Further contributions on the question of eclampsia

532

THE

ANERICAN

Solomons, Bethel: CIinioal

Journal

JOURMBL

OF

The Treatment (London),

19,22,

OBSTETRICS

of Eclampsia li, SOP.

:iISD by

the

GYNECOI-OBP Dnblin

pciet&oci.

Tho

The treatment insisted upon c0nsist.s of starvation, nothing hut water being allowe~d on the ground that the fetal toxin takes something from the blood. intended for use in the digestion of food. Stomach lavage is continued until the return is clear and then two ounces o8-f conoentrated magnesium sulphalte are left in the stomach. Bowel Iawge is employed until the return is clea,r, soda. biearb~onate is the agent employed. Morphia may or may not be use& Sodium bicarbonate, one draehm to the pint should! be injected rontineZy in all eases. The patient should be carefully w&dud because many of them drown in their own mucus due to negli” gence on the part of the attendant. The uncertainty of progno&s is ciemonstrated by the fad that one woman had a hnndrea oonvulsions and rec80vered while another had only one convulsion and died, January, February and March together with September seem to be the usual months of occurrence. In 204 eases, of eslampsia Y,he death rate wa,s 10.29 and this rate, compared with the death rate under other treatment, is sufficient argument for the so-c&lied Dublin Method. A. 6. WILLJAMSON.

ngelmznn, sehrift

P. : fiir

Further Geburtshiilfe

Contributions on the uesti.on of Eclampsia. und GynSkologie, 1923, Ixii, 187.

Monats-

The author reports his last 59 cases of eclampsia. TBere II-as a m,aternal mortality of 10 per cent and approximately 90 per cent of all the children were born alive. TheI best treatment is careful, active prophylaxis an& after co~nvulsions have occurred, the treatment must be individual. Venesection is of the greatest importance and its efIleacy is doubled or trebled when combined with infusion. Venesection not only reduces the blood pressure au& relieves the he&t, but also diminishes the viscosity of the bloosd and reduces the body temperature. Labor should be hastened preferably by rupture of the membranes. Tn only 10 per cent of the cases was it necessary to resort to operative procedures so that 90 per cent of both mothers and children were save’d without operative interfererme. Prodromal symptoms were present in all but 2 out of 223 cases of eclampsia which have come under the author’s observa’tio.n. Hence it is practically always possible to take prophylactic measures. The author claims that the rest-nitrogen is not increased, the blood eoagulat,es quicker than that o,f normally pregnant women or women in labor, the blood platelets are markedly reducea in number, and the blood possesses a higher viscosity than normally. Venesection reduces the viscosity 17 per cent, -and infusion of sodium chloride reduces it 25 per cent. The combination of vene~section and infusion reduce~s the viscosity 33 per cent. The important factors in the therapy are ha,stening of labor through rupture of the membranos~ delivery without force as soon as possible, venesection of 500400 CD., infusion of sodium ohloridg administration of ohloral, luminal and pantopon. To re’duce the maternal mortality, treatment mnst be begun besfore the convulsions occur or immediately sfter the first one. J. P. GREENHILL

tevew and

The Treatment Gynaeeology

of F&lamp&

of the

British

by Verahum

Empire,

1922,

Viride. xxix,

Journal

3f Obstctries

4%.

The author does not usme veratrone in a purely expectant. manner. The ii-eatment advocated is the injection of one cubic een’timeter of veratrum viride at the Grst opportunity. This is accompanied by the rupture of the bag of wbaters and ~110 introduction of a dilating bag for eare~s not in labcr. The drug produeos a rapid fall both in blood pressure and pulse rate. Radical operative interference is