convulsions, is best combated by means of an ice-bag or cold com- presses, or in appropriate cases and depending on circumstances by means of wet or dry cups applied to the nape of the neck, or by leeches applied behind the ears. [Some attempts have been made to relieve symptoms of eclamptic coma—supposed cerebral edema and pressure— by lumbar puncture, but so far with very uncertain and indifferent success,—Ed,] Since the eclampsia usually subsides after the uterus has discharged its contents, labor, if it is in progress, should be terminated as speedily as possible. Whether labor should be induced artifically, and at what period such interference is indicated, is an obstetric question which has been answered in different ways and which does not fall within the present discussion. Experience shows that the nearer the normal term of pregnancy, the more favorable is the result of the artificial induction of labor to both mother and child. [The question of induction of premature labor is, as said, an obstetric one, but our own views may be hinted at when we say that we have several times in the case of the kidney of pregnancy regretted not having induced labor; we have never regretted having induced it prematurely when the complexus of albuminuria, edema, nausea, headache, and epigastric pain was present. Temporizing measures seem under these circumstances hazardous,— Ed,] The question whether a woman rcith albuminuria shall be allowed to nurse her child is of great practical importance. The writer says advisedly a woman with albuminuria and not with nephritis, because, as he has already explained, the diagnosis cannot always be made positively immediately after labor when the antecedent history is
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