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On the Employment of Cold Water and the Ergot of Rye in the Practice of MidwiferyAuthor(s): Thomas PopeSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 8, No. 11 (Jun. 12, 1844), pp.158-159Published by: BMJStable URL: http://www.jstor.org/stable/25497924 .

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158 ERGOT OF RYE.

fair account of my work every day; and this will be

done until I come home. When I was about to leave

the doctor on Saturday, I asked him how soon he

thought I should be ready to return. He thinks I

shall be ready in three or four weeks from to-day,

Tuesday, May 7th." On Wednesday, May 8th, Mr. Waite writes,

" I think I may now say that I am in a fair way of recovery,

according to the doctor's account, and I hope he is correct."

On Thursday, May 9th, Mr. Waite became suddenly worse. Excruciating pain in the body, continuing for

upwards of twenty-four hours, exhausted the powers of

life, and he died on Friday night, May 10th.

Sectio Cadaveris.-I had an opportunity of examin ing the body of Mr. Waite, on Tuesday morning, seven

a.m., May 14th, in the presence of Dr. Hobson, Dr.

Drennan, Mr. Atkinson, surgeon dentist,* Mr. York, Mr. Holwell, and two friends of the deceased.

Before describing the appearances that were met

with, it may not be improper for me here to say that

in a conversation which I had with Mr. Hey, surgeon to

the Leeds Infirmary, on the preceding evening, on the

subject of this case, I stated to him that I expected to find peritonitis with perforation of the stomach.

The same statement was made to my assistant, Mr.

Holwell. And now to proceed with the morbid

appearances. On opening the cavity of the abdomen, the most

marked evidence of very extensive peritonitis imme

diately struck the eye, and a perforation capable of

admitting the point of the little finger, situate in the

anterior wall of the stomach, on its small curvature, and at its pyloric extremity, was distinctly visible before

the viscera were disturbed.

A large quantity of fluid was found in the general peritoneal bag, evidently the contents of the stomach

which had escaped through the perforation. The

stomach was empty. An incision, extending along the large curvature, exposed the inner surface of the

stomach, and brought into view three distinct ulcers

at its pyloric extremity; each of a size larger than

a kidney bean; each presenting, round, smooth,

well-defined, elevated edges; and each differing from the others in the progress of the ulcerative stage. In one of them, the mucous membrane only was

destroyed; in a second, the ulceration had extended

through the mucous coat and the muscular coat,

leaving only the peritoneal coat entire; while in

the third, the peritoneal coat was also destroyed, and

the perforation rendered complete. The whole of the

mucous membrane of the stomach was much thickened, but more especially that part of it immediately sur

rounding the ulcers.

The liver was of a very dark chocolate colour, appa rently the result of congestion, inasmuch as its struc ture did not appear to be morbid. There was not the

slightest appearance of abscess,t and there was no other abnormal condition of the body.

Having been asked whether the ulcers, situated in the walls of the stomach, would have proved fatal

under any mode of treatment, and if so, whether the

* Mr. Atkinson is an active supporter of the water esta blishment.

+ The widow of the deceased has been informed that Dr. R. has stated that her husband died from Abscess.

fatal result had been accelerated by the water treat

ment; I think it right to say that an account of the

appearances after death, together with the following written opinion, signed by Dr. Hobson, Dr. Drennan, and myself, has been given to the friends of the

deceased, and to the supporters of the water establish ment.

"We feel ourselves called upon to state that the morbid condition of the stomach, which has been described in the above account of the post-mortem examination, would, in all human probability, at some time have proved fatal under any mode of treatment; but we are of opinion that its progress might have been

retarded, and the life of the patient prolonged, by judicious treatment.

"On the other hand, it is our conviction that the

hydropathic treatment would contribute materially to accelerate the progress of that ulceration which, by perforating the coats of the stomach, gave rise to the acute peritonitis which proved so rapidly fatal."

ON THE EMPLOYMENT OF COLD WATER

AND THE ERGOT OF RYE IN THE PRAC

TICE OF MIDWIFERY.

TO THE EDITOR OF THE PROVINCIAL MEDICAL AND

SURGICAL JOURNAL. SIR,

Midwifery ought to be considered, not only by every member of the profession, but by every member of the

community, as the most important branch of the

healing art; for by it more lives are saved, and suffer

ings shortened, and more deplorable consequences

averted, than by any other. Any one who thinks otherwise. must, on a calm view of the subject, be

impressed with the same opinion. The number of infants who are mutilated, murdered, or consigned to the grave when death is only apparent; and that of the mothers who are kept lingering in agonies, suffered to expire, lacerated, and made crripples or loathsome for life, by ignorant, meddlesome pretenders to the almost divine art of scientific midwifery, sur

passes credulity. These observations are occasioned by Dr. Toogood's

paper, " On the Practice of Midwifery, with Remarks,"

in your number of May 22d; and, as whatever issues from his pen is entitled to the highest respect, it seems desirable to me to raise from the mire into which he has almost consigned them, two of the most important and influential agents in the good work-cold water and ergot of rye.

It may not be amiss here to state my qualifi cation for the task; and as he and I are sailing in the same ship, on a voyage of discovery, for the improve

ment of the obstetric art, I presume he will hail me as a worthy ship-mate. It is now nearly half a century (upwards of forty.eight years) since I had my first case of midwifery; and, with the exception of four years and a half spent in London, this has been the field of my labour.

I will not follow the doctor through the whole of his

paper, though I should be tempted to do so, if time and better ability permitted, but confine myself chiefly to the use of cold water for uterine hemorrhage,

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MESMERISM. 159

particularly post - partum, and the wonderful and

hitherto never-failing power in every case, in my

hands, of the secale cornutum, in inducing the uterus

to energetic,safe, and decisive action.

I perfectly agree with Dr. Toogood, that in haemor.

rhage likely, if left to nature, to run on to a fatal termin

ation, at any time between conception and the full

period of gestation, we should rupture the membranes.

This and forcible delivery under peculiar circum

stances, have, hitherto, preserved me, thank Heaven, from even one death to the mother, within some months

after the event.

The hemorrhages most to be dreaded, perhaps, are

those, as the Doctor remarks, post-partum,when, after a

perfectly natural labour, the placenta has been expelled and everything seems to augur well. Here cold water, both internally and externally, profusely applied,

together with all the cold air that can be had, and

perfect quiescence and free exposure-even continued,

ifnecessary, for hours-have been invariably successful

with me. Yesterday morning I delivered a woman of

her third child, and each time was a case in point. Her labours were natural, and with the exception of

the first, terminated after my arrival, within two hours.

My plan is to compress the uterus externally with my hands, but never to introduce one into it, after the

placenta has left it; to allow her as much cold

water to drink as she wishes; to open the window and

door, to forbid her speaking or moving; to throw off the

bed-clothes, and apply to the hypogastric region and

vulva, cloths dipped in cold water and vinegar, and

renewed every two or three minutes till the wished-for

event be obtained. This never occurs till after the

lapse of two or three hours, when the pulse at the

wrist and consciousness for some time cease. She and

her children do well, and her health and strength return nearly as soon as if she had only a natural loss.

Still, as Dr. Toogood observes, some women are more

tardy in recovering from such dreadful losses.

A few months ago, one of the most agravated cases

of flooding at and after labour, occurred to me in

the person of Mrs. Price, of Weston Gate, near this

town. During her pregnancy, which was obscure, she

was in the Worcester Infirmary, and some months

before her full time she came home, and placed herself

under my care. I immediately pronounced her with

child, and led her on to her full period. Labour com

menced, and with it a trifling disharge of blood. I

ruptured the membranes immediately, and knowing the necessity of delivering her as speedily as possible,

especially as the draining continued, and the pulse was

becoming more feeble, I sent for my son and requested him to bring with him our bag of instruments; but ere

he arrived (an hour had not elapsed) I had the child

and placenta; notwithstanding we were for three

hours assiduously engaged in applying cold water

and vinegar to the region of the uterus by means

of cloths, and occasionally compressing the uterus, which seemed tolerably contracted. As long as the

power of swallowing remained, we plied her well

with cold water. The discharge persisting, the pulse at the wrist and consciousness left her for upwards of

an hour; as a last resource, my son dashed a pailful of cold water against the abdomen, soon after which, the pulse became feebly perceptible, she opened her

eyes, and every moment witnessed an improvement. She and her child are now in good health.

I now turn to the secale cornutum. My plan of administering this is, in cases where the pelvis is capacious enough to admit of the passage of

the child, and where the uterus is fully dilated, or

where there is no rigidity of the os uteri, and where

the pains are enfeebled, or where after having con

tinued so for some time they gradually fall away, and a

calm ensues, nothing being wanting but thorough

expulsive efforts, to have two drachms of the fresh

grain powdered, and then divided into four equal

parts. One of these I give infused in about two

ounces of boiling water, to which I add a little

sugar, every twenty minutes, if necessary, till the whole be taken. Used thus, it has never disappointed me, so that I look upon it as a most invaluable boon,

generally terminating the case, with perfect safety to

the mother and child within an hour after the last dose

be taken. Sometimes one dose will suffice, sometimes

two, three, or the whole; but beyond this, I never go.

On one occasion it seemed to be altogether inert, as the

uterus remained passive after four doses were taken, for nearly four hours, when suddenly it arose to deci

sive action, and the case happily terminated within the

hour. Before the peculiar action of the ergot com

mences there seems to be a calm more or less transient.

About a year ago I was sent for, early in the

morning, to Boyton, about two miles distant, to a

woman whom I was engaged to attend, who had evi.

dently gone two or three weeks beyond her full time; on my arrival, her pains had partly left her. After

staying two or three hours, I went home, promising to

return in the evening. On my return, I found matters

in statu quo, and having armed myself with four doses

of the ergot, and satisfied myself of the state of the

parts concerned in labour, I gave her one dose, and

before the expiration of the first twenty minutes she

complained of a peculiar pain in the bowels, which, she said, was not labour; this pain persisting, I

examined and found the head gradually descending, and in less than half an hour, all was happily over.

This was her second labour, the first, about two years

before, being a very severe one.

I am, Sir, Your obedient humble servant,

THOMAS POPE. Cleobury Mortimer, Salop, May 27, 1844.

PROVINCIAL

tubical & surgical Sournal. WEDNESDAY, JUNE 12, 1844.

Notwithstanding the frequent exposures of the

fallacies and absurdities of mesmerism, which have

taken place, since this so called science came pro.

minently before the public, there is something about it so captivating to the unlearned and

unlettered many, there is so much " soft witchery" in the insinuating manner in which it seeks to

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