XII, B, 4 Loivell: Treatme7it of Cholera Patients 195 



and the greater the severity of the case. The foetuses are usually 

 cyanotic and often show various degrees of maceration, thus 

 indicating that death had taken place a considerable time previous 

 to the delivery. As a rule, the foetus, membranes, and placenta 

 were delivered intact in direct proportion to the severity of the 

 patient's condition and inversely to the period of gestation. 



Therefore, if abortions occur in the majority of the cases of 

 cholera and the foetuses are stillborn, what effect do they have 

 on the mortality of the mother? Galliard and Schutz(6) saw 

 the majority of pregnant cholera cases die after abortion had 

 taken place. Rumpf(i4) entertains a similar opinion to Bou- 

 chut, (2) who states that abortion offers an unfavorable prognosis 

 for the mother. Table II shows the aborting cases in the present 

 series, which resulted in a mortality of 49 per cent for the 

 mother, and in those cases in which abortion did not occur, 42 

 per cent of the mothers died. Hirsch's(8) results are almost 

 equal for those who did not abort (63 per cent) and for those 

 who did abort (65 per cent), but Schutz(i6) obtained a much 

 greater mortality for those who did abort, that is, 62 per cent 

 in comparison with the 44 per cent mortality for those who did 

 not abort. 



From these percentages it seems that the patients who aborted 

 thereby decreased their chances for recovery, whereas those who 

 did not abort had a better prognosis and kept their foetuses 

 intact. But my clinical observations have inclined me to believe 

 otherwise, and this belief is strengthened by a study of the 

 figures of Bouchut,(2) who states that of his 18 cases which 

 aborted only 9 died, while 19 of the 25 which did not abort died. 

 I am convinced that the abortion is a life-saving measure for 

 the mother when it occurs in time, although the high percentage 

 of mortality as given by others seems to indicate the contrary. 

 This act of abortion is a possible factor for recovery in the 

 severe form of the disease and unnecessary in the mild form. 

 Can we conclude that such cases would not have terminated 

 fatally if they had not aborted? The fact that it required an 

 average period of 9.6 days in order to recover in those cases 

 that did abort in comparison with the average of 7.3 days 

 required for recovery in the cases that did not abort does not 

 signify that the abortion retarded the recovery, but indicates 

 that this class of patients was of a more serious type. Although 

 many died after abortion, it does not necessarily mean that the 

 abortion was a cause of it but an effect of the disease and 

 a necessary requirement for recovery and that the abortion 



