The saline irrigation—if a number of quarts are used at a time—promotes di uresis and diaphoresis and indirectly en forces intestinal peristalsis, and such irri gation should become the established custom not alone in face of impending eclampsia, but also in the presence of eclampsia. Where the pulse of tension exists venesection—too seldom resorted to nowadays—is called for.
Saline transfusion should be resorted to if the patient is in a collapse and death seems imminent. These hypoder mic injections of warm sterilized water, salt (1 per cent.), to the amount of one half pint, into the vascular tissues of the will be readily absorbed. G. Covert (Chicago Medical Times, Apr., '98).
Inasmuch as eclampsia is undoubtedly a toxfernia, one should look for good re sults from the intracellular transfusion of saline solution. Bacon's apparatus consists of a glass funnel and long rub ber tube, which is connected by means of a Y-shaped glass tube and two short rubber tubes with two aspirator needles. The solution can be injected into the two axillm at the same time, and thus the main objection against the intracellular contrasted with the intravenous method may be in great part obviated. Edgar (Glasgow Med. Jour., Apr., '99).
Three cases of eclampsia treated by saline infusion. As soon as the patient rouses sufficiently, drachm doses of Ep som salts every hour are given. The salt solution usually acts wonderfully in stimulating the kidneys; but, if neces sary, dry and wet cups may be used with ounce of infusion of digitalis every four hours. The diet is exclusively milk. To stimulate the skin, the hot air bath or the wet pack is used. Tonics are given during convalescence. Allen (Amer. Jour. of Obstet., May, '99).
The experiments of Tarnier, Ludwig, and Savor certainly show that the tox icity of the blood-serum is increased in eclampsia, while, on the other hand, those of Charrin and Volhard seem to prove just as conclusively that it is not. In treatment, prophylaxis stands pre eminent. When the trouble has devel oped the treatment may be summed up in one word, "elimination," and nothing will give such immediate results as bloodletting, followed by infusion or transfusion of saline solution. If the patient be anfemie, do not bleed, but use the saline injection. The results of
such treatment observed to the effect that: (1) the patient's general condi tion will improve; (2) the cyanosis. muscular twitching., and rigidity will have ceased; (3) the pulse, which before was hard and bounding, will have lost its tenseness, and the attendant coma, be it never so deep, will slowly, but surely, be lifted. The writer says, in conclusion, that if bloodletting, together with saline infusion or transfusion, were more generally employed, better results would he obtained in the treatment. E. T. Abrams (Amer. Jonr. of Obstet rics, Jan., 1903).
Possibly vcratrum viride administered hypodermically every two or three hours in the dosage of 10 minims, until the pulse-rate is materially lowered (down to 60 or 40) will accomplish the same result as venesection, and at times the free use of this drug will render unnecessary re sort to active surgery, except where the symptoms are very urgent, when we are amply satisfied that dallying with drugs should cease.
Twenty-six cases with no deaths treated with veratrum viride by the mouth or subcutaneously until pulse had been lowered below GO and con vulsions controlled, after which the fol lowing mixture given:— Acidi beuzoici, 2 drachms. Potass. bicarb., 1/2 ounce. Spirit. mther. nit., 1 ounce. Spirit. Mindereri, 2 ounces. Syr. limonis, q. s. ad 6 ounces.
Sig.: A teaspoonful every four hours. R. C. Newton (N. Y. Med. Jour., Dec. 14, '95).
The toxins causing unentia are varied and numerous. In eclamptics the urine is less toxic than normal, while the blood serum is more toxic. The foetus is an additional source of waste-products and an additional cause of danger to the mother. The indications for treatment are to remove the toxic materials in every way practicable. Veratrum viride in cases where the pulse is strong enough to warrant its employment will be found useful. The depressing action of pilocar pine makes it a dangerous drug. Many patients with eclampsia die from over medication. Labor should be induced or delivery hastened when other methods fail to control the convulsions. P. IV. Van Peyma (N. Y. Med. Jour., Feb. 22, '96).