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Page 104 - Two lives are at stake, and by addressing ourselves assiduously to speedy delivery of the fetus we contribute in the largest manner to the conservation of both. Rapid dilatation, first with steel dilators, if need be, then with manual stretching of the os and cervix, followed by the forceps, is the nearest approach to idealism. Only rarely can the deep incision of Duhrssen be required.
Page 104 - If it fails to eliminate toxins, symptoms are promptly presented in the pregnant woman. Renal insufficiency is a usual accompaniment of the eclamptic state. Over-production of toxins and underelimination by the kidney is a short route to an eclamptic seizure. However, many women with albuminuria escape eclampsia and many eclamptics fail to exhibit albuminous urine. The microbic theory of eclampsia has not yet been demonstrated. The toxemic theory in the present state of our knowledge furnishes the...
Page 104 - Cesarean section should be reserved for extreme complications, as deformed pelvis, or to preserve the fetus when the mother's condition is hopeless. Veratrum viride is dangerous, uncertain and deceptive in action. In eclampsia of pregnancy, ie, prior to term, the aseptic bougie, introduced to the fundus and coiled within the vagina, may be employed to induce labor. Finally, to promote the elimination of toxic material diuresis, catharsis, and diaphoresis should not be forgotten : neither should the...
Page 104 - One of the surest ways to control progressive toxemia is to place the woman upon an exclusive milk diet. This will also serve to flush the kidneys and thus favor elimination. Distilled water is one of the best diuretics; it increases activity and supplies material — two important elements. In the pre-eclamptic state, when there is a full pulse with tendency to cyanosis, one good full bleeding may be permissible, but its repetition should be regarded with suspicion. If there is high arterial tension...
Page 104 - ... fail to exhibit albuminous urine. The microbic theory of eclampsia has not yet been demonstrated. The toxemic theory in the present state of our knowledge furnishes the best working hypothesis for prevention or cure. Treatment should be classified into (a) preventive, and (b) curative. The preventive treatment should be subdivided into medicinal and hygienic ; and the curative into medicinal and obstetric. A qualitative and quantitative analysis of the urine must be made at the onset. If there...
Page 105 - ... the nervous erethism, producing a decided effect in a short time, — sometimes in fifteen minutes, but almost certainly within an hour, — and keeping the nervous system under control for several hours. The administration is followed by cooling of the surface, great lowering of the pulse in rate, but not in strength, and along with this complete arrest of the convulsions. The state of the pulse is the guide in treatment. From a high rate, which rules in the disease, it is reduced to the normal...
Page 105 - With the pulse for a guide, no untoward symptoms need occur from its use; the pulse may be brought to 50 without any general depression; if carried so far as to produce vomiting we may find great prostration produced by the nausea, which is overcome within thirty or forty minutes by opium or any diffusible stimulant, perhaps in less time by a solution of morphia hypodermically.
Page 105 - The state of the pulse is the guide in treatment. From a high rate, which rules in the disease, it is reduced to the normal standard or below it ; and while it is kept below 60 there need be no fear of a recurrence of the paroxysms. When this effect has been once produced, it will continue several hours, and a single dose will do it ; if not apparent within an hour or less, the medicine must be repeated in smaller doses, and it can be safely repeated at intervals until the pulse begins to fall. With...
Page 248 - ... fourth or fifth day after the operation the patient may die. At the necropsy the peritoneum may be found to be practically unchanged, or to exhibit so trifling a degree of peritonitis as not to account for the symptoms, nor for the fatal result. Various explanations of this condition have been given. There is no doubt that the nervous disturbance which attends any abdominal operation leads to some degree of intestinal paralysis. This paralysis, attended, as it is, by vasomotor changes in the...
Page 277 - ... be the basis of military operations against the latest addition to the republics of the world, such action being, as I shall herein point out, without foundation in justice. Lest it may be thought that, in addressing you, I am exceeding the just rights of those whom I have the honor to represent, I may be pardoned for calling your attention to the fact that the Constitution of the United States provides in substance that no person, howsoever humble he may be, shall be deprived of his life, liberty,...

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