Statements, &c., respecting the cases of Christina Cameron and David Hutcheon / by the House Committee of the Royal Infirmary, Dr. Johnston, and Mr. Morison.

  • Royal Infirmary (Montrose, Scotland). House Committee.
Date:
[1852]
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Licence: Public Domain Mark

Credit: Statements, &c., respecting the cases of Christina Cameron and David Hutcheon / by the House Committee of the Royal Infirmary, Dr. Johnston, and Mr. Morison. Source: Wellcome Collection.

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    premature labour or abortion, in the earlier stages of pregnancy.” He adds, “ it appears to me that treatment of such severity was not called for, as I am aware that, when the patient entered the Infirmary, she had walked from Braco to my house, and thence to the Infirmary, a distance of eight or ten miles.” From Dr. Johnston’s admissions as to the sources of his knowledge of this case, and the nature of the grounds he has for forming an opinion upon it, I con¬ sider it would be derogatory to myself to refute any conclusion he may have come to. In my statement of the case, however, I mentioned that, a day or two before the admission, she had been largely bled by a surgeon in the country, by whose advice she obtained a line for admission into the Infirmary, plainly showing that he considered her disorder a serious one—a walk of eight or ten miles under these circumstances was by no means likely to improve her state of health. To my knowledge, also, before coming to the Infirmary she called at the house of another medical practitioner in the town, by whom she was described as looking “most miserably ill.” For the information of the members of the Committee, I beg to add that, during the fortnight preceding delivery, she took in all but thirty-seven grains of calomel, five of which were administered upon the first day, along with fifteen of jalap —a moderate purgative merely, and one that, to be effective, required the admi¬ nistration of castor oil in the morning. The only other laxative, not “ powerful purgative,” medicine administered was a dessert spoonful of castor oil on the mornings of Wednesday and Thursday preceding labour. The diuretic remedies termed “powerful” were of the mildest kind, and administered in usual doses— they were utterly incapable of injuring even a woman in pregnancy.* The patient had no one symptom whatever of a person labouring under the constitutional effects of mercury at or before the time of her delivery, and in fact it is a matter of regret to me that she was not under the influence of this drug, as I have no hesitation in stating that the peritoneal inflammation after birth, if it occurred at all, would most probably not have been fatal. That Dr. Johnston having originated a false and malicious report, should now endeavour to establish its truth by resorting to the unworthy and unpro ■ fessional means he has done does not astonish me, but his assertion of the extreme rarity of dropsy accompanying pregnancy certainly has taken me by surprise, f * Refer to Prescriptions.—T. C. M. f Dr Campbell, late lecturer on midwifery, in his work, p. 518, states that “ sometimes premature labour is induced by the combined irritation of the dropsy and pregnancy, and the patient gradually sinks after delivery. I once witnessed a case of this kind when the disease had been brought on by chronic disease of the liver. Such cases are exceedingly intractable.” The same authority recommends, in the treatment of such cases, mild diuretics, laxatives, and bleeding. So far from the complication of dropsy and pregnancy being the very rare occurrence Dr. Johnston represents it to be, Dr. Campbell had one patient in whom it occurred in two successive pregnancies—the second time proving fatal, twelve hours after delivery. Burns, no mean authority as an obstetrician, states, edit. 8, p. 240, “ Ascites, like oedema, may be excited, in consecpience of some condition connected with gestation, or may be (as in Cameron’s case) independent of it, arising from some of the ordinary causes of dropsy, especially from disease of the liver. In the last case medicine has seldom much effect in palliating or removing the disease, and the patient usually dies within a week or two of delivery, whether that have been premature, or delayed to the ordinary time.” Blundell, edit. 1840, p. 1118, “ When the effusion is general there is much to be apprehended, for the water may accumulate so largely as to interrupt the great functions i of the body, and in that manner destroy life. If a patient labour under one of these gene- E ral effusions, dangerous in their consequences, of course your treatment should not be i inactive. You are justified in using the most powerful hydropic remedies, including elaterium, besides the ordinary remedies proper in dropsical affections, and I should feel strongly disposed to make trial of bleeding.” At page 1119, lie relates a case in several of its features resembling Cameron’s, “ This woman was freely bled, premature labour was intended, but parturition came on of I itself in the course of four and twenty hours. The next day I found the patient a great ; deal better. The day afterwards she was so much improved that she appeared to be in a ] state of speedy convalescence; unfortunately, however, she was seized with puerperal fever, i and sunk under the disease.”-T. C. M.