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

XXXIV
THE CHARLOTTE MEDICAL JOURNAL.
Their experience has led tliem to .strongly will develop eclampsia and which not, alfavor
inlul)ation as the routine hospital op- though probably the one most subject to
eration in cases of laryngeal diphtheria,
Their procedure has been first to try an inheadache
and nervous recklessness is more
liable to do so. Althoush the amont of albuitial
dose of antitoxin, say 2(t,0()n units, min in the urine before the onset of the conaccompanied
by external applications of vulsions may be very slight, in most cases
heat to the throat; if that failed, them to the urine becomes solid with albumin afterintubate,
probably giving more antitoxin; ward. He does not deal with the many
and finally, if failure again, to do trache- theories as to the causation of eclampsia,
otomy as a last resort, the child getting
40,000 to 50,000 units of antitoxin.
beyond saying that most authorities agree
that it is a toxemia. The onset is always
Paralysis Agitans.—Taylor, in the Lonsudden,
and in most cases probably the
medical attendant called in has not seen
don Lancet, states the well-known fact that
paralysis agitans is one of the most disthe
patient defore. The main principles of
treatment to be followed are: (1) To con
tressing diseases of degenerative type with trol the convulsions; (2) to empty the uterwhich
we have to deal. The most trouble- us, if the attack be antepartum; (.i) to ensome
symptom is the shaking, but besides deavor to insure the eliminative action of
this the patient frequently complains of the the bowels, the kidneys, and the skin. The
feeling of constant heat, of free and trou- two chief methods of checking the fits are
blesome perspirations, and not infrec(uently (a) the administration of chloroform, and
of sleeplessness. It is idle to hope that we (f, ) the hypodermic injection of morphine,
shall ever be able to cure such a disease. He has an objection to keeping a patient
But it would be something to be able to re- under chloroform for a long time in this
lieve .some of the troublesome symptoms, condition, as it tends to increase conges- i
and Dr. Taylor has been greatly imiiressed tion of the kidneys. For many years he |
with the efficacy of hypocine in modifying has trusted almost entirely to morphine to i
—one might almost say, in some cases, in control the fits, giving at first half a grain, I
controlling—the tremors. The writer gives and repeating a quarter of a grain every J
the hydrobromide, and he gives it with a three or four hours if necessary. In cases '•
small dose of strychnine in an acid mix- of eclampsia the os general! dilates very [
ture. The dose he usually begins with is rapidly, as if nature was making an effort r
1-200 of a grain three times a day, and this to empty the uterus, so that on making a j'
can sometimes be increased up to even vaginal examination the os is found dilated '
1-100, but sometimes is efficacious even if to the size of a half-crown, or a crown piece. :
only given 1-200 twice daily. The draw- If the patient is not comatose a little chlo- ,!
back to its use in this and in other diseases reform should be administered, and thecer- I
with tremor is the excessive dryness of the vix dilated either manually or with a Hos- i
throat which it produces, and it also in si's or other dilator. As soon as the os is ',
some people very readily apparently pro- dilated to the size of the closed fist, the 1
duces, and paralysis of accommotion and child should be delivered either with forceps 1
pupil dilatation, so that these two incon- or podalic version. The placenta should I
veniences have to be borne in mind, as it be quickly peeled off and the uterine cavitv
is often necessary to reassure the patient douched '
with hot saline solution. The j
who complains of them. Of course, one I
bowels are acted upon bv enemata or bv
meets with certain cases—perhaps it is that placing a drop or two of croton oil on the |
ui these the disease has reached a certain tongue in butter. The skin and kidneys are I
stage—in whicli no benefit is experienced stimulated to action bv wrapping the pafrom
the drug. Vet in many cases, as tient in a blanket wrung out of very hot
above slated, it is useful m controlling, or water. A pint of normal saline solution
at least in modifying, the severity of the should be run in under each breast. When i
tremor.
^jje patient is able to swallow, water or i
„ . ^ . . , barley water may be given freelv. He bled ,
;
Puerperal EC amps.a.-Lrago Austra- ( three out of four of his earlier' cases over
lasian Medical (.azette) says that fortunt^,„t^
Thev all recovered, but
ately a bumiiuina in a pregnant woman ^^^ symptom remained' for a long time in
does not always spell eclampsia. During .,. r r, r ,
the writer's connection with
evidence, viz., a forgetfulness of
a maternity
everything
hospital, as well as in private practice, he that had occurred before the illness,
has seen very many cases of albuminuria
in pregnant women (in some the urine was ^^i^'V »«» '^c Semilunar Cartilages ol
almost solid on boiling) who did not de- •*** Knee.— JMorrisoii, in The London f^anvelop
eclampsia. The author knows of no cet, has had occasion to see a large number
means of deciding beforehand which patient of the above cases. He has operated on 75
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