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

358 THE CH RLOTTE MEDICAL JODRNAL
hydrotlierapy. Stimulants are e^ dv called to cleaning out the uterus. In acute sal- ,:
for of which brandv, in small doses fre- piugitis, of gonorrhceal or other origin, even i
queutly repeated, is the best. Port wine before pus has formed, the tubes will aland
claret may also be given. The only ways drop low down behind the uterus, so i
other druo- that he has ever seen do good is that they can be very easily gotten at through ;
mercury Either as calomel placed on the this incision, and then swabbed out with |
tongue'or as bichloride in 1-100 grain doses carbolic acid or tincture of iodine, or other- i
every two hours. If collapse be present, wise treated conservatively. This opera- i
the child should be placed in a pack, the tion may be done more than once on the !
temperature of which is 100 degrees, and same patient if there is a re-accumulatioii .
kept at this by pouring on hot water -very of the pus. In cases which are not entirely !
twenty minutes. At the same time, hypo- relieved by this treatment, it is much easier ,
dermoclysis should be gi-en, to which caf- and safer later on to do a complete opera- i
feine, 1-6'to 1-2 grain, is added. Ether and tiou by the abdominal route,
camphor may be given hypodermically.
Alcohol should not be given m this stage
If the hot pack is not used, a hot mustard
,rf,is,_Dr. T. E. Mitchell says that in the i
treatment of iritis three indications are to be :
^^^^ .^^ ^^^^^ ^^ follows: (1) Relieve i
bath should be given, the child being kept ^^ ^^it; te the pain; (2) keep the pupil j
in the bath until the attendants hand is dilated in order to prevent posterior adhes- !
reddened. In using either the hot pack or .^^^^ ^^^^ pupillary false membianes as a :
the bath, cold cloths should be kept on the ^^^^^ ^f i„flammatorv exudates; and (3)!
child's head. The ears should be stopped ^^^^^.^ ^^ ^^^^ therapeutic agents as are I
with cotton during the bath, and the eyes, indicated the constitutional disease of which ;
if open, as they generally are in this condi- ^^^ inflamed iris is but a local manifesta- i
tion, should be covered with moist gauze. ^.^^^
Food, as a rule, does not enter in the treat- ^^'^ ^ routine procedure, which should be ;
ment of the acute attack, all efforts tor the jjj^^ ted just so soon as a diagnosis is ,
first twenty-four hours being directed to ^^^^^^ the eye should be anesthetized with i
keeping the baby ahve.
^ ^^^^ p^^ ^^^^ solution of cocaine, fol-
Atlanta Journal-Record of Medicine, August, lowed by a few drops of a three per cent, i
iggg solution of atropia at intervals ot fave min-;
Pelvic operations in the Female per ^tes for half an hour. The above sugges-
Vaginam.-Dr. W. L. Cook thus describes tions should be carried out by the physic an ,
vdyiu^.:,^;:;E e^ient course of the dis-i
StlittSe^ru^L^P^^^^^^^^^^
the vaginal sheath, then introduce the and with as much frequency as may be
finger, and boldly, but carefully, dissect necessary to maintain a wide and uniform,]
along the posterior surface of the broad dilatation of the pupil. \
ligaments and uterus, breaking into each
^.^^^ ^^^ ^^.j^ ^^^ ciliary muscle thor-ij
pocket of pus as it is encountered. This j ^i • n f », „ (i,^i:
^ 1 1 ..,1 r . r , f , „^ ouo-hlv under the influence of atropia, the';
may be done with perfect safety, so tar as ""»"'.)' "'
|i
, ,. j i
infecting the general peritoneal cavity is pain is by this alone greatly relieved on th«^i
concerned, as there are always sufficient broad surgical principal of putting an inj
adhesions above to prevent this, and the flamed organ at rest. However, should th(i
pus escapes by the side of the finger as fast
continue, applications of moist or dr))!
as it is liberated. After thoroughly evacu- , ... , n Y
ating all the collections of pus, the opening l^eat will be of service.
_
in the vhgina should be well stretched, to Owing to the fact that the majority of all;
permit of good drainage. Now pack the cases have a specific origin, and because o,j
pelvic cavity well with 5 per cent, iodoform ^j-j^ additional fact that mercury is suppose^
gauze, which has been washed in a 1-4000
^^ ^^^^ ^ salutory effect on plastic formsoli
bichloride solution. Allow this gauze to . ^ . ,, ^- i -r*- ~.-',
remain in place four or five days, then be- inflammation generally, antisyphilitic remejl
gin to remove it, taking out a small piece dies should be resorted to without delay,
^j
each day until it is all removed, when the In rheumatic iritis, besides the local treatji
pus cavity will have almost closed up. A jjjg,,^ already outlihed, we have recourse t|!
small wick of gauze should be left in for a
^^^^ well-known anti -rheumatic thera;few
days longer to keep up the drainage. . ,. ,. -j i- i * r ^iki
This plan of treatment should be used in all Peutics as salicylic acid, salicylate of sod
cases of puerperal sepsis that do not yield and the alkalis generally. ,
; !