The Brooklyn Medical Journal. Vol. II. No. 2. Aug., 1888Various
Science
The Brooklyn Medical Journal. Vol. II. No. 2. Aug., 1888
Various
Medicine -- Periodicals
Dr. D. B. Hart (E. M. J., Feb. 1888,) reports eight cases of this
complication with seven deaths. With reference to the etiology Dr. Hart
thinks the progress of the cardiac lesion is greatly accelerated by the
increased amount of work imposed upon the crippled heart during
pregnancy. At the beginning of labor, therefore, we may get failure of
compensation, dilated heart and engorgement of the lungs. At the close
of the labor, if free hæmorrhage does not occur, the extra blood before
accommodated in the utero-placental sinuses is returned to the right
heart. Death is therefore liable to occur in the third stage from over
distention of the right heart.
Dr. Ballantyne (E. M. J., March, 1888,) adds two more cases to the above
record, both terminating fatally. Sphygmograms obtained in these cases
show that the period immediately following the expulsion of the placenta
is the one of greatest danger, and they are entirely consistent with
Hart’s theory of the cause of death.
TREATMENT OF ABORTION.
Fry (Am. Obs. J., June, 1888,) advocates the use of the galvanic current
as a substitute for the curette for the removal of retained fragments of
the secundines. He uses a current of sixty to ninety milliamperes with
the anode in the uterus. The application is continued from six to ten
minutes and repeated on alternate days. The placental tissue, owing to
its relatively low vitality, is destroyed without injury to the uterus
itself. Separation and expulsion follow. Hæmorrhage is relieved by the
well known hæmostatic action of the positive electrode. Dr. Fry also
claims antiseptic properties for the positive pole since here are
liberated oxygen and chlorine in a nascent state and also acids.
Goodell thinks the curette an inefficient instrument for the evacuation
of the uterine cavity and liable to injure the uterus. He advocates
polypus forceps. Parrish finds the curette deceptive. He uses the
finger. Longaker prefers the finger. [A Sims’ speculum, a dull curette
and a strong, straight uterine dressing forceps, with its joint two and
a half inches from its distal end need never fail. The finger is
awkward, difficult, painful, and sometimes requires preliminary dilation
of the cervix. It cannot, moreover, be so easily sterilized, and even
though clean primarily is liable to carry septic organisms from the
vagina. Injuries to the uterus are for the most part the fault of
imperfect asepsis.]
PLACENTA PRÆVIA.
Obermann (Arch. f. Gyn., B. 32 H. 1.) discusses the treatment of
placenta prævia by version with the results obtained in sixty-four cases
at the Leipsic clinic. The method, which has become known as Hofmeier’s
method, he states as follows:
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