A System of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman.
- William Leishman
- Date:
- 1875
Licence: Public Domain Mark
Credit: A System of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman. 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.
732/824 page 716
![surrounded with oiled silk. We have seen Misters applied id the early stage of the disease, but at this time they are not only useless, but are actually injurious. During the second stage, after the acute symptoms have disappeared, a blister is useful in the treatment of the inflammatory indurations which result from the disease. Under these circumstances it not only subdues the remaining inflammation, but it materially as- sists in effecting the resolution and absorption of the inflammatory formations in the peritoneal cavity. If the symptoms of purulent infection should supervene, in conse- quence of an attack of general peritonitis, the patient must be treated as in other cases of pyaemia.—P.] In the worst forms of the disease, and especially in hospital epi- demics, the power of medicine and the skill of the practitioner are alike set at defiance; but, however desperate the symptoms, and ap- parently hopeless the prognosis, we must persevere so long as life lasts. Between simple puerperal peritonitis and the malignant fever—which is as deadly as the plague—infinite varieties may be observed ; but the management of all will be more successful if we proceed upon gen- eral principles, rather than minute and special distinctions. We shall, therefore, content ourselves by mentioning, in addition to the means already detailed, the various remedies which have been found useful by the most experienced and able of those who have written on the subject. M. Doulcet, in the course of a severe epidemic at the Hotel Dieu, thought of using emetics at an early stage of the disease, and the results, as detailed by him, were eminently satisfactory. Subsequent experience, however, has not realized, in the hands of others, the hopes which M. Doulcet's statements seemed to encourage. The emetic em- ployed was ipecacuanha, and it was repeated daily until the symptoms were subdued—a potion being administered in the interval, composed of oil of almonds, syrup of marshmallow, and Kermes' mineral. At one time, calomel was given very freely in those cases, and, on the whole, as it would appear, with benefit. On this point Gooch observes. I have never given it systematically in a number of cases, but what experience I have is in its favor. In the Westminster Lying-in Hos- pital, where ten or twenty grains of calomel used to be given every day, with purgatives, the gums sometimes were affected, and these patients invariably recovered. The fact of all those recovering where the gums were affected may, however, be otherwise explained, on the supposition that if they live long enough for mercury to produce its constitutional effect, the urgent danger of the case has necessarily, in some measure, passed. It will generally be found advantageous to combine opium with the mercury, but, in this respect, much will depend upon the stage which the disease has reached. Spirits of turpentine has been very highly recommended in the treatment of puerperal fever, but the effects produced by its internal administration seem to have been somewhat exaggerated. Flatulent distension of the bowels is. however, so frequent a complication, that we would naturally antici- pate some benefit from this drug, although, perhaps, it would be more correctly described as a palliative. In point of fact, there is nothing of the nature of a specific remedy which we are warranted in recom-](https://iiif.wellcomecollection.org/image/b21016112_0732.jp2/full/800%2C/0/default.jpg)
