Vol. 60, 1909 - University of North Carolina at Chapel Hill

ORIGINIAL COMMUNICATIONS. 7
careful examination and found her symp- hours if bowels did not move freely. They
turns as here recorded. Pulse 144, temp, had begun moving however before I left
')'>.6 F., resp. 40. Patient complaining of
uneasiness in chest and severe headache.
She was having regular uterine contractions,
but said it was not time for her confinement.
She was coughing almopt constautly
and expectorating freely a very
liquid, frothy, blood-stained fluid. The
cough and inc eased respiration began Dec.
.51, 191)8— four days previous to my visit,
the house, between 7:00 and 8:00 A. M.
Upon reaching my office an examination
of the urine was made and found to be load-
ed with albumin. At my second visit the
following day patient's mother, who was
nursing her, reported to me that there had
been more than twenty movements of the
Ijowels. Her pulse was now 128, temp.
V9.6, resp. 30. Digitalis was now given
and became so severe that patient felt as if with the strychnine to increase the volume
she would choke to death. There were nu- of the pulse which at this time was small,
merous moist rales in the chest, and slight
dullness on percussion over the bases with
Morphine and atropine punctures at visits
for restlessness, and Dover's powder in my
diminished resonance over the apices, absence. The bowels were kept open with
There was
face or the
no edema
extremities.
of either the salts and the position of the patient's body
Then I made changed frequently. Also, Hasham's mixta
vaginal examination and found the urein tablespoon ful doses was given after
OS dilated sufficiently to readily
two fingers. A diagnosis of
admit
"pulmeals.
fruits.
The diet was restricted to milk and
Jan. f)th, pulse \20, temp. 99.6,
mouary edema complicating pregnancy" resp. 28. Jan. 8th, pulse KM, temp. 99.2,
was made, and 1 thought it best to termi- resp. 24. Jan. 24th, pulse 100, temp. norm,
uate the labor as ciuickly as possible. This resp. 20. At this visit 1 catheterized pawas
4:00 A. M. Deeming it advisable to tient again and urine was still highly albuset
up free purgation as well as to hurry the ininous. Jan. 17th, i>ulse 8), temp. norm.,
labor, five grains of calomel and two ounces resp. 20, urine albuminous. The urine was
of l-lpsom salts were administered, and the examined at regular intervlas and was almembranes
punctured. There was a large buminous till Jan 27th, when it was found
amount of amniotic fluid, and when it drain- to be normal. The abnormal signs in chest
ed away 1 proceeded to give special atteu- iminoved in proportion as did the pulse and
tion to the presentation; which proved to resp., and i>dtient made a complete recovbe
transverse, the right elbow over the in- ery.
ternal os. With two fingers in the os and
indirect or external version, Braxton Hicks'
method, was quickly done without an an- Personal Experience In Proslatic
aesthetic. Instead of bringing down a foot, Surgery.*
the right knee was drawn into the os and
the labor left to nature's efforts mainly, an
and was completed at (,:M) A. M.—just two
p.- ,,y j. ,,,^3,, m. I)., Riclnnon.l, Va., Professor
of Descriptive Anatomy an.l Oeiiilouriiiary Sur-
gery, fniversity College of Medicine,
and and one-half hours after the membranes ^y,^^^^ ^ ^^^^ ^^^^^ ^^ ^^^^ ^ ^^.^^
were punctured. After performing the
^ hesitated to accept, as my ex-
'
version, in, 1 ascertained from trom patient the date .
, , _ ,. .,., ',, . , ,,
,
p
perience has been so limited that I deemed
of last menstruation and 'ound that the .^ ,11 r ,• 1 r.n ,
.
, ,
, .it would be of comijaratively little value to
labor was six weeks or more premature. ,
c ,1 \ i„
., „M , , ,. , ^ , , f any member of the Academy. ^
1 he child was alive about one hour before -'
delivery, the foetal heart beats num- It is so frequently the case that vye membering'l60;
but was still-born on account bers of different medical societies hear paof
time required in delivering head. When Pers upon the observations deduced from
the labor was completed, twoComp. Cathar. tlie consecutive outcome of .100 cases of appillsandtwo
ounces of salts were given pendicitis, or 700 or a 1000 cases of hyster-
The respirations now numbered 44, an in- ectomy or some other operation, that the
crease of four after my entering the house: "Perator whose opportunities along special
due, I suppose, to the muscular exertion lines has not been of such numerical dimenduring
last hours of travail. Kelieving my S'ons feels a hesitancy in asking the attenpatient
to be suffering from albuminuria, ^'o" of a medical body to review the outshe
was thoroughly cleansed to avoid get- ^'"me of a few cases only; and further feels
ting any blood from the vaginal discharge H^at he would much rather wait, even if it
mixed with the urine, and catheterized with is a considerable time, until his numbers
a sterile catheter. Patient being five miles too become possibly a little more hyperfrom
my office, I gave directions that she trophied, that the experience gained from
have a tablet (coiitaiiiiiigstrych.gr. I-6O)
every two hours, a small amount of water
when thirsty, and a dose of salts every two
»Reaa t)efore tlie Kicliniond Aca.leniy of Medi-
ciueand Surgery, April 13, 1909.