Volume 2

A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    12/414
    coflc'e or ton, half a cupful of milk aiul lime-water, early iu the morn- iiifj;, iu 1)0(1 iu the horizontal position, and lie (piietly for one or two hours after the meal. Small (piautities of easily-digestihle lood pep- touizwl milk, egg-albumou iu water, animal broths—at brief intervals will be tolerated when the {(atieut has given up all pretence at keei)ing to regular meals. Koumiss, milk and S(xla-Mater, dry champagne, are frcfiuently grateful beverages on account of the carbonic acid. Abso- lute dietetic rule.s, however, cannot be maintained. The stomach of the ])regnant woman is proverbially caj)ricions and fanciful. Chari)en- tier narrates the history of a ea.se .suggestive in connection with this subject. The i)atient, four months advanced in j)regnancy, in a critical condition from uncontrollable vomiting, came under the care of Beau in the Ilopital de la CharitC. One day she asked for crawfish h la bonleluLie. Ik>an granted her request, and at once ordert>d the cra^vfish from a neighboring caf6. On the fii-st day two crawfish wore retained; on the second, six ; on the third, crawfish ad libitum, bouillon, and milk. “How oflen, indeed,” remarks Cazeaux, “have I not seen women cat ham, pat6-de-foie-gras, and the like, who could not digest a piece of sole or the white meat of fowl !” It is nccessan' to respect these caprices and fancies. M'hen all food exhibited per os is rejected, absolute stomach-rest is indicated. Nutrient encmata may now be tried. Of the great value of rectal alimentation under these conditions there c'an be no doubt. Henry F. Campbell* relates the history of a cjlsc of iK'rnicions vomit- ing of ])regnancy in which he fed the ])atient by the rcH'tnm alone for fifty-two days. In commenting u])on the value of this method Camp- bell remarks: “ Under the careftd and systematic a])plication of rc'ctal alimentation artificial abortion for the relief of gravid nausea can be banished from practice, even as a last resort.” There is .‘iomc danger, however, of irritating the mncosji of the intestine and causing diarrhoea —a pmdiarly unfavorable complication at this time. This danger can be obviated commoidy by attention to the (piantity of fluid injected, the number of the cnemata, and the chemi(“al reaction of the foods. Of the various nutrient cnemata, Lenbe’s bcef-and-])ancreas mixture,* cmim, defibrinatc'd l>eef’s 1)1o(k1,® peptonized milk, cgg-albnmcn, beef- extracts containing .soluble albnminoid.s, are among the best. From four to six ounces should l>e cxhibiUxl, not more frerpiently than once in six hours. The chemical reaction of the fluid employed should be ' Trans. Am. Gyn. Soc., vol. iii. ’ Foster: Qinicai Medicine, p. 24. The formula for Leuhe’s beef-and-pancrens mix- ture is live to ten ounces of finely-chop|>e<l beef; one-third as much finely-miueed pan- creas (pig or ox). Treat this mixture in a mortar witli five fiuidounces of lukewarm water. ’ The late .\lbert IT. Smith suggests the addition of one grain and a half of chloral to the fluidounee to prevent decomposition.