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.

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    one-quartor grain—at short intervals until the physiological action is evident. Otto has nswl eoeaine with benefit in the aggravatetl ea.ses of .seu-sieknes.s of pregnant women. Aconite diminishes the .sensibility of the afferent peripheral nerves or benumbs the semsory reflex centres. Belladonna, crea.sote, carbolic acid, and the volatile oils may also be included in this list of more or le.ss efficient remctlies. One drop of the wine of ipecacuanha in a tea.spoonful of water, given every hour, (Kicjisionally yiehls excellent results. Talma* ascribes the di.sorder to cerebral anaemia, and advi.ses the use of nitro-glyccrin, the drug being exhibited in alcoholic .solution or in olive oil in capsules. One milligramme is admini.stered daily in three dosas. Alcohol is of undoubted value in ca«es of centric emesis. It is quite po.ssiblc that the great value of champagne in sea-sickness and in cer- tain c“a.scs of the vomiting of pregnancy is due not so much to its local action as to its absorption. Of all medical agents, however, chloral, the bromides, and the ]irep- arations of opium are by far the mo.st reliable, especially Avhen the diagnosis of the purely rcflc.x nature of the vomiting is rea.sonably clear. Under these (•onditions it is well to re.sort at once to these drugs, without temjxjrizing with the remctlies already mentioned. Chloral and the bromides are l)cst exhibited by the rectum. Do.ses of sufficient size, and repeatetl at such intervals as to de]>res.s—and maintain in this .state—reflex activity, are indicatetl. Thii’ty grains of chloral and sixty of |M>ta.s.sium bromide may be addtHl to one of the nutrient enemata, and the dost* repeatetl, according to the indications in the concrete ca.«e, from one to thret' times in the c(uirse of twenty-four hours. IIypt)dcrmatic injections of morphine and atrt)j)ine or su])])o.s- itories of the aqueous extract of opium will frequently allay the tli.s- trc-ssing .synqitom after the failure of other measures. lu many cases the exhibition of opium is contraindirated by the veiy great secondary nausea, depn'.s.i;i()n, or even excitement, which it cause's. Potassium bro- mide, as ])ointed t»ut by Da Ctxsta, and atropine, measurably counteract this tendency. Bli.sters, the ether spray, the Faradic current applied to the epigas- trium, C’hapman’s ic'c-bag a]iplie<l to the dorso-lumbar region, have been of avail in the minor degrees of hyjx'remesis. Gi/nccolof/ical.—Under the gynecologi«d treatment a number of ini|)ortant operative procedures are included. Commonly, a rational indication for their employment exi.sts and can be made out; iu many cases, however, their u.se is entirely emj)irical. 1. If bimanual exploration reveals any morbid uterine displacement capable of producing symjitoms, an attempt at rectification must be ' Revue Medlco-chirurgicale dcs Maladies dcs Femmes, Feb., 188G.