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SUCCESSFUL CASE OF CÆSAREAN SECTION.
By Professor Jacobucci of Naples. On the 4th of August, 1862, Philomene Morvillo, nine months preg. nant, was brought to the Hospital of Incurables. This woman was only forty-one inches in stature. On examination, the following were ascertained to be the dimensions of the pelvis :-From right to left anterior superior spinous process of the ilium, eight inches; from middle of one iliac crest to the corresponding point on the other side, a little less than two inches; right sacro-coty-löidion space rather more than one inch, left ditto one inch. On the 27th August labour pains set in, and on the arrival of Professor Jacolucci he found that the waters had escaped, and that the umbilical cord was protruding. The pulsation in the cord becoming gradually more feeble, the Cæsarean section by the method of Mauriceau was decided on. The abdominal cavity and anterior wall of the uterus having been laid open, the operator introduced his hand in the direction of the right iliac fossa in which was found the head of the still living foetus. The loss of blood was considerable. By the retraction of the uterus the wound in that organ diminished to half its extent. The twisted suture was then employed, and the application of a bladder filled with ice to the abdomen and cold enemas constituted the entire treatment during the next three days. The wound in the abdomen united by the first intention.
The thirteenth day after the operation the points of suture were remored, the cicatrisation being complete. The lochial discharge and lacteal secretion were established normally; and at the expiration of fifty days the patient left the hospital.
Professor Wurtz has been appointed Dean of the Faculty of Medicine of Paris.—Dublin Medical Press and Circular.
OBSTETRICAL CLINIC OF PROF. CHAS. A BUDD. Reported by S. HENDRICKSON. Sub-acute Inlammation of Cervix Uteri, with
Endocervicitis. Mrs. S., æt. 24 years; has been married fifteen months. No children. Patient enjoyed good health previous to her marriage. Her general health is also at present good; appetite fair; bowels regular; monthly periods constant, lasting four days. She comes here complaining that she experiences pain during the act of sexual congress.
Now, a priori, upon what may this inconvenience depend? This pain during copulation may be dependent upon-first, vaginitis, which condition always causes violent paroxysms of pain on introducing anything
into the vagina, even the finger in making a digital examination. Another cause is ulcerations in the vagina, around the carunculæ myrtiformes, from a failure of the hymen, lacerated in the natural way, to heal. Another cause is vulvitis. Other causes may be a general hyperæsthesia of the uterus from hyperæmia, or inflammation, or ulceration of the cervix. We very frequently find this hyperæthesia at the time of sexual intercourse, associated with sterility.
On making a digital examination, there seems to be no soreness about the vulva or vagina, but the patient shrinks on touching the neck of the uterus. There is a slight disposition to retroversion of the uterus.
On making an examination per speculum, the neck of the uterus is seen to be the seat of a subacute inflammation, giving rise to endocervicitis, or catarrh of the neck. The pain, therefore, which the patient complains of, is due to this sub-acute inflammation of the cervix, and the sterility upon the endocervicitis.
(The case was now exhibited to the class. There was seen a thick, tenacious, alluminous fluid issuing from the cervix.)
Probably this inflammation may have existed for many months, and is not the result of her new relations. What is the cause of the cervical catarrh? All we can say is that it is a remnant of the detritus resulting from inflammation which has existed at an antecedent period.
One great obstacle to the success of our treatment in these cases is the continuance of sexual intercourse. Hence you can see the benefit to be derived in such cases by causing a temporary separation of the wife from her husband. We will treat this patient by scarifying the cervix, taking about half an ounce of blood, and then pass the saturated tr. iodine by means of a probe tipped with cotton, to the os internum.
Materia Medica and Chemistry.
THE NEW ANÆSTHETIC.
Professor Simpson, the well known discoverer of Chloroform, has recently been experimenting further in the same direction. In a late number of the Medical Times and Gazette he gives his observations concerning its effects the essential portions of which are embraced in the following:
“ The last of these compounds—the bichloride of carbon is the new anæsthetic which forms the special subject of the present observations. It was first, I believe, discovered by M. Regnault, in 1839. It has already received various appellations from various chemists, as perchloroformene, perchlorinated chloride of methyl, dichloride of carbon, carbonic chloride, tetrachloride of carbon, superchloride of carbon, perchloruretted hydrochloric ether, and perchloruretted formene (see Gmelin's * Handbook of Chemistry,' vol., vii., p. 355, and Watt's “ Dictionary of Chemistry,' vol. i, p. 765).
“ If it becomes, as I believe it will, for some medicinal purposes, an article of the materia medica, it will require to have a pharmaceutical name appended to it, and perhaps the designation of perchloroformene, or the shorter term chlorocarbon, may prove sufficiently distinctive. In its chemical constitution, bichloride of carbon, or chlorocarbon, is analogous to chloroform; with this difference, that the single atom of hydrogen existing in chloroform is replaced in chlorocarbon by an atom of chlorine, for the relative chemical consitution of these two bodies may be stated as follows:- Chloroform C, HCl, Chlorocarbon = C,CICI,.
, “The chlorocarbon can be made from chloroform by the action of chlorine upon that liquid ; and Genther has shown that the process may be also reversed, and chloroform produced from chlorocarbon, by treating it in an appropriate vessel with zinc and dilute sulphuric acid, and thus exposing it to the action of nascent hydrogen. The most common way hitherto adopted of forming bichloride of carbon consists in passing the vapour of bisulphide or bisulphuret of carbon together with chlorine through a red-hot tube either made of procelain or containing within it fragments of porcelain. There result from this process chloride of sulphur and bichloride of carbon, the latter being easily separated from the former by the action of potash.
The bichloride of carbon, or chlorocarbon, is a transparent, colourless Auid having an ethereal and sweetish odour, not unlike chloroform. Its specific gravity is great, being as high as 1.56, chloroform is 1:49. It boils 170° Fahrenheit, the boiling point of chloroform being 141o. The density of its vapour is 533, that of chloroform being 4.2.
Beside trying the anæsthetic effects of bichloride of carbon upon myself and others, I have used it in one or two cases of midwifery and surgery. Its primary effects are very analogous to those of chloroform, but it takes a longer time to produce the same degree of anæsthesia, and generally a longer time to recover from it. Some experiments with it upon mice and rabbits have shown this—two corresponding animals in these experiments being simultaneously exposed, under exactly similar circumstances, to the same doses of chloroform and chlorocarbon. But the depressing influences of chlorocarbon upon the heart is greater than that of chloroform; and, consequently, I believe it to be far more dangerous to employ as a general anæsthetic agent. In a case of midwifery in
which it was exhibited by my friend and assistant, Dr. Black, and myself, for above an hour, with the usual anæsthetic effects, the pulse latterly became extremely feeble and weak. In another case in which it was exhibited by Dr. Black, the patient who had taken chloroform several times before, was unaware that the new anæsthetic was different from the old; her pulse continued steady and firm, although she is the subject of valvular disease of the heart. The surgical operations in which I have used chlorocarbon have been, the closure of a vesicovaginal fistula, the division of the cervix uteri, the enlargement of the orifice of the vagina, and the application of potassa fusa to a large flat nævus upon the chest of a young infant. In all of these cases it answered quite well as an anæsthetic. The child did not waken up for more than an hour and a half after the employment of the caustic, which was used so as to produce a large slough. Its pulse was rapid and weak during the greatest degree of anæsthetic sleep. One of the mice exposed to its influence, and which was removed from the tumbler where the experiment upon it was made, as soon as the animal fell over, breathed imperfectly for some time after being laid upon the table, and then died.
“Chlorocarbon, when applied externally to the skin, acts much less as a stimulant and irritant than chloroform, and will hence, I believe, in all likelihood be found of use as a local anæsthetic in the composition of sedative liniments.
"In two cases of severe hysteralgia I have injected air loaded with the vapours of chlorocarbon into the vagina. The simplest apparatus for this purpose consists of a common enema syringe, with the nozzle introduced into the vagina, and the other extremity of the apparatus placed an inch or more down into the interior of a four-ounce phial, containing a small quanity—as an ounce or so—of the fluid whose vapour it is wished to inject through the syringe. Both patients were at once temporarily relieved from pain."
NEW TEST FOR ARSENIC.
The wonderful delicacy of the previous tests for arsenic which have been thought to be almost perfect, are surpassed by the electrical test. By means of a simple apparatus all the arsenic in a substance may be rapidly extracted. Place a solution of arsenic matter in a platinum vessel, plunge a zinc wire into the liquid, and the arsenic will appear on the platinum; by prolonging the action the whole of the arsenic may be extracted from the compound. This process is superior in sensibility, and as it requires far less manipulation of the suspected substance, is much more trustworthy for toxicological examinations than the methods now
Canada Medical Journal.
MONTREAL, MARCH, 1866.
A HEALTH OFFICER.
Although we have written strongly in previous numbers of the journal of the apathy of the Health Committee-we feel that as they have at at last moved in the matter of sanitary reform, we can extend to them our congratulations upon having taken a step for which the entire city will commend them. The Finance Committee, having agreed to recommend an appropriation of $1600 for the employment of a medical man as Health Officer for the City of Montreal for eight months, the Health Committee advertised for applicants. On the 2nd of this month the Committee met, and opened a number of applications. After mature deliberation, it was decided to recommend the appointment of Gilbert Prout Girdwood, M.D., M.R.C.S.E., late assistant-surgeon 1st Battalion Grenadier Guards; and without detracting from the merits of other applicants, we think, that from the high testimonials presented on behalf of Dr. Girdwood, (a requisition in his favour signed by all the leading English practitioners being presented) the Committee could not well come to any other decision. At the time we write, the Council have not met, and the appointment has not therefore been made, but, in the meantime we congratulate Dr. Girdwood on the probability of his appointment. When made, we trust he will at once enter heart and soul into his work, and practically show the value of his labours—when, we believe, the city will see they cannot dispense with his services. As we said in our last number, the appointment of a Health Officer should be permanent, and we trust that he may so become.
DR. MARSDEN'S PLAN OF QUARANTINE. In our February number, we inserted an article from our friend Dr. Marsden, of Quebec, giving the details (along with a plan) of a system of quarantine which he has suggested, and which, we understand, he is