[Ingluvin in doses of 5 to 10 grains three or four times a day is frequently followed by marked success in control ling the vomiting. ED.] Cocaine in capsules—V., grain of co caine to 3 of monobrornate of camphor— will invariably stop the vomiting of preg nancy. Dudley (Amer. Jour. of Obstet., Feb., 1900).
The treatment that has been generally satisfactory personally in the nausea and vomiting of pregnancy is feeding the patient day and night. Of course, one cannot expect to get permanent re lief in all cases; but feeding the patient, constantly feeding her, gives the most relief and comfort to the patient. A pregnant woman, with nausea and vom iting, then should have a glass of milk, crackers, oranges, or anything else she may take a fancy to, setting on a table near her bed at night so she can satisfy her hunger at any time. Before rising in the morning she should have a good substantial meal, consisting of coffee, milk, eggs, mutton-chops or beefsteak, buttered toast, or whatever else she may fancy. After partaking of her breakfast in bed she may arise, and during the day thereafter she may take about three more substantial meals. during the night is conducive to sickness in the morning and possibly during the ensu ing day. J. M. Batten (Phila. Med. Jour., Mar., 1901).
Eight cases of persistent vomiting of pregnancy treated by systematic saline injections, preferentially by the rectum, of from 3 to 4 litres of artificial serum daily, in divided closes of 300 cubic centi metres (10 ounces) each. The injection is made so slowly as to occupy from ten to fifteen minutes, and is arrested if it produces peristalsis, to be recommenced when the movements have eceased. Should there be intolerance a few drops of laudanum may be added, or. if neces sary, the serum may be introduced hypo dermically. During the ten days or so that the treatment is continued the pa tient takes neither liquids nor solids by the mouth, and then, while the injec tions are continued for several days, oral nourishment is gradually increased from a few mouthfuls to the ordinary quantity. This treatment is based on the idea that the persistent vomiting of pregnancy is due to general intoxica tion, and averted the necessity of in ducing abortion in any of the eight cases in which it was adopted. Condamin (Lyon Medical, Feb., 1902).
Finally there remains the emptying of the uterus as a last resort, and only as a last resort. It should only be done after careful deliberation and with the ap proval of skilled counsel. It should never be done merely to please or satisfy the patient or her friends.
When the patient shows signs of ex haustion as manifested by rise of pulse to 115 or 120, and the vomit becomes • dark brown or blackish, abortion should be induced without delay. This should be done under iinaosthesia in most cases Mauray (Brit. Med. Jour., Oct. 23, '97).
Ptyalism.
This complication is far less common than the previous one. It consists in an aggravated irritability of the salivary glands, the saliva being poured out in an almost constant stream. It is apt to occur with primiparm, and in the first three or four months of pregnancy. Its effect is to weaken the patient and im pair the digestive function. The quan tity of saliva secreted in the twenty-four hours may amount to one or more pints. The saliva may be purely fluid or watery, or it may be mingled with an abundance of mucus, and be thick and ropy.
Treatment—There is no remedy for this trouble which compares in efficiency, so far as I am aware, with the sulphate of atropine, which may be given in grain doses repeated every three or four hours until physiological effects are ap parent.
Two cases of ptyalism during preg nancy. In one case the cervix was cau terized, and bromides and cocaine were given, and, later, atropine, with good results. In the second case this treat ment was without result, and abortion was procured. This was followed by cessation of the salivation. Lvoff (Cen tralb. f. Gyn., No. 29, '97).
Displacements of the Uterus.
This condition may be present when pregnancy begins or it may be acquired at any period of gestation. The subject has already been alluded to in the fore going pages. The displacement may be lateral, anterior, or posterior, and it may be more or less exaggerated. It may be simple or it may be complicated by adhesion of the peritoneal surface to the contiguous peritoneum. Whether the adherence exists at the beginning of pregnancy or is acquired subsequently. it is always an unfortunate—not to say a dangerous—complication in so far as the continuance of pregnancy is concerned.