OBSTETRICAL CASES


OBSTETRICAL CASES.
GEO. W. SHERBINO, M. D.

CASE I.

I was called one night to see a woman t……


GEO. W. SHERBINO, M. D.

CASE I.

I was called one night to see a woman threatened with premature labor at about four and a half months. The pains came on at regular intervals and she soon gave birth to a dead foetus. I tried to deliver the placenta, but could not. I gave her to understand that she would probably have a severe haemorrhage when the after birth came away. I called every day to see her and she was feeling very comfortable, no pain or bad feeling any where.

About 12 P.M. one dark night I was sent for as the patient was flooding badly. I found a very profuse haemorrhage; labor-like pains had come on and they called for belladonna. I gave her a dose of the cm. I then could detect the placenta for the first time, but it was too high up to reach.

The Belladonna seemed to bring on the pains more vigorously, and with every pain there was severe flooding of bright red blood that had a hot feeling (Lac. c.); she said, “I am flooding to death.” Now nausea and vomiting with red blood, the symptoms had changed to those of Ipec. I gave her a dose of cm (H. S.) and the haemorrhage continued for several minutes when she exclaimed. “Something has passed me,” and I found an after birth about as large as the pain of my hand.

The haemorrhage up to now had been frightful. She said, “Doctor, am I dying?” I said, “No; only fainting.” Her face was as pale and white as a sheet of paper; she had ringing in the cars, imperceptible pulse. I pulled the pillow from under her head to let the blood flow to the brain, and gave her a dose of Cinchona, Sm. We used hot applications to the cold extremities and heart. She thought she was dying, and had reasons to think so.

This case shows how rapidly the symptoms may change from one remedy to another in the course of half an hour.

CASE II. A STRANGE CASE: SECALE.

Mrs. E., primipara, a small, delicate woman, was taken with labor. When I arrived the room was cold, no fire in the stove, and she did not desire any; her hands, feet and limbs were cold; her vagina was cold. Her temperature was 96, and yet she did not want hut very little cover on her. I gave a dose of Secale cm. (H. S.), and in a half hour her temperature came up and she permitted me to have a fire made, and allowed her feet to be put in hot water for an hour or two, and labor progressed normally.

CASE III. SPONTANEOUS EVOLUTION: PULSATILLA 200TH.

In my early practice I met with a primipara, who had the windows and doors opened, desiring fresh air; was tearfully disposed. After the second stage of labor set in I found the right shoulder presenting. I could detect the axilla and the intercostal spaces. i sent for an allopath who had retired from practice, who volunteered his services in such cases, Meantime, I gave Pulsatilla 200. He had a small hand. I had tried to pass the vulva, but could not.

A messenger was sent for him. I waited not more than twenty minutes before the messenger had time to return, and was sitting in a chair, telling her to keep back the pains all she could. One of the women said, “Doctor, something is hanging there.” I looked, and to my surprise, I found the child born all but the head. The allopath did not put in an appearance; I did not need him. Did Pulsatilla have anything to do with it? M. Dubois has seen two such cases.

We have, in fact, a first period of flexion of the trunk, of the foetus towards the side opposite to that which presents, a second one of descent, interrupted by the third movement or stage of rotation; fourth, a period of deflexion or disengagement, and according to the observation of M. Dubois, for the dorsal position we may add a fifth movement or period of exterior rotation.

Such is the account given by M. Cazeaux. Of course no one at the present day would think of allowing any of these unusual presentations to continue for the sake of observing a possible spontaneous evolution. Speedy interposing should be instituted for the purpose of saving both mother and child. -GUERNSEY.

CASE IV. SUBINVOLUTION.

This lady came from an adjoining city on the recommendation of two allopathic physicians; they thought that probably a change of air would do her good. She had taken morphine for a long time and was almost addicted to it.

I found her restless and she thought it was caused by the morphine; she could not sleep at night. Her symptoms were those of Rhus, and she got it in the cm. and she rested well that night. She evidently had had an abortion with pelvic cellulitis, the pus discharging into the rectum. She had a great deal of pelvic distress with bearing down feeling, she could not be on her feet or walk without bringing on this bad feeling.

She was constipated and the stools were ribbon shaped, with a continual desire to evacuate the bowels. This led me to believe that she had retroversion; so I made an examination and found the uterus retroflexed and lying on the floor of the pelvis; the index finger came in contact with the fundus on passing the sphincter muscle.

I used one of Guernsey’s uterine repositors in the rectum with the patient in the geno-pectoral position. I had to persist in breaking up the adhesions. For a day or two I put in a tampon of cotton to put the tissues on the stretch; by this treatment and the use of the repositor, I soon had the uterus in position.

But now, what should I do to keep it there? Must I use the abominable pessary, something I have never used in my life, nor have I ever found it necessary in one single instance to make use of “ox yokes” in any case of prolapsus; it matters not how large or heavy the uterus may be it is never necessary to resort to such contrivances.

Pray tell me how to find the similimum with this cursed torture in a woman’s vagina. I always have them removed to let the symptoms develop, for how can we tell what the symptoms are when the uterus is propped up suppressing the symptoms. You may think I am not a gynecologist, but I have cases come to me from different parts of the States to be cured of uterine troubles, and I have never found the law of cure wanting or had to use anything else than the indicated remedy.

One case took me five months and another seven. They were cases that could not be cured by the doctors that had attended them, but I had to use the remedies to meet each condition as it came up, and I kept on that way till they were completely cured. This lady had menstruated continually, for two months, and the uterus was greatly enlarged. She was always holding up her abdomen or pressing her hands against the vulva. This pressing down feeling was so great that her husband had to hold his hands and press up for her in bed at night. She was cured with Lilium tig. cm. (H.S.).

CASE V. SUBINVOLUTION.

The subject was a mother of four children, and one miscarriage, at about four mouths, from which she never regained her former health. Her husband said that he wanted me to make on examination, which I did, and found the following conditions: The vaginal speculum shows the os swollen, dark red and very sensitive; the sound indicates the uterus enlarged, retroverted and flexed in about the second degree. My diagnosis was confirmed by digital examination of the rectum.

I used Guernsey’s repositor in the retain with the patient in the knee and elbow position, but the uterus was so tender and sore she could not stand the operation. I told her I would wait a few days and see what I could do with the indicated remedy. The totality of the symptoms was as follows: She had a weakness ever since the mishap; she knew that there was something wrong there. Coition was very painful, and had been for several months.

She was taken in church one Sunday with a faint feeling, and when she started to come home by walking, she felt a bearing down so severe that she had to take hold of her abdomen with both hands and hold herself up; and she got relief from pressure upon the vulva; and lying down with a large old-fashioned Bible under hips. I gave her a dose of Lilium cm. (H.S.).

I wish to remark here that I never had to restore that uterus. She improved rapidly and all of those distressing symptoms left. I did not trouble her any more. Lilium a few doses at proper intervals cured her. The patient is a living witness to the fact.

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