XII, B, 4 Lowell: Treatment of Cholera Patients 193 



17 per cent obtained for this period can be explained by the 

 fact that the treatment administered to the cases in this period 

 carried many over it that would have otherwise died in it. The 

 mortality for the algid stage was 65 per cent, an important fact, 

 which will be referred to later on, and for the third period, or 

 the stage of reaction, it was 18 per cent. 



When one considers that the system is greatly taxed during 

 cholera and that the continuation of the pregnancy is in danger, 

 as is found in the other acute infections, one must naturally ex- 

 pect abortions to occur. This was true in the present series 

 of 66 cases, which gave a total of 37 abortions (56 per cent), 

 which can be favorably compared with the 50 per cent reported 

 by Bouchut.(2) For the sake of clearness the term "abortion" 

 is used to denote any kind of delivery at any month. Lieber- 

 meister(ii) and Nichols and Andrews(i2) agree that the preg- 

 nant cholera patients usually abort. Hirsch,(8) in his summary 

 of cases in 1854, gives a high percentage (78 per cent) ; 17 of 

 his 25 cases aborted. Schutz(i6) reports 52 abortions in 115 

 cases (45 per cent), calling attention to the tendency to abort 

 more frequently as the pregnancy is advanced, which condition 

 was present in this series, as is illustrated in Table II, but not 

 in the arithmetical progression as stated by Schiitz. 



As to the stages of the disease when abortion most frequently 

 occurs, Liebermeister(li) states that if the mother does not 

 succumb she usually aborts during the period of reaction. The 

 present series of cases does not support this statement, as 5 per 

 cent of the foetuses were delivered in the first stage of the disease, 

 75 per cent in the second, and 20 per cent in the third. In 

 1892 Klautsch(9) saw in Hamburg 10 pregnant cholera cases 

 abort in the second stage of the disease. These results are fur- 

 ther supported by Davis, (3) who claims that the foetuses usually 

 die in the second stage, the abortions setting in during the same 

 period- 



Of the 66 cases of pregnancy in the present series, 37 aborted, 

 of which only 2 foetuses were born alive, one of which died 

 within a few hours after delivery, and the other was dis- 

 charged from the hospital alive with the mother. All other 

 cases were either born dead or before the age of viability ; adding 

 to this number those that died with the mother, we obtain a total 

 of 49 foetal deaths in 66 pregnancies (71 per cent). Koval- 

 sky (10) states that over 80 per cent of the pregnancies in his cases 

 came to an untimely end, and Bouchut(2) and Hirsch(8) saw 

 equal fatal results (80 per cent) in their respective experiences. 



