Obstetrics: the science and the art.

  • Meigs, Charles D. (Charles Delucena), 1792-1869.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Obstetrics: the science and the art. 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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    beforeliand, that twenty-four ounces shall be suf&cient in all con- stitutions alike to effect the cure; and certainly some women may bear, and even require to have taken away thirty ounces, or even a larger quantity. Vide Case, p. 26, my Introd. Essay to Gordon, &c., 1842. What I most desire in the Student, and what I thank Gordon most for, is the earnestness with which he fixes the lowest limit at twenty ounces. Let the Student read Hey, Armstrong, and Lee, Legouais, Baudelocque, Dance, Meissner, and Kiwisch, to discover more clearly, if possible, the grounds for defending the antiphlo- gistic treatment. 859. It is true that this treatment is combated in very high quarters, and among others by that most excellent and worthy writer. Dr. Eobert Collins, of Dublin. This gentleman's experience in the treatment of hospital cases, which was considerable, led him to the opinion that bleeding is not the proper remedy for these cases, however much it may be applicable in out-of-door patients. He says, at least, in four epidemics which I have witnessed, the symptoms were usually of the lowest typhoid description, the pulse being so feeble and indistinct, as to make you dread, in many, even the application of leeches, &c. Dr. Collins had charge of eighty- eight cases, of which thirty-two recovered, and fifty-six died. Only fifteen of the eighty-eight were bled, of whom seven recovered, and eight died. He adds: The result of my observations upon the treatment of puerperal fever is, that general bleeding, except when there is a strong full pulse, and the symptoms are of a highly inflam- matory character, is injurious. Such are the words of Dr. Collins, from which it is plain that he entertains views of the malady different from those I have in this chapter set forth. I look upon the cases of peritonitic form as being invariably dependent upon a primordial area or disk of inflammation, which ought to be limited and then resolved, by early venesection. Upon examining Dr. Collins's cases of fatal disease, the No. 60, p. 424, gives us the example of a woman delivered at 4 P. M. on the 12th. On the 13th, had slight pain in uterine region; pulse quick; an oil draught. In the after- noon, pain greater; soreness; hurried pulse; moist white tongue. (The case probably installed early on the 13th.) Four dozen leeches, &c. On the 14th, 9 A. M. (say twenty-four hours after the attack), she was in great pain, on account of which four dozen leeches had been applied at 1 A. M. Twenty-five ounces of blood were taken from the arm, which she bore extremely well, though the vene- section did not in the least relieve the pain. At 9 P. M., the pulse being full and beating 138, she was again bled twenty-two ounces,