페이지 이미지
[ocr errors]

In the pro

which it is applied, or it may excite a real eczema. And Hebra, in his article on erythema nodosum, speaks as follows: “Some medical men, however, suppose that the tincture of arnica is a perfectly harınless remedy in erythema nodosum, and in similar affections. But I would give a friendly warning to those who advocate its use, unless, indeed, they propose to use it homeopathically, and in infinitessimal doses. portion of a drop of the tincture to a pail of water, this substance may certainly be applied without any risk of doing harın. But I have in practice had abundant reason to observe that the tincture of arnica, even when much diluted, acts most injuriously upon the skin of some persons. I have frequently seen eczema or dermatitis excited by the assiduous application of lotions containing this drug in the treatment of slight bruises or sprains.” In the Medical and Surgicul Journal, of Boston, Jan. 21st, 1875, Dr. Jas. C. White reports three cases, somewhat similar to inine. His patients had received injuries of some severity, and following the ancient and honorable custom, applied arnica, which in every case produced hyperæmia, vesicles, etc., in regular order. In view of the universal belief of the harmlessness of this drug, it seems best to place on record well attested facts in regard to its poisonous effects on, at least, a certain number of those who use it.

CHAS. W. EARLE, M. D. No. 37 Park Avenue.

Atresia Vagino with Retention of the Menses.

Mrs. H. came under my observation thirteen months after the birth of her first child. The attending physician in her confinement found the hymen unruptured, and he could only, with great difficulty, force the index finger into the vagina.

The labor was natural, and in its progress the hymen was ruptured without any interference.

The patient made a good recovery; no sloughing or other bad symptom followed, and the lochia, which was not very abundant, ceased in ten days. About the ninth month after delivery, she had all the symptoms of menstruation with the exception that there was no discharge.

A month later, there was again the menstrual molimen present, with pain and more general disturbance. With each succeeding month, the pain increased and was, as she described it, like colic. The pain, each time, was caused probably by the distention of the vagina, and the contraction of the uterus in its efforts to expel its contents. She suffered but little inconvenience during the intervals between the menstrual periods. Examination of the patient, four months after menstruation began, disclosed a small tumor as high as the umbilicus, which proved to be the uterus. Upon attempting vaginal examination, I found the opening occluded just within the internal labia. Inspection disclosed a firm star-like, or radiated cicatrix at the site of the hymen, or carunculæ myrtiformes. Further examination per rectum disclosed an elastic tumor, impinging upon the rectum and extending upward, beyond exploration in that direction.

There was no doubt as to the correct diagnosis of the case. The vagina had been hermetically sealed by the reunion of the forcibly ruptured hymen. The accumulated menstrual flow had distended the vagina, and pushed the uterus up out of the pelvis.

The following plan of treatment was pursued. Having introduced a catheter into the bladder, and the index finger of the left hand into the rectum as guides, a trocar and canula were then pushed through the center of the cicatrix, into the distended vagina. On the withdrawal of the trocar, there began to flow through the canula, a thick black fluid, resembling tar or treacle. The canula was then removed, and the opening dilated; first with one finger, then with the index finger of each hand, the force being applied in opposite directions. The contents were soon discharged through the ample opening with aid of a little pressure over the abdomen.

The vagina was then washed out with a weak solution of carbolic acid and warm water. The parts were kept from contracting by the introduction of a good sized glass pestle, which was retained in situ by a T bandage. The patient made good recovery without one bad symptum. There is a ques. tion as to the safest method of discharging the retained men

[ocr errors]

ses; whether at once by full, free opening, or by a small one, permitting the fluid to dribble away guttatim. The discharge of this fluid is by no means unattended with danger, as death has followed the operation for relief of retention, caused by an imperforate hymen. The different methods of operating by free incision, or forcible dilation, to prevent contraction and reclosure, have each their advocates. In this case forcible dilation was followed by little tendency to contract. Olina, Ini.


A Case of Belladonna-poisoning --Recovery.

August 3d. Was called about 10:30 A. M. to see Corda R., aged 34 years. When I arrived the child was apparently sleeping soundly. Pulse, 130; respirations, 20 per minutc; the entire surface of the body was covered with a very bright scarlatinal eruption, with occasionally livid spots of variable size. Upon lifting the eyelids, found the pupils dilated to such an extent that only a very small circle of the irides remained visible.

The mother stated that the child had a chill on the day previous, and that she had given a large teaspoonful of quinine mixture, (quinine snlph. 3j, syrup glycyrrhiz. Zj) at 8 o'clock, to prevent the recurrence of the chill. In a few minutes after taking the dose the child had vomited slightly, and in less than an hour after she cominenced having spasms, which continued, alternated with periods of repose until my arrival, two hours and a half later.

Upon examining the supposed quinine mixture, it proved to be fluid extract of belladonna, which the mother had used locally, some time prior to this, for the purpose of suppressing a threatened mammary abscess.

The diagnosis being settled, I gave the patient a teaspoonful of ground mustard, mixed with water, repeating the dose in a few minutes, but the imperfect deglutition rendered the administration very difficult. It was followed, however, in a short time by rather imperfect emesis. I then determined to test the antidotal powers of opium.

At 11 A. M. injected $ grain of acet. morph. hypodermically in right arm, and gave a teaspoonful of a strong solution of tannic acid by the mouth every half hour. Patient slept soundly directly after the injection, except frequent slight subsultus, and the slightest touch on the finger tips would produce profound digital flexion. Pulse 126, during sleep; 2 P. M., patient aroused voluntarily, talks a great deal in a thick, gruff voice. Rash entirely disappeared. Right pupil slightly contracted; left very large; very restless; injected gr. acet. morph. in left arm; continued solution of tannin. 4. P. M.

Very restless; wants to walk about, but is unable to stand alone, becoming delirious, laughing wildly one moment, screaming and clutching with fright the next. Muscular incoördination in reaching for anything.

Will overreach or fall short of the object; has lost all idea of distance; power of articulation destroyed. Tongue appears greatly swollen.

Rash has appeared again over the entire body, more marked at flexion of joints. Pupils intensely dilated; morbid sensitiveness to sounds and objects; is terribly frightened at objects lying about. Afraid of visitors, shrinking from them and screaming wildly; insatiable thirst; motions and calls for water incessantly, but swallows it with difficulty.

6 P. M. No better; injected š grain acet. morph. in right arm. .

8 P. M. Fully under influence of last injection; resting, except occasional tossing and rolling about; subsultus tendinum when quiet; pulse, 130. 10 P. M.

Aroused patient-still wild and grasping at everything. Pupils slightly contracted, with diverging strabismus. Pulse, 128; respirations very slow; allowed patient to sleep again.

At midnight patient sleeping soundly; pulse, 126; respirations quite slow, with crowing sound on inspiration; becomes very rigid when aroused; relaxed when sleeping; rash disappeared again, giving solution of tannin every hour; roused the patient occasionally until 2 A. M., when she awoke-Talks much; articulation more distinct; calls constantly for water; gave olei olivae, olei ricini, āā, a teaspoonful

every hour; discontinued solution of tannin and injected to gr. acet. morph. in left arm.

4 A. M. Roused up and passed a large quantity of dark colored urine; pulse, 115; profuse perspiration with warm surface; remained about the same until 8 A. M., when the bowels operated freely. 10 A. M.

Patient roused up much improved; disposed to play; pupils alınost normal, dilating readily in the dark; contracting tardidly, when exposed to light; voice nearly normal; pulse, 96.

12 m. Twenty-eight hours after taking the belladonna all traces of it have disappeared; pulse, 90; pupil normal, but dilating readily; everything appears to indicate a rapid and perinanent recovery. Oakland, nl.



SCIENCE AND POLITICS. In our issue for October of last year, we published a somewhat extended editorial notice of the Chicago Botanical Garden, in which, speaking for the medical profession of the city, we expressed our satisfaction with the work already accomplished by the Directors, and commended the object they had in view to all who were interested in the study of science.

Since that date, those who have visited the south-eastern corner of the northern of the two south parks, have noticed with pleasure the labor expended in the cultivation of the more than one thousand beds-fifteen acres-of plants arranged in their natural order, as well as the luxuriant development of the flora in the four hot-houses.

And here we have to present the resolutions lately passed by the Board of South Park Commissioners, which are subjoined:

WAEREAS, The great stagnation in all industrial enterprises of our country has made taxation at this time specially burdensome, therefore

« 이전계속 »