Blistering the cervical vertebrae, often recommended in vomiting of pregnancy, is generally useless and only adds to the discomforts of the patients. Unmarried women are not often afflicted. Limited sexual intercourse or absolute abstention should be enjoined. Pathological vomit ing is not the vomiting of pregnancy, but vomiting in pregnancy. McDonald (Montreal Med. Jour., Sept., '97).
In the treatment of vomiting of preg nancy, following suggestions offered: 1. The abnormal irritability of the nervous system, including the vomiting-centre, is to be allayed by keeping the patient in the horizontal position, by attention to the skin and bowels and kidneys, using rectal and, if necessary, hypodermic in jections of salt solution. 2. The hyster ical condition which is so commonly found present should be controlled by strengthening the will and influencing the dominant idea of the patient. 3. All sources of peripheral irritation should be discovered and treated. 4. In extreme cases subcutaneous saline injections serve the threefold purpose of (a) diluting the blood and increasing vascular tension; (b) eliminating toxins through renal and intestinal emunctories; (c) furnishing two most important kinds of food. 5. Induction of abortion is never indicated. At a stage when it is safe and efficient it is not necessary; and in extreme cases it adds greatly to the danger, rarely stops the vomiting, and can be substi tuted by the artificial serum. Bacon (Amer. Jour. Med. Sci., June, '98).
Copeman's plan of dilating the cervix with steel dilators has been pronounced very efficient, but it will not always suc ceed.
Case of hyperemesis gravidarum for which various remedies had been used without success, until it was decided to empty uterus. In thirteenth week cer vix was packed with iodoform gauze, with the woman in Sims's position. Vomiting immediately decreased, and in twenty-four hours ceased entirely. Abor tion did not take place, and woman went on for another twelve weeks perfectly well. Then vomiting began again as violently as before, and in the twenty sixth week gauze tamponade of cervix was repeated. Once more vomiting was greatly relieved, though not entirely stopped. A third time, in thirtieth week, vomiting became so severe that the cer vical tamponade was used, and following this the vomiting again ceased entirely.
In the thirty-third week vomiting re curred, and, as child was viable, preg nancy was terminated, living child being obtained and mother made a good re covery. F. A. Kehrer (Centralb. f. Gyn., Apr. 11, '96).
Dilation of the cervix relieves vomit ing of pregnancy very promptly in some cases, in others within a few days. As regards the ultimate procedure of empty ing the uterus, the general tendency is to delay too long the operation, one which in itself is not without danger, especially in patients whose vitality is very low from inanition. Gardner (Brit. Med. Jour., Oct. 23, '97).
Two cases that had resisted absolutely all other measures were permanently cured by the following: Etherizing the patient, dilating the cervix slowly and carefully to the width of about an inch, and then painting the cervical canal with Churchill's tincture of iodine thor oughly. F. W. Johnson (Boston Med. and Surg. Jour., Mar. 21, 1901).
As to the drug treatment, one may use a mixture containing Bismuthi subnitr., gr. x. Cerii oral., gr. v.
Sodii bicarb., gr. v.
Cocaina2 mur., gr. j.
This may be taken dry, upon the tongue, or the cocaine alone may be used. Dilute hydrocyanic acid, in 1-drop doses, or pure carbolic acid, in 1-drop doses, are sometimes efficient.
Nine cases of vomiting of pregnancy in which orexin tannate yielded good results. As a rule, the desired effect was obtained after only a few powders had been given, and remained permanent even when the use of the remedy was suspended. F. Hermanni (Ther. Monats, xiii, p. 24).
Oxygen-water employed with very great success in the treatment of the vomiting of pregnancy. Inhalations of oxygen are also useful. The oxygen water employed contains 10 volumes of the gas, and is administered in the dose of 1 teaspoonful to the ounce, diluted with an equal quantity of water; to be taken in half to one teaspoonful at a time. Gallois (Jour. des Pract., Mar. 20, '97).
Orexin given in doses of grains, two or three times a day, followed by a little cold fluid, water or milk, has proved very prompt in relieving hyper emesis gravidarum. R. Frommel (Thera pist, June 15, '98).