Abortion-Help Wanted by a Doctor in Jail.

It has been four years since my last article appeared in the BRIEF. I have just looked it up. It was an hypodermic injection of 1-64 grain calomel for syphilis, and 1-16 gr. sulph. morph. in puerperal convulsions. I was then practicing in Pennsylvania. At present I am temporarily secluded from society, and in jail.

As I am just renewing my subscription, I thought I would ask for help in the way of information. I will be as brief as possible.

I am proprietor of the Hotel Palmer, in Cincinnati. Vianna S., a domestic in my employ, was enceinte. Blonde ; bright and beautiful, age twenty-four years. Married, but not living with her husband. Primipara.

On evening of December 2d, 1888, she complained of abdominal pains. Made digital examination, but found no sign of approaching confinement. Gave her no medicine, but ordered her to bed. Morning of December 3d, was again examined, about 9 o'clock. I found os-cervix dilated and liquor amnii escaping. She complained of "bearing down pains nothing more. I called a colored nurse (an entire stranger to me), and about two o'clock she was delivered of a female fœtus-dead. I used no instrument whatever, and gave no drug. Period of gestation was about the fifth month. Foetus was quite perfect in form, with exception of digital extremities, which were somewhat shorter than might be expected. Immediately after delivery she began to improve, and on fourth day she was walking around her room quite well.

On the 7th day of December I discharged two of my boarders from the hotel, who owed me a big board bill, for which I held their baggage. They were a man and woman, both in third stage of syphilis, who had slept together as man and wife, and polluted the beds so that the clothing had to be burned. They were registered as "Mr. and Mrs.

-." I ascertained the man to have another wife, and the woman to be a prostitute, and at once discharged them. They went to the police, and assured them that I had procured abortion.

Detectives visited my hotel, and so annoyed the patient that she relapsed on the 8th day, and became hysterical and delirious. I was arrested, and she was sent to hospital. When nineteen days at hospital, she died of blood-poisoning. Coroner's verdict: "Died from bloodpoison caused by a wound in the uterus." Now, what caused this wound?

Dr. Kebler, an able physician, who performed examination, says that it was a "small sharp cut," near os cervix, one quarter inch deep and one inch long. Foetus was perfect-not a scratch on it; no scar, no laceration. In either honorable delivery or abortion, no instrument would be used that would make a sharp cut. And no instrument could cut the internal wall of the uterus without puncturing the foetus in some manner. Foetus was delivered in presence of two respectable women, one of whom slept with the patient every night.

Foetus, with placenta, weighed two pounds four ounces, avoirdupois. Foetus alone weighed one pound fifteen ounces. This is all I need say.

What I want to know is, how was it possible for said cut to be there under the circumstances?

Patient went to hospital on eighth day after miscarriage.

The grand jury heard the testimony and refused to indict me for the reason that the patient herself did not charge abortion. I am still in jail, and as my case will come before a second grand jury, the first week of April, I will be very thankful for some one to send me some suggestions by mail.

Has any one had a similar case in obstetrics?

There was no inducement for abortion. Patient was poor and worked for low wages. No respectable doctor will stoop to commit such act under any circumstance. And no doctor, respectable or not, will run the awful risk of imprisonment without big pay.

Now, brethren, please write me, and I hope to read something in the BRIEF on the subject. Knowing the danger a doctor runs at the hands of prostitutes, and others liable to blackmail, etc., why not discuss this subject a little for a change? THOMAS G. SINCLAIR, M. D.

Cincinnati Jail.

Typhoid Fever.

(Continued from page 128.)

Now for the treatment. This disease can not be cut short, even in its early stage. Some have thought by giving emetics, but few think so now. Others that a purge of calomel and colocynth would cut short the attack, but this has almost been entirely given up. Others say that large doses of quinine will shorten the attack, or at least prevent serious complications, but I was called to where large doses of quinine had been given, and the man was almost dead from hemorrhage, so that in this case the disease was neither cut short nor complications prevented.

At the present time it must be granted that when once the patient has begun to go down the curve we must not dose him with medicine. We must not give physic. The best thing is to place him in bed (prefer mattress), horizontal position, and reserve his nervous powers, remembering that he must, if he lives, go through the whole course of the disease. He has to go through the reactions of his nervous absorbent and nutritive system; he has, in fact, to go through 66 a great physiological storm."

Let the patient alone, then, in this stage, and early rest will save his power. But how is he to be treated through the remainder of the course? Is there anything to make the course less severe? Probably not. Quinine has been tried for this, also, but has failed here as signally as when given to cut short the disease. It must be said that the treatment consists of simple measures, and simple good liquid dieting; medicines are only required for special conditions; for instance, if diarrhea occurs some will give what is called chalk mixture. We must remember that this has to go through about twenty-five feet of intestines. The best thing I think is to fill the rectum with five or six ounces of starch.

The diarrhea only sets in when the rectum, sigmoid flexure, or descending colon is affected or irritated by acrid matters; you may add a little pulverized opium to the starch, but if you fill these the contact of noxious matters is prevented and the diarrhea checked.

If hemorrhage sets in I use gallic acid or tannin, lead, or some powerful astrin

gent, if hemorrhage is,or about to become, alarming and is prostrating my patient. If not, I trust to nature, and very frequently it will cure itself. It is much the best to keep your patient at rest in the horizontal posture, giving a little opium (one-half grain) by rectum or mouth, if necessary to quiet the intestines. I very frequently use ice to the abdomen, which is very soothing to the patient. It is much better not to use the gallic or tannic acids, or the lead as astringents on account of nauseating the patient's stomach, if you can avoid it, if it should make the patient sick. It is too apt to make the hemorrhage worse. If hemorrhage is not too great, let it alone, and keep the patient quiet with small doses of opium, and be sure to use this sparingly. Be certain to give your patient plenty of good, fresh, sweet milk, good soup from fresh beef-nothing solid. If you do, it is apt to derange the stomach and bring about delirium. Often it comes on under best of treatment. tient gets out of bed or even commits suicide by jumping out of the window.

Pa

The question naturally comes up: what is to be done for the delirium? Well, I never leave my patient alone, day or night, after he has begun to descend the curve, for the delirium may come on at any time.

In the treatment of this complication remember that it is due to brain irritation and not to inflammation, as some have imagined. There is one great remedy for this, and it is alcohol. Alcohol is the remedy for nervous irritation in typhoid fever. In fact, in any fever. How it acts for certain, I can not say, but I know by trying it, it allays nervous irritation and soothes the nervous system. Whenever, therefore, there is delirium or reflex irritation, give alcohol in some form, as brandy or good wine, but when the result has been obtained stop it, and only give when necessary.

In fevers the use of stimulants is for the delirium and in no way alters the local process, but only the reflex condition. All cases do not require alcohol, and some only require it occasionally and for a short time. Delirium, even in the early stages, may be checked by brandy, and may never come on again during the whole course of the disease.

There is another point: I never allow my typhoid cases, if I can avoid it, to be moved out of bed. I have them to use a bed pan and have the parts properly cleansed to avoid bed sores. Avoid, therefore, every possible cause of irritation or abrasion of the skin, and by being careful you need not have any bed sores. Before I close I will say more about treating typhoid fever, as I have treated a great many. I made it a rule to never give much medicine, yet we have to do something in order to keep the confidence of patient and family.

In controlling temperature I rely more on aconite than anything else. I have tried sedative doses of quinine, and in some cases I thought it did well, while in others I could find no good from it. I have used antipyrine for some, and when I come to sum up all such remedies I must say I have realized but little good.

In the sweating stage I sponge them with cold water. I make it a rule, so far as I can, to visit all my typhoid cases in the evening, as the temperature runs higher than it does in the forenoon, consequently, I can tell better how they are doing, and no physician can tell how they are doing except to note the temperature. For instance, you may call in the forenoon, and find his temperature way down, you then say he or she is better, but as night approaches the temperature comes up again, and so on. The thermometer and good nursing, with a good diet but little physic, is my treatment.

God bless the BRIEF, may she live long and prosper. A. F. WATKINS, M. D. Potosi, Mo.

Knots in the Cord.

In reply to Dr. J. A. Lamberson, of Lebanon, Oregon, March BRIEF, page 132, will say, I had one case, similar to the one he mentions. There was a perfect knot in the cord, about midway. Labor was normal in every respect. Child a fine healthy girl. Is now in her fifth year, and is as healthy a looking 64 'corn cracker" as one would desire to see.

Here's to the BRIEF, "and may she live long and prosper."

C. S. CABELL, M. D.

Henderson, Ky.

Obstetrical-Tinct. Colocynth.

Was called, January 30th, to Mrs. J. Found her in labor, sack of waters protruding from the vagina; found the presentation all right. I ruptured the sack, and in a few moments a six-pound girl was born. The pains not ceasing, I made another examination, and found another head presenting itself for birth. In a moment more another sack of waters was protruding from the vagina. This was ruptured, and in a short time a five-pound boy "was crying for his part of the pretty little things in the trunk under the bed."

In this case I had two separate and distinct sacks of waters and placentæ.

Was called on February 13th to Mrs. W., in labor, in her second confinement, with an occipito-posterior position. With my index and middle finger under the occiput, and my thumb on the frontal bone, I was able to keep the chin well flexed on the sternum, was also able to lift the occiput out of the hollow of the sacrum, and in this way assisted in distending the perineum. Also assisted in delivering the shoulders by introducing the middle finger under the arm, and making traction during pains, and in less time than three hours after true labor pains came on we were through, and all doing well.

Would ask Dr. B. Brown Williams, Meadville, Pa., where he gets his tinct. colocynth? There isn't any such preparation in the U.S. P.

Medical Experiences Among the “Kajans. ”

BY J. F. GRIFFIN, M. D.

(Continued from March BRIEF.)

Since I have been writing these experiences, some one has written to me asking: "Who and what are the Kajans?"

I feel like replying to him as the littlepiney woods boy did, to the stranger, in the old time story, who asked him who his father was. "Don't you know dad?" he asked, "why, I know dad just as well!" New Brunswick and Nova Scotia, being originally settled by the French, bore the name of Acadie, and the people were therefore Acadiens, and by corruption they were called Cajans or Kajans.

After Acadie was conquered by England, many hundreds of the Acadiens emigrated and came to Louisiana, and settled along the lower Mississippi and Red River, and it is their descendants, along with the Creoles, who constitute great proportion of the inhabitants of Southern Louisiana.

And let me say now, once for all, that these people, both the Acadiens and Creoles, are the nicest, quietest and best people I ever lived among.

I have been among them for over a quarter of a century. They have their eccentricities, but I take pleasure in saying that no better people exist anywhere, so far as my knowledge extends. I come now to speak of one of the eccentricities of the half-fledged Kajans.

When one wishes to enter your house, he never knows what it is to knock, but will come and work at the latch or knob of the door, and if it does not yield to his manipulations, will push the door open and bolt right in, whether you will or nil.

Should the door not yield to him, he will go to a window, and if it is open, will push aside the curtain, and stick his head in, or even attempt to climb through; the idea of knocking at the door never occurring to him.

He has but one thought, and that is to effect an entrance into your presence without announcing himself.

Should the door and windows fail him, he proceeds to the rear of the house, in order to effect an entrance in some way, and, before you are aware of it, he is standing in your presence.

Often have I been in the act of taking a bath, when, looking up, would find a Kajan standing before me.

For a long time, at first, it was my custom, under such circumstances, to send forth a volley of imprecations upon their heads, and I have been surprised that they have not immolated me on the spot.

Notwithstanding the roughest kind of talk to them, when they have entered my domicile so unceremoniously, they have always taken it as a matter of course, and will repeat the offense as often as they come.

Only a week ago, like Mr. Oldbook in the pictures, I was "turning over a new leaf," in other words, I was putting on a clean shirt, and just as I had got my arms through the sleeves and had poked my head through the shirt bosom, there I saw standing before me John Baptiste Couvillon, looking as if he thought I was the most charming object he had ever beheld. He had such an innocent look, and such an ineffable smile, that so far from feeling wicked at his unwarrantable intrusion, I smole a smile that must have make me look ineffable, too.

Baptiste was sick. He had a fever and wanted a prescription. I gave him four compound cathartic pills, which I made him swallow on the spot, and as he had quinine at home, I directed him to take it on the morrow, sending him off happy.

That afternoon late, I was attempting to finish reading, before it grew too dark, an article in the BRIEF, by Dr. Goss, on the evils of taking calomel, when, looking up from my reading, I saw that Baptiste had put in an appearance, and there he stood, reaching out to me a scrap of paper with something wrapped in it, which I took and opened, and found inside four pills.

"What's this?" I asked, "Vel, doctaire," said he, "dees morning ven has de fievre, you make me take quarte pillules (four pills). Vel, de fievre, it go off, an' I vomit de quarte pillules, an' I now got no more fievre, an' now I no more sick, I got no more use for de quarte pillules, an' I bring 'em back to you, an' I no have to pay for de pillules."

I did not blow off the top of his head, I did not impale him, I did not even

swear-no- no- no!

(To be continued.)

Chloral Hydrate and Ergot.

Mrs. C. was taken in labor on the eve of the 1st of March. I saw her early that night. When I first arrived at her bedside, she was having light, irregular pains. She being a primipara, I expected a tedious labor. The os at this time was dilated but very little.

I made repeated examinations, as I was up all night, but it was about 1 A. M. before I detected the proper position; it being the third vertex presentation, and being my first case of third presentation, I watched it closely. At this time, everything seemed to be doing well, os dilating nicely, amniotic membrane still in tact. I was careful not to rupture the membrane, but it ruptured spontaneously, then a cessation of pains for short while; all at once, she began to jerk, and was almost convulsed. I examined the os, and found it had become very rigid, indeed, pains returned, but to no use, the os would not yield. I gave her one-half drachm hydrate chloral. In a very few minutes she was quiet, pain not so severe, os was by this time dilated so it was impossible to perceive it. I then gave her one drachm ergot; in a few minutes the pains returned with renewed vigor, and about one-half hour after, child was delivered. It took some little efforts to make it breathe, and as it did, it made a cry that every mother loves to hear first, but never afterwards.

She looked around and asked: "What's that?" "Only your baby crying for you," I said. She then said she had been asleep ever since I gave her that dose of medicine.

Now, gentlemen, you who have not tried the chloral for rigid os, my word for it, it will never deceive you. I have tried belladonna ointment to the os, and hot water injections, but have laid aside everything, and rely solely upon chloral, and then after you get the system and os thoroughly relaxed, give ergot, and don't be afraid to give it. I generally give chloral in twenty-grain doses, every half hour, till three doses are taken, if the third dose be necessary, but seldom have to give more than two.

I don't think morphine would stop labor at all, after once it has begun. Like Dr. J. F. Newman, I have given

Radical Cure of Hydrocele.

Dr. J. A. Matthews, of Caddo, Tex., asks for a substitute for iodine, as an injection in the hydrocele sac, and I would suggest the pure crystals of carbolic acid. Dilution, of course, will be necessary, to render the acid sufficiently fluid for the purpose of injection, by means of a long-nozzled syringe. But it should. be used in as nearly full strength as possible.

The writer claims no originality as to this use of carbolic acid-it having been first brought to his notice by his friend, Dr. R. J. Levis, who had largely used it, both in private practice and the hospitals of Philadelphia with "satisfaction and success," claiming for it more certainty in producing the necessary plastic inflammation that obliterates the sac of hydrocele.

The quantity of the acid required will vary from one to two drachms, according to the extent of the surface that is to be covered. If, for instance, the tumor is the size of a small cocoanut, use sixty grains of the acid.

This I regard as almost a specific, and have no doubt it will prove so in the case mentioned by Dr. Matthews.

N. ROE BRADNER, M. D.

Philadelphia, Pa.

Types of Fevers.

I have practiced medicine in this place for fifty-two years, and have stacks of medical journals, but none suits me as well as the BRIEF.

I would like to hear from some old timers on the question of change of type of fevers and consequently of remedies in the West, sometime in the forties.

A. M. ARMSTRONG, M. D.

Doylestown, O.

BRYONIA is the remedy for serous pain, and infantile rheumatism.