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

338 THE CHARLOTTE MEDICAL JOURNAL
but the indication is not to incise before an uterus was still found fixed. The patient
unmistakable abscess has formed: special was not seen again until 15 hours after the
caution is to be observed before operating onset of labor. Pain was complained of in,
where there is an infectious pyosalpinx. and there was tenderness over, the lower
The author finds that incision and drainage abdomen; there was some external hsemorin
recent puerperal peritonitis has not been rhage; pulse 100. On examination no presuccessful.
Benefit is to be obtained in senting part could be felt, and the outline
suitable cases from compresses, cataplasms, of the os could not be made out. Campbell
painting with iodine, hot air, etc. The saw her two hours later. The patient was
hot-?ir treatment is useful in aiding the re- put under antesthesia in the cross-bed posisorption
of older exudates, but is not to be tion, the vulva washed, and the vagina
used until the inflammatory process has douched with a 1 in 2000 sublimate solualtogether
quieted down. General treat- tion. On inserting the hand into the vagina
ment is of great value. The serum treat- a large opening was found which led into
ment is considered. Fresh human normal the abdominal cavity, the hand passing beserum
has been found to have a good effect tween the posterior lip of the cervix behind
in cases of staphylomycosis and strepto- and the bladder in front. No remains of
mycosis. Large quantities of fluid are help- the anterior cervical lip could be felt. The
ful. Water is to be given either subcu- finger could be passed over the posterior lip
taneously in large amounts oris to be slowly and downwards into the contracted uterus,
injected, J 2 litre at a time, into the rectum which lay completely retro verted in Dougmany
times a day. Alcohol is to be recom- las's pouch. On passing the hand above
mended in small doses to meet symptoms the pelvic brim the foetus with the memonly.
The food must be easily assimilable; branes enclosing it entire was found lying
milk is especially useful; deficiency in food free in the peritoneal cavity. The memis
less dangerous than an excess leading to branes were ruptured and the foetus easily
dyspepsia. Adrenalin is to be given in extracted, the placenta and membranes becases
of peritonitis to combat the vasomotor ing subsequently removed by hand easily,
paralysis. In view of the fact that a rise The coils of small intestine tenditig to proof
temperature aids the organism in its fight lapse into the vagina, a number of strips of
against infection, antipyretics are to be ex- sterilized gauze were packed into the opencluded
if the general condition admits of ing so as to protrude well into the peritoneal
it. cavity above and to fill the vagina. Finally
»;„.„!„„i i„^..„i