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ERGOT OF RYE.
795 go on to the natural term of utero gestation. The conclusions I would deduce from thu She was now about five months and a half’ case are, ist, That when the production of advanced in pregnancy. She naished prpmature delivery is decided upon, it is statement by informing me that the proper to give ergot of rye, because by its rhage had continued more or less, daily, toi agency we secure a proper contraction of the present time, and that it was then ez-, the uterus, sufficient to expel the fœtus, and also to contract the organ itself to its cessive. The woman was œdematous, so weak,; natural dimensions after delivery, and, 2ndly, That cases exist when this potent pale in the face, and greatly that I entertained a very unfavourable remedy may be useless and ita action inniou of the case ; and my fear was muchjurious, unless the unyielding membranes increased when I reflected that the most! be perforated. JOHN POCOCK HOLMES. judicious treatment that could be adopted had already been put in force ; and, as she 21, Old Fish-St., Doctors Commons. assured me, with the greatest strictness and attention on her part. I mentioned the
her boemor-
easanguineous, opi-
I
that something must shortly but as she had mentioned Dr. ERGOT OF RYE. Darling’s name, I was desirous of consulting him. In the interim 1 prescribed. The To the Editor of THE LANCET. remedies I employed had, however, no effect; and on the 21st I had the pleasure SIR,-In TiiF. LANCET for February 9th. of consultation with Dr. Darling, when I 1828, No.232. I read Mr. Howell’s case of stated my opinion that nothing could be transfusion with much interest, and there ia done but to bring on premature labour. great reason to believe that the life of the The Doctor assented, and I then suggested woman was preserved by the efficient prothe use of the ergot of rye; and if that cess employed by Mr. Howell and his failed, the necessity of puncturing the friends, and the case does them great credit. membranes. This was agreed to, and on Having a case lately that greatly resembled the same day (Saturday), I proceeded to it, and was relieved less operose means, I bring on labour. For this purpose I ad- transmit it to you for publication in THE ministered, about half past 11 o’clock, p.M. LANCET, if you think it deserving of notice. a wine glassful of infusion of ergot of rye M. A. Sodey, cetat. 28, of a spare habit, (made by infusing 5iij of ergot in half a pint pale countenance, and delicate constitution, of boiling water) ; I soon after examined the requested I would attend her on her third vagina ; but I could not, by any means, in- confinement, as she was extremely weak, troduce my finger in utero, on account of its and had suffered severely from the incapa. recession. Some time elapsed and I re- city of a midwife in her last labour. Here, peated the dose of medicine, which brought the placenta had been retained seven hours, on griping pains. At intervals of ten mi- with profuse hæmorrhage; she recovered nutes, two more doses were given. The slowly, and from that time was subject to pains came on in an intense degree ; I in- partial haemorrhage till the death of her troduced my finger into the uterus and eiifrom cholera, when twelve months old ; deavoured to rupture the membranes; these, after this the discharge increased, and my however, were so tough that 1 did not suc- assistance was desired ; by the usual remeceed ; the pains continued, and in the end dies, she soon amended, and again bebecame so violent that I began to fear injury came pregnant. I was called to her in lato the uterus might occur. I therefore bour, a distance of three miles, about eleven cured my perforating stilet and punctured at night ; found her up, complaining of great the membranes. The pains now took effect debility and nausea, but the pains had toon the foetal mass; and being kept up by tally ceased, and she thought labour would fresh doses of ergot, the child was expelled, not come on. After waiting two hours, I breech foremost, about half past five o’clock. desired she would go to bed and take some The placenta followed shortly, and the gruel ; and soon after the nurse came uterus became perfectly contracted. It was down stairs, and told me, that in straining singular that this woman lost not a drop of to vomit, the membranes were ruptured, but blood after delivery, a circumstance which without pain. I went up about an liotrr I attribute to the administration of the after, and was astonished to find her ao ergot of rye. changed ; she had become so weak, that she could scarcely articulate ; her countenance * For this stilet, which I invented last ; had assumed a cadaverous aspect, and her year, I received the Society of Arts’ gold ’ pulse was barely perceptible. On examinemedal for 1828. The instrument has re- tion, I found a most prodigious hæmorrhage ceived the’warm approbation of my friends, . had taken place (which had been mistaken Dr. Blundell, Mr. Shipman, &c. for the waters,) and still continued ; the
probability, be
done ;
by
child
pro-
warm
796 was a little dilated, but she had no I could just discover, that the presentation was natural, and directly gave her some brandy and water, which was instantly rejected. I then infused thirty grains of the secile cornutum in hot water, and gave her; this remained on her stomach, hut she had become nearly motionless; in twenty minutes a little pain came on and increased slowly ; soon after the haemorrhage abated, and was totally suspended. In five-andforty minutes, she continued almost without pulsation, except when roused by the pains, till near six o’clock, A.M., when a living child was expelled, and was soon followed by the placenta ; a little brandy was now given, and repeated at intervals, which restored her slowly, and she is now quite recovered. The ergot was given at half past two A.M., upwards of three hours before the expulsion of the child ; but appeared to act regularly from the first, and the bmmorrbage was restrained as soon as the effect of the os
uteri
Two
days.
days ago, nausea and retching Taxis has been tried by a surg’eon, but without success. taxis was again tried by both the attending surgeons. The child was ordered a warm bath, 3 grains of calomel to be fol-
puins.
came on.
The
lowed
by 3ij
of castor oil, and if necessary
an enema.
Five
o’clock,
P.3i.
The medicine not
having operated, an enema was given which produced a scybalous stool. No diminution of the tumour, which is now more tender on pressure. The child is more restless; fever has increased, and pulse is 140. A consultation was immediately called ; and although some doubts were entained, an operation was determined upon, as, under all the circumstances of the case, the safest course. It may also be stated, though not mentioned in the case taken in the J oumal, that a short time after the tumour was first observed, it was shown to two surgeons, who both reduced it, considered it a rupture and recommended a truss.
remedy became apparent.
1 remain,
Your very obedient servant, Now, Sir, compare these symptoms with PETER ROGERS, M.R.C.S. Al.R.C.S. the statement of your correspondent, that there was .neither fever, 1liceup, vomiting Looe, Cornwall, August, 1828. of foetid matter, want of stools, tenderness over the abdomen, or in the parts, &c. and you will be at no loss what opinion to form GLASGOW ROYAL INFIRMARY. of his veracity. He is deprived cf the plea of ignorance or mistake, for the Journals of this Institution are open to the students, To the Editor of THE LANCET. and kept with regularity. SIR,—The remarks in THE LANCET Of Having contradicted the mistatement in the 19th inst., on an operation lately per- this instance we need scarcely add, that it formed at the Glasgow Pvoyal 1-n4irmary, is expected of your justice, that you be more contain the grossest misrepresentations ; of cautious with regard to future reports from which, as they have greatly affected the the same quarter asyour last. Strict juscredit of your Journal here, it is presumed tice, Indeed, would demand that you should you will be glad to insert a contradiction publish the name of your informant, that as early as possible. he may enjoy the reward of contempt to The following’ is an abstract of the case which his conduct so justly entities him. We might have dwelt more minutely on alluded to, as it is detailed in the Journals of the Hospital. the case in question, but it will, in all proJ. P., aged 2. In right side of scrotum is bability, appear in the half-yearly account a tumour, the size of a small walnut, which of the surgical practice of the Infirmary, gives uneasiness when pressed. The abdo- which it is now usual to publish in the men is much distended, tympanitic, and, at Glasgow Medical Journal. lower part, tender to the touch. Bowels We fear no inquiry into the accuracy of constipated ; slin warm and dry ; tongue our statement, and shall not, like your white ; pulse 120; tlirst urgent. Nausea, correspondent, withhold our names. We occasional retching, and loathing of food might add to them, were it necessary, those for two days past. of a hundred of our fellow-students, The mother states, that three months ago J. R. WOOD, she observed a small swelling in the situa- .’ WM. B. LORRAIN, LORRAIX,, tion of inguinal hernia, of the size of a tilNEWLANDS. JAMES B. NEWLANDS, bert. It gradually increased, descended Students at the Glasgow into the scrotum, and in six weeks had atRoyal tained its present size. Pressure readily Glasgow, July 29th: 1828.* caused its disappearance, which was always accompanied by a gurgling noise. It has * We regret that a press of matter prebeen in its present situation for two weeks vented us from givingan earlier insertion past, and he has had no stool for eight to this letter.—LD. L. .
-
Infirmary.
her boemor-
easanguineous, opi-
I
that something must shortly but as she had mentioned Dr. ERGOT OF RYE. Darling’s name, I was desirous of consulting him. In the interim 1 prescribed. The To the Editor of THE LANCET. remedies I employed had, however, no effect; and on the 21st I had the pleasure SIR,-In TiiF. LANCET for February 9th. of consultation with Dr. Darling, when I 1828, No.232. I read Mr. Howell’s case of stated my opinion that nothing could be transfusion with much interest, and there ia done but to bring on premature labour. great reason to believe that the life of the The Doctor assented, and I then suggested woman was preserved by the efficient prothe use of the ergot of rye; and if that cess employed by Mr. Howell and his failed, the necessity of puncturing the friends, and the case does them great credit. membranes. This was agreed to, and on Having a case lately that greatly resembled the same day (Saturday), I proceeded to it, and was relieved less operose means, I bring on labour. For this purpose I ad- transmit it to you for publication in THE ministered, about half past 11 o’clock, p.M. LANCET, if you think it deserving of notice. a wine glassful of infusion of ergot of rye M. A. Sodey, cetat. 28, of a spare habit, (made by infusing 5iij of ergot in half a pint pale countenance, and delicate constitution, of boiling water) ; I soon after examined the requested I would attend her on her third vagina ; but I could not, by any means, in- confinement, as she was extremely weak, troduce my finger in utero, on account of its and had suffered severely from the incapa. recession. Some time elapsed and I re- city of a midwife in her last labour. Here, peated the dose of medicine, which brought the placenta had been retained seven hours, on griping pains. At intervals of ten mi- with profuse hæmorrhage; she recovered nutes, two more doses were given. The slowly, and from that time was subject to pains came on in an intense degree ; I in- partial haemorrhage till the death of her troduced my finger into the uterus and eiifrom cholera, when twelve months old ; deavoured to rupture the membranes; these, after this the discharge increased, and my however, were so tough that 1 did not suc- assistance was desired ; by the usual remeceed ; the pains continued, and in the end dies, she soon amended, and again bebecame so violent that I began to fear injury came pregnant. I was called to her in lato the uterus might occur. I therefore bour, a distance of three miles, about eleven cured my perforating stilet and punctured at night ; found her up, complaining of great the membranes. The pains now took effect debility and nausea, but the pains had toon the foetal mass; and being kept up by tally ceased, and she thought labour would fresh doses of ergot, the child was expelled, not come on. After waiting two hours, I breech foremost, about half past five o’clock. desired she would go to bed and take some The placenta followed shortly, and the gruel ; and soon after the nurse came uterus became perfectly contracted. It was down stairs, and told me, that in straining singular that this woman lost not a drop of to vomit, the membranes were ruptured, but blood after delivery, a circumstance which without pain. I went up about an liotrr I attribute to the administration of the after, and was astonished to find her ao ergot of rye. changed ; she had become so weak, that she could scarcely articulate ; her countenance * For this stilet, which I invented last ; had assumed a cadaverous aspect, and her year, I received the Society of Arts’ gold ’ pulse was barely perceptible. On examinemedal for 1828. The instrument has re- tion, I found a most prodigious hæmorrhage ceived the’warm approbation of my friends, . had taken place (which had been mistaken Dr. Blundell, Mr. Shipman, &c. for the waters,) and still continued ; the
probability, be
done ;
by
child
pro-
warm
796 was a little dilated, but she had no I could just discover, that the presentation was natural, and directly gave her some brandy and water, which was instantly rejected. I then infused thirty grains of the secile cornutum in hot water, and gave her; this remained on her stomach, hut she had become nearly motionless; in twenty minutes a little pain came on and increased slowly ; soon after the haemorrhage abated, and was totally suspended. In five-andforty minutes, she continued almost without pulsation, except when roused by the pains, till near six o’clock, A.M., when a living child was expelled, and was soon followed by the placenta ; a little brandy was now given, and repeated at intervals, which restored her slowly, and she is now quite recovered. The ergot was given at half past two A.M., upwards of three hours before the expulsion of the child ; but appeared to act regularly from the first, and the bmmorrbage was restrained as soon as the effect of the os
uteri
Two
days.
days ago, nausea and retching Taxis has been tried by a surg’eon, but without success. taxis was again tried by both the attending surgeons. The child was ordered a warm bath, 3 grains of calomel to be fol-
puins.
came on.
The
lowed
by 3ij
of castor oil, and if necessary
an enema.
Five
o’clock,
P.3i.
The medicine not
having operated, an enema was given which produced a scybalous stool. No diminution of the tumour, which is now more tender on pressure. The child is more restless; fever has increased, and pulse is 140. A consultation was immediately called ; and although some doubts were entained, an operation was determined upon, as, under all the circumstances of the case, the safest course. It may also be stated, though not mentioned in the case taken in the J oumal, that a short time after the tumour was first observed, it was shown to two surgeons, who both reduced it, considered it a rupture and recommended a truss.
remedy became apparent.
1 remain,
Your very obedient servant, Now, Sir, compare these symptoms with PETER ROGERS, M.R.C.S. Al.R.C.S. the statement of your correspondent, that there was .neither fever, 1liceup, vomiting Looe, Cornwall, August, 1828. of foetid matter, want of stools, tenderness over the abdomen, or in the parts, &c. and you will be at no loss what opinion to form GLASGOW ROYAL INFIRMARY. of his veracity. He is deprived cf the plea of ignorance or mistake, for the Journals of this Institution are open to the students, To the Editor of THE LANCET. and kept with regularity. SIR,—The remarks in THE LANCET Of Having contradicted the mistatement in the 19th inst., on an operation lately per- this instance we need scarcely add, that it formed at the Glasgow Pvoyal 1-n4irmary, is expected of your justice, that you be more contain the grossest misrepresentations ; of cautious with regard to future reports from which, as they have greatly affected the the same quarter asyour last. Strict juscredit of your Journal here, it is presumed tice, Indeed, would demand that you should you will be glad to insert a contradiction publish the name of your informant, that as early as possible. he may enjoy the reward of contempt to The following’ is an abstract of the case which his conduct so justly entities him. We might have dwelt more minutely on alluded to, as it is detailed in the Journals of the Hospital. the case in question, but it will, in all proJ. P., aged 2. In right side of scrotum is bability, appear in the half-yearly account a tumour, the size of a small walnut, which of the surgical practice of the Infirmary, gives uneasiness when pressed. The abdo- which it is now usual to publish in the men is much distended, tympanitic, and, at Glasgow Medical Journal. lower part, tender to the touch. Bowels We fear no inquiry into the accuracy of constipated ; slin warm and dry ; tongue our statement, and shall not, like your white ; pulse 120; tlirst urgent. Nausea, correspondent, withhold our names. We occasional retching, and loathing of food might add to them, were it necessary, those for two days past. of a hundred of our fellow-students, The mother states, that three months ago J. R. WOOD, she observed a small swelling in the situa- .’ WM. B. LORRAIN, LORRAIX,, tion of inguinal hernia, of the size of a tilNEWLANDS. JAMES B. NEWLANDS, bert. It gradually increased, descended Students at the Glasgow into the scrotum, and in six weeks had atRoyal tained its present size. Pressure readily Glasgow, July 29th: 1828.* caused its disappearance, which was always accompanied by a gurgling noise. It has * We regret that a press of matter prebeen in its present situation for two weeks vented us from givingan earlier insertion past, and he has had no stool for eight to this letter.—LD. L. .
-
Infirmary.