Parturition Fever, etc. 313 



rather than useful. There is then serious pressure on the brain, 

 with serous effusion, and perhaps blood extravasation, and in any 

 case anaemia, and this latter may be dangerously or even fatally 

 increased by the lessening of the blood pressure, without any 

 compensating advantage in the way of reabsorption of the effusion. 

 In such cases eliminating agents are a safer resort. 



Purgatives commend themselves, but with the drawback of a 

 too tardy action. Now however with the peristaltic stimulants 

 given hypodermically this objection is largely obviated. Pilocar- 

 pin xyi. gr., and eserine 3 grs. will often secure a noticeable 

 movement of the bowels in the course of fifteen minutes, imply- 

 ing a corresponding motion onward in the bowels more anteriorly 

 and even of the contents of the gastric cavities. If there is al- 

 ready palsy of the muscles of deglutition, this may be repeated 

 several times at intervals of four or five hours. If however de- 

 glutition is still well performed a purgative of one or two pounds 

 .Epsom salts, with 10 drops croton oil, and i oz. oil of turpentine 

 may be given by the mouth. Should this operate, it will supple- 

 ment and carry on even more effectively the work of the hypo- 

 dermic agents, and even lessen the density, plasticity and ten- 

 sion of the blood and act as a potent derivative from the brain. 



A compromise may be made by giving aloes 2 ozs., croton oil 

 20 drops in bolus ; or i to 2 ozs. sulphate of soda in solution 

 may be injected subcutem. 



In any case oil of turpentine or other antiseptic is of great 

 value in the stomach in preventing fermentation and tympany, 

 and thereby obviating a whole series of troubles such as : cerebral 

 disturbance by nervous shock and blood pressure ; impaired res- 

 piration and haematosis by pressure on the diaphragm : and eruc- 

 tations of food to the pharynx and its inhalation or gravitation 

 into the lungs. 



It is always well to clear out the rectum by injections, when if 

 there is any indication of pharyngeal paralysis most of the 

 remedies may be given by this channel. 



Stimulants (ammonia carbonate, alcohol, anise, fennel, ether, 

 nux, etc. ) have been largely employed by the mouth .and may 

 be by the rectum. In the absence of spasm's I have relied largely 

 on nux or strychnia. 



When the skin chills, some have sought to heat it by enveloping 



