The method by which veratrum viride is supposed to do good in cases of puer peral eclampsia is a double one. Chiefly from the action of its alkaloid, jervine, it powerfully depresses the circulation, and so bleeds the woman into her own vessels, relieving by this means conges tion of the cerebral and spinal vessels and reducing in all probability any spasm of the renal blood-vessels which may be present, thereby causing marked increase in the flow of urine. In addi tion to this action, jervinc also acts as a powerful sedative to the motor tracts of the spinal cord, and so directly quiets nervous excitation, while the copious sweating which often follows its admin istration aids in relieving the blood of impurities, the kidneys of congestion, and relaxes tbe peripheral blood-vessels. Editorial (Therap. Gaz., Mar. 10, '96).
Vcratrum viridc used with marked success. The remedy notably diminishes the frequency of the pulse, and convul sions rarely occur when the pulse is kept at or below GO. Of 100 patients treated by veratrum viride in the writer's practice, 92 were saved. Parvin (Universal Med. Jour., Oct., '96).
During the attack itself chloroform administered. As soon as the attack passes, 15 drops of the fluid extract of veratrum viride are given hypodermic ally, and a drachm of chloral in solution by enema. Two drops of croton-oil di luted with a little sweet oil are placed upon the tongue. Diaphoresis is induced by hot packs and extra bed-clothing. A pint or more of decinormal salt solu tion should be injected by gravity under the breast, or several quarts of the solu tion by enema. If convulsions recur, the veratrum may be repeated in 5-drop doses if the pulse is quick and strong. If the face is congested and the pulse full, venesection enough to reduce the pulse should be enaployed. The chloral may be repeated during the attack two or three times. Stimulants are to be used if the pulse is weak and rapid. If the convulsions cease and the patient is in a stupor, but can be aroused enough to swallow, dessertspoonfuls of concentrated solution of Epsom salts should be given every. fifteen or thirty minutes until free catharsis takes place. B. C. Hirst (Med. Record, Mar. 4, '99).
In five personal cases of eclampsia there was not a single convulsion after ether had been thoroughly given. though in these cases many convulsions had fol lowed other lines of treatment. The harmlessness of continuous and thorough anresthesia is emphasized. In the five
cases atursthesia was kept up front eight to twenty-four hours, deeply enough to keep the patient quiet, and there was not a single symptom that showed that any of the women was any the worse for the anmsthetie. J. P. Reynolds (Boston Med. and Surg. Jour., Nov. 9, '99).
Veratrum viride is the remedy par ex cellence in celampsia. acting to reduce arterial tension and to soften the rigid os, thereby removing the causes pro ducing the malady, F. L. Brigham (Amer. Gyntec. and Obstet. Jour., Dec., '90).
Nitroglycerin, in the dosage of grain, hypodermically, repeated pro re nata will tend to relieve the cephalalgia. When the convulsions appear suddenly morphine, 1 grain hypodermically, is called for until chloroform anfesthesia to the surgical degree is secured; but otherwise opium and its derivatives should not be countenanced, because of their tendency to inhibit secretion from the intestinal canal and from the kid neys, thus defeating the prime peutic aim, which is to increase secretion and excretion.
Case of puerperal infection treated by Marmorek's antistreptococcic serum with very successful results. Other drugs were used with no benefieial effects; but, upon beginning the serum-treatment, im provement \vas steady and rapid. and four days after the first injection the temperature was normal. r, . de Seig neaux (Centralb. f. Dec. 16, '99).
The pathological features and symp toms that require treatment are: The toxmmia, anmmia, the convulsions, the labor-pains, hypersensitiveness of the nervous system, to avoid causing cedema the lungs, heart-failure, and high tension pulse.
For the toxmmia, elimination by pur gation with calomel, accompanied by magnesium sulphate in V,-ounce doses of the saturated solution. In antepar turn cases this purgation, with an occa sional (lose of calomel, must be kept up until the child is born. One of personal cases carried on in this way after the patient had had eight convulsions for seven weeks, when a healthy child was born, and thrived. In 2 eases it hap Pened that when the mornine. course of saline:3 was omitted, owing to the bowels having moved early in the morn ing, convulsions eame on again at night. In 1 of them, after the patient had been kept free from convulsions for a week. In case of nnconsciousness, 2 minims of croton-oil may be introduced through a stomach-tube.