On alcoholism in gynaecology and obstetrics / by J. Matthews Duncan.

  • James Matthews Duncan
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: On alcoholism in gynaecology and obstetrics / by J. Matthews Duncan. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ill women than in men; and this comparative rarity is so great as to justify tlie belief that women are less liable to it than men. In other words, this comparative rarity justifies the belief that the same amount of inebriety in women and in men will have as a consequence far fewer cases of delirium tremens in the female than in the male sex. But fuller demonstration of this belief is desiderated. The disease is not restricted, as a complication, to the recently operated on : it occurs in medical cases, as of pneumonia, as well as in surgical cases. Lancereaux,i believing the nervous delirium of Dupuytreu, Albers de Breme, and Lind, to be delirium tremens, cites GrisoUe, Eayer, Briquet, Schmidt, and Chansing, as describ- ing its occurrence in medical cases, and as supervening on the seventh or eighth day, not at the beginning of the disease, or during convalescence. He adds that, of 636 cases in the Duchy of Nassau recorded by J. B. V. Frank, 117 occurred in the course of various diseases and injuries. In pneumonia, 50 ; in compound fractures, 11 ; in pleurisy, 7, etc. The puerperal state may be described as partaking of characters both medical and surgical. The following case began, as in medical cases, on the seventh day. Mrs E., 31 years of age, 11 years married, has had six children and three miscarriages, was attended by Dr Mack at the birth of her seventh child, in which there was nothing unnatural. On the second day after delivery, symptoms which suggested an attack of typhoid fever made their appearance ; copious peasoup stools; pulse about 120 ; temperature from 103° to 104°-5 ; manner excited and otherwise unnatural. [There did not at any time appear the eruption of typhoid.] On the fourth day of her confinement I could find no distinct local disorder to account for her peculiar condition. There was little milk in the breasts. There was some tenderness on deep pressure in both iliac fosste; and, per vaginam, some fulness was suspected on each side of the uterus. These slight conditions remained, little modified, till the patient was convalescent, in the course of the third week after the birth of the child. The womb was slow in its progress of involution. Oil the sixth day there were traces of delusions, but no other notable addition to former symptoms. At this time alcoholism was provisionally diagnosed, but inquiry obtained only asseverations of strictest temperance. Yet the nurse said her patient frequently asked for brandy. On the seventh day it was accidentally dis- covered that she had daily been having frequent small doses of brandy during the latter part of the pregnancy. In the evening she had regular delirium tremens. No milk in the breasts. Tongue has whitish fur and is red along the middle line. A large opiate did not procure sleep. On the ninth day the vivid delusions disappeared, she was rational [but an excited, unnatural manner 1 Loc. cif., p. 693.